Hirsutism is a medical condition where women experience unwanted hair growth in a manner, such as seen in men. In this condition women have unwanted hair growth which is pigmented and stiff in nature on regions where men usually have hair, such as on the face like a beard and moustache; back, chest etc. The extent of this male pattern hair growth depends on the genetic composition of a woman. Hirsutism can be due to excessive androgen/ testosterone which are male hormones; or hirsutism could also be hereditary.
Prevention of hirsutism is not usually possible; however, women suffering from polycystic ovary syndrome should control their weight gain to help with their Hirsutism.
Treatment comprises of medicines, different procedures/therapies and home remedies for removing unwanted hair.
Causes of Hirsutism
At the time of menarche, female ovaries start producing a combination of male and female sex hormones, which are responsible for hair growth in the armpits and pubic region. If there is any imbalance in these hormones with a higher proportion of androgens (male sex hormones), then it results in hirsutism. Causes of this include:
- PCOS or Polycystic Ovary Syndrome is a common condition concurring as a result of a disproportion in the sex hormones. Symptoms of this medical condition include irregular menstrual cycles, infertility, weight gain and multiple cysts on ovaries.
- Cushing's syndrome is a medical condition occurring as a result of excessive cortisol hormone. The cause behind this is excessive production of cortisol by the adrenal glands or it can also occur as a result of taking certain medications like prednisone for a prolonged period of time.
- Congenital adrenal hyperplasia is an inherited medical condition in which there is abnormal production of androgen and cortisol (steroid hormones) by the adrenal glands.
- Tumors which secrete androgen in the ovaries or the adrenal glands can also cause hirsutism; however, this is very rare.
- Certain medications like danazol for treating endometriosis can also cause hirsutism.
- Sometimes, the cause for hirsutism cannot be identified.
Risk Factors for Hirsutism
- Having a family history of medical conditions which cause hirsutism such as PCOS and congenital adrenal hyperplasia increases the risk of hirsutism.
- Females belonging to Middle Eastern, Mediterranean and South Asian ancestry are at an increased risk to develop hirsutism; although the cause for this is not known.
Symptoms of Hirsutism
Other than excessive pigmented and stiff hair growth in regions where typically men have hair, other symptoms which women experience and which come under the process known as virilization are:
- Losing hair to the point of balding.
- Voice deepening.
- Increase in the size of clitoris.
- Decrease in the size of the breasts.
Investigations for Hirsutism
Tests which measure the quantity of hormones, such as testosterone in the blood are done. These tests help in finding out if the hirsutism is caused due to increased levels of androgen. An ultrasound or a CT scan is done to check for cysts or tumors in the ovaries and adrenal glands.
Treatment for Hirsutism
Medications Taken For Hirsutism Include:
- Birth control pills/ hormonal oral contraceptives containing the hormones estrogen and progestin help in treating hirsutism by slowing or preventing the production of androgen by the ovaries. Side effects include nausea, dizziness, stomach upset and headache.
- Anti-androgens, such as spironolactone, block the hormone androgen from attaching to the receptors in the patient's body. This drug is contraindicated in pregnancy, as it can cause birth defects in the baby.
- Topical creams, such as eflornithine is prescribed by the doctor for surplus facial hair in women. This cream is directly applied to the area of hair growth on the face. This cream helps by slowing down the growth of new hair growth and it does not get rid of the already existing excessive facial hair.
Medical Procedures For Removing Unwanted Hair In Women Include:
- Electrolysis: In this procedure, a very small needle is inserted into individual hair follicles and this needle generates electric current, which destroys the hair follicle. This procedure is quite effective; however, it can be painful.
- Laser Therapy: This procedure comprises of rays of highly concentrated light which known as laser directed towards the skin, which destroys the hair follicles and stops the hair growth. There may be some swelling and redness of the skin after this procedure. Other risks include burning and discoloration of the skin, and also laser therapies are quite expensive.
Home Remedies for Hirsutism
- Plucking with the help of tweezers is helpful in removing some stray hairs, otherwise not of much use in large areas of hair growth.
- Shaving is a method, which is fast and cheap, but it needs to be done regularly with less interval time, as the hair grows quickly back because it is removed at the skin surface only.
- Waxing is helpful in removing areas of hair growth. In this procedure warm wax is applied to the skin and once it cools a bit, it's pulled back in the opposite direction of the hair growth with a wax strip.
- There may temporary redness and stinging of the skin after waxing.
- Chemical depilatories are available in creams, gels or lotions and they work by breaking the protein structure in the hair. However, some people may be allergic to the chemical depilatories, so it is important to do a patch test before actually using it for hair removal.
- Bleaching is a procedure which does not actually remove the unwanted hair, but changes the color of the hair to match the person's skin color, so the surplus hairs are not that apparent or visible. Again, some people may be allergic to the chemicals in bleaching cream, so it's important to do a patch test before commencing with it.