Hirsutism

Hirsutism is a condition that affects some women. It causes more hair growth than usual in areas where men typically have more hair, such as the face, chest, and back. This extra hair is often dark and thick.

Excessive hair growth on a woman's body, particularly on the face, chest, abdomen, inner thighs, and back, is called hirsutism. What counts as "too much" hair varies from person to person.

Sometimes, high levels of male hormones (androgens) cause hirsutism. This can lead to other changes in a woman's body over time, called virilization. Virilization can mean:

• A deeper voice
• Hair loss on the head (balding)
• Acne breakouts
• Smaller breasts
• More muscle development
• An enlarged clitoris

If you're concerned about excessive hair growth on your face or body, it's important to talk to your doctor.

Unusually fast or significant hair growth, especially over several months, could be a sign of a health issue. This includes noticeable changes like more hair on your face or body, or other signs of virilization. Virilization is a process where your body develops more masculine traits. If you notice these changes, schedule an appointment with your doctor. They might refer you to a specialist in hormone problems (an endocrinologist) or skin conditions (a dermatologist) to get a proper diagnosis and treatment plan.

Excessive hair growth, called hirsutism, can happen for various reasons:

• Polycystic ovary syndrome (PCOS): This is a common condition, often starting during puberty. PCOS causes a problem with the balance of hormones in the body. Over time, this hormonal imbalance can lead to extra hair growth, missed or irregular periods, weight gain, trouble getting pregnant, and sometimes small fluid-filled sacs (cysts) on the ovaries.

• Cushing's syndrome: This happens when your body has too much of the hormone cortisol. This excess cortisol can come from your adrenal glands producing too much cortisol, or from taking certain medications like prednisone for a long time.

• Congenital adrenal hyperplasia: This is a condition you're born with. It affects the adrenal glands, which normally make certain steroid hormones. With congenital adrenal hyperplasia, the glands make the wrong amount of these hormones, including cortisol and androgens.

• Tumors: In rare cases, a tumor in the ovaries or adrenal glands can produce extra androgens, leading to excessive hair growth.

• Medications: Some medicines can cause hirsutism. This includes medications like minoxidil (used for hair loss), danazol (used for endometriosis), testosterone (used for certain conditions), and dehydroepiandrosterone (DHEA). Even topical products containing androgens used by a partner can lead to hirsutism through skin contact.

• Unknown cause: In many cases, the cause of hirsutism isn't clear.

Hirsutism, which is extra hair growth, can be influenced by several things:

• Family history: Sometimes, conditions like congenital adrenal hyperplasia (CAH) and polycystic ovary syndrome (PCOS) are passed down through families. If these conditions run in your family, you might be more likely to develop hirsutism. These conditions affect hormone balance, and that imbalance can lead to extra hair growth.

• Ethnicity: Women of Mediterranean, Middle Eastern, and South Asian descent often have more body hair than women of other ethnicities, even without a specific medical cause. This is a normal variation, and doesn't necessarily mean there's a problem.

• Weight: Being overweight or obese can increase the amount of androgens (hormones) in your body. Androgens are linked to hair growth. This increased level of androgens can make hirsutism worse.

Hirsutism, the growth of unwanted hair in women, can be upsetting. Many women feel embarrassed or self-conscious about the extra hair. Sometimes, this can lead to feelings of sadness or depression. While hirsutism itself doesn't usually cause any physical health problems, the underlying hormonal imbalance that causes it can lead to other health issues.

If you have hirsutism and your periods are irregular, you might have a condition called polycystic ovary syndrome (PCOS). PCOS can make it harder to get pregnant. If you have hirsutism and are taking medicine to treat it, it's important to talk to your doctor about the possibility of getting pregnant. Some medications used to treat hirsutism may increase the risk of birth defects in a developing baby. It's crucial to discuss any potential pregnancy plans with your doctor to ensure your safety and the health of any future child.

Hirsutism, which is extra hair growth, is usually something you can't prevent. However, losing weight, if you're carrying extra pounds, might help lessen the amount of hair growth, especially if you have a condition called polycystic ovary syndrome (PCOS). PCOS is a common hormonal imbalance that can cause various symptoms, including hirsutism. Losing weight can sometimes help regulate hormones in people with PCOS, which may, in turn, reduce the extra hair growth.

Blood tests can check the levels of hormones like testosterone in your body. High levels of these hormones, called androgens, might be the reason for excessive hair growth (hirsutism).

Your doctor may also physically examine your abdomen and pelvis. They might look for any lumps or growths that could be a sign of a tumor.

Dealing with Unwanted Hair Growth (Hirsutism)

Hirsutism is extra hair growth in women that may or may not need treatment. If there's no underlying hormone imbalance, no treatment is needed. However, if a woman wants or needs treatment, options exist.

Treating the Underlying Cause:

If hirsutism is related to an underlying medical condition, treating that condition is the first step.

Self-Care and Cosmetic Methods:

Many women start with self-care routines like shaving, waxing, or depilatory creams. These methods can help manage unwanted hair, but the results are temporary.

Medical Treatments:

If self-care isn't sufficient, talk to your doctor about medical options. Results often take several months to become noticeable, as hair growth has a natural cycle.

• Medications:

  • Anti-androgens: These medications prevent androgens (male hormones) from attaching to receptors in the body. One common example is spironolactone. While they can be helpful, results typically take at least six months to show, and they might not be effective enough on their own. Some women may be prescribed these medications after trying birth control pills for six months. Important to note: These medications can affect the menstrual cycle and may cause birth defects, so reliable birth control is crucial during treatment.

  • Oral Contraceptives (Birth Control Pills): Hormonal birth control pills can help reduce hair growth if the excess hair stems from the production of androgens. The pills contain estrogen and progestin, which can help balance hormones. While this is a common treatment, it might not work for everyone. Possible side effects include nausea and headaches.

• Other Treatments:

  • Topical Creams: Eflornithine (Vaniqa) cream is applied to the affected area, typically the face, to slow down new hair growth. It doesn't remove existing hair. It can be used in conjunction with other methods like laser therapy.

  • Laser Therapy (Photoepilation): This method uses a concentrated light beam to damage hair follicles and prevent future hair growth. It is often a better choice for darker hair (black, brown, or auburn) than electrolysis. Multiple sessions are usually required. It is important to discuss the specific risks and benefits of different laser types with your doctor, as skin tone can affect the response to treatment, potentially causing skin discoloration, blistering, or inflammation.

  • Electrolysis: This involves using a tiny needle to deliver electrical pulses to each hair follicle, damaging and destroying it. Electrolysis can be more effective for lighter hair (blond or white). Multiple sessions are typically needed. While effective, it can be a painful process. Using a numbing cream before treatment can help reduce discomfort.

Important Considerations:

• Individual Results: The effectiveness and best treatment approach will vary depending on the individual and the cause of hirsutism.
• Timeframe: It's important to be patient, as many treatments require several months to show a noticeable difference.
• Doctor Consultation: It's crucial to consult with a doctor to discuss the best course of action for your specific situation, considering underlying health conditions and potential risks and benefits of each treatment option.