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Hirsutism: Symptoms, Causes, Diagnosis, And Treatment

hirsutism facail hair

When I was in class two, there was a teacher whose facial hair on her upper lip was very prominent. And as kids, we used to call her by different names but the most common one was “moustache-teacher”. As none of the other teachers looked that way, we didn’t think much calling her names. But it was only years later that I realised she could be suffering from a condition known as hirsutism. 

When I was in college, one of our classmates suffered from excess facial hair, which was quite prominent in the upper lip and chin area. It was in graduation that I got to delve deep into this term and knew what it exactly means. And this was when I learnt that it is due to a health condition, which is known as hirsutism. As a science student, it was not difficult to know the causes and factors that lead to unwanted and excessive facial hair. 

Hirsutism is a common clinical condition seen in female patients of all ages and affects around 5-10% of the women[1]. So here we are to tell you more about the causes, symptoms, diagnosis and treatment of hirsutism and what it really means.

What Is Hirsutism?

Hirsutism causes excessive facial or body hair growth among women[1]. Women do have hair on the face but it is faintly visible. However, when you are suffering from this condition, it causes a male pattern of hair growth. This means that just like men, women also tend to have hair on the upper lip (moustache), on the chin (beard) and also other places such as chest, etc. It is also seen in women with hormonal problems such as polycystic Ovarian Syndrome(PCOS). So if you have hair growth in unusual places which makes your feel like a man, then you might suffering from hirsutism. 

Hirsutism is caused due to an excessive production of androgens (male hormones) in the female body. Androgens are naturally present in the female body but with in a meager level. But if suffering from hirsutism, there is excessive secretion of the hormones, which lead to unwanted facial growth in women. Higher insulin levels in the body can also stimulate the production of androgens leading to excessive hair growth[1]. Some of the common causes of hirsutism include:

PCOS which is resulted due to hormonal imbalance causes cysts (fluid filled sacs) on the ovaries which can lead to irregular menses and infertility.

Cushing’s syndrome is an adrenal gland disorder in which the body is exposed to high levels of the hormone cortisol for a long time.

Tumors of the adrenal gland or ovaries can cause excess production of hormones leading to hirsutism.

Certain medicines such as anabolic steroids (which contain hormones), drugs used to promote hair growth or those used to treat endometriosis or depression can cause hormonal changes. 

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What Are The Symptoms Associated with Hirsutism?

The symptoms of hirsutism may be a genetic in nature or could be due to an underlying medical condition or problem. An excessive hair growth in areas like face, upper lip, chin chest, upper back, shoulders, sternum, and lower abdomen is one of the common symptoms of hirsutism. Apart from these, some prominent symptoms of hirsutism include[2]:

-Heavier than normal feminine voice.

-Oily skin and acne.

-Hail loss and receding hairline.

-Enlarged clitoris.

Diagnosis of Hirsutism

If you experience any of these symptoms of hirsutism, you should consult a doctor. Your doctor may ask your few questions and do a physical examination before ordering any tests. In most cases, the family history and medical history of the woman is evaluated to know about any health conditions that may increase the risk of this condition. Also, if you are on any medications, then it is wise to let your doctor know about it as in some cases, even steroids and hormonal pills can lead to this condition. 

Post physical examination, your doctor may examine your menstrual cycle to determine the existence of PCOS. Further, if the hirsutism and irregularity in periods have started occurring recently, additional tests may be carried out. These tests will look for health conditions related to the adrenal glands and the ovaries. Mild hirsutism may not show significant signs and may not require additional tests hormonal levels of testosterone, follicle stimulating hormone and luteinizing hormone in the blood. 

Also, imaging tests such as pelvic examination, sonography and CT scan are also recommended if pelvic mass is suspected. Additionally, your cholesterol and blood sugar levels will be tested along with other hormonal tests in some cases. 

Treatment of Hirsutism 

Hirsutism can be treated if the exact cause of the disease is known. For example, if high levels of insulin are the cause, the treatment procedure aims at lowering the insulin levels. Similarly, if a woman is suffering from hirsutism and is obese, then the first line of treatment involves weight reduction which goes a long way to balance the hormonal imbalance of the body. If there is an excess of androgens in the body, then drugs such as oral contraceptives, steroids and anti-androgenic drugs might be recommended to keep your hormonal levels in control.

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Some temporary treatments include shaving and waxing while permanent hirsutism treatment includes electrolyte treatment and laser treatment. Among these two popular treatments, electrolyte treatment is known to last longer compared to the laser treatment. Electrolyte treatment includes the destruction of hair follicles using electric tweezers[2]. Laser treatment, on the other hand, includes damaging the hair follicles using a concentrated beam of light of the same wavelength. If your hair regrows even after treatment, do not panic, it will most probably due to the hormonal imbalance. Make sure that you maintain a healthy lifestyle and take the aftercare measures for the best results.

Bottom line: Hirsutism is a condition that causes excessive hair growth in women which can be treated with medications and other dermatological procedures. Do not panic or lose hope but make sure you consult a doctor to diagnose the exact cause of it and get it treated after weighing down the pros and cons of it. 

(The article is reviewed by Dr. Swati Mishra, Medical Editor)

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References:

1. Sachdeva S. Hirsutism: Evaluation and treatment. Indian Journal of Dermatology. 2010;55(1):3.

2. Hirsutism, acne, and irregular menses in a girl. Journal of the American Academy of Dermatology. 2017;76(6):AB155.

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