Affecting 5 to 10 percent of women in their reproductive age, Hirsutism is a medical condition during which women develop excessive hair growth in the areas of male hair growth pattern distribution like face, chest, upper lip, chin, hand, stomach and other areas of lower abdomen.
All women have facial and body hair (also called as Peach Fuzz), which is usually very fine in thickness and very light in color. The texture of hair caused by Hirsutism is coarse and dark and different from that of the typical peach fuzz facial and body hair of women.
Studies in dermatology have revealed that Hirsutism is primarily caused by the impact of androgens on body hair during which the vellus hair develops into terminal hair. Depending on the innate susceptibility of the hair follicle, the terminal hair results from the interaction between androgen and the sensitivity of hair follicle to androgen. This begins primarily at puberty in response to increasing levels of androgens and develops over several hair cycles gradually in the teens and twenties and becomes irreversible over a period of time.
Caused by hormones, genes or medication, Hirsutism is one of the most common symptoms of PolyCystic Ovary Syndrome (PCOS) and other conditions being tumors in adrenal glands, insulin resistance and Cushing’s syndrome, which you is due to increased levels of the cortisol (stress hormone) over a period of time.
Hirsutism must be distinguished from Hypertrichosis, which is excessive hair growth in areas that are not of male hair distribution pattern (non-androgen dependent areas). Hypertrichosis is much less common and is caused by certain genetic conditions, malnutrition, hypothyroidism, porphyria and drugs like diazoxide, phenytoin, minoxidil, cyclosporine, progestagens and danazol.
Even though two out of three women with hirsutism have elevated levels of androgens, it is not necessarily same to all the hirsutism cases. Such cases with excess terminal hair growth in a male-like distributed pattern, but does not typically androgenic is called as Idiopathic hirsutism. Women with Idiopathic hirsutism may have normal androgen levels and regular ovulation.
It is important to understand that hirsute women can develop stress and emotional burden and affect their body image and self-esteem. Since hair removal can be time-consuming, frustrating and expensive, many women with hirsutism feel it is challenging to manage the hair removal and experience depression. However, substantial variability is reported by hirsute women on how view their hirsutism, which ranges widely from something that is not bothersome to humiliating.
While Cosmetic hair removal methods like depilatory creams, waxing, plucking, bleaching and shaving may to temporarily manage the removal of hair from face and other areas of body, Dermatologists may usually suggest non-hormonal therapies like electrolysis or laser hair removal as a long-term solution. Medications like , Metformin, Finasteride, Flutamide, Spironolactone, Cyproterone acetate, Ketoconazole and Oral contraceptives may be also prescribed by the physician depending on the specific conditions observed with the individual patient.
Many patients with hirsutism have some disturbance of menstruation and also develop overweight or obesity, which worsens the underlying insulin resistance and androgen excess and obstructs the response to treatment. Most women who are successful in managing or overcoming hirsutism seek appropriate advice on diet and exercise and non-hormonal therapies.