Hirsutism: Causes, Symptoms, Risk Factors and Diagnosis

Hirsutism is a condition that affects women that results in excessive growth of coarse or black hair in a pattern resembling that of men on the face, chest, and back.

The excess production of male hormones, or androgens, primarily testosterone, is often the cause of the increased hair growth linked to hirsutism.

There are effective treatments and self-care strategies available to women who desire to treat their hirsutism.

Causes Of Hirsutism

Causes to which hirsutism might occur include:

• Polycystic Ovarian Syndrome, or PCOS: This condition causes an imbalance of sex hormones and often begins during puberty. Over time, PCOS (polycystic ovarian syndrome) can lead to ovarian cysts, obesity, irregular menstruation, excessive hair growth, and infertility.
• Cushing syndrome: This is what occurs when your body is exposed to high cortisol levels. It could result from long-term use of prescription medications like prednisone or an overabundance of cortisol produced by your adrenal glands.
• Congenital adrenal hyperplasia: This genetic condition causes your adrenal glands to generate steroid hormones like cortisol and androgen abnormally.
• Cancers: Rarely, an androgen-secreting tumor in the ovaries or adrenal glands might cause hirsutism.
• Medication: Hirsutism may result from using specific medications. These include minoxidil (Minoxidil, Rogaine), testosterone (Androgel, Testim), dehydroepiandrosterone (DHEA), and danazol, which is used to treat endometriosis in women. You might also be affected by topical androgen-containing products if you and your partner come into skin-to-skin contact.

Many times, hirsutism develops for unknown reasons.

Symptoms Of Hirsutism

Hair on areas of the body where women typically don't have hair, like the face, chest, lower abdomen, inner thighs, and back, is called hirsutism and can be stiff or black. The concept of excess is interpreted somewhat differently by each individual.

Further symptoms known as virilization may eventually show up if high testosterone levels are the cause of hirsutism. Some signs of virilization could be:

• Deeper voice
• Reduced breast size
• Baldness
• Acne
• An increase in muscle mass
• Enlarged clitoris

Risk Factors Of Hirsutism

Some of the following variables could affect your chance of developing hirsutism:

• The family's background: Hirsutism can result from two conditions that run in families: polycystic ovarian syndrome and congenital adrenal hyperplasia.
• Family tree ancestry of women of South Asian, Middle Eastern, and Mediterranean heritage, there are unidentified causes for the greater body hair in comparison to other women.
• Obesity: obesity leads to excessive production of androgens which can lead to hirsutism.

Diagnosis Of  Hirsutism

To find out how much-unexpected hair growth you have, your doctor will perform a physical examination. Aside from the hair growth, any other physical symptoms that may be present will also be recorded, such as acne.

The Ferriman-Gallwey scale may be used by your healthcare professional to assess the severity of hirsutism following a diagnosis. The Ferriman-Gallwey scale looks at the upper lip, chin, chest, upper abdomen, lower abdomen, upper arms, thighs, upper back, and lower back/butt (buttocks).

These areas are scored from 0 to 4 according to the amount of hair growth. A low score for hirsutism indicates a moderate condition, whereas a high score indicates a more severe disease.

After evaluating each area, your healthcare provider will total the scores. It is typical for both Black and White people to receive a total score below 8. People who describe themselves as Middle Eastern, Mediterranean, or Hispanic typically score lower than 9 or 10. Asians typically receive fewer than two points overall.

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Which examinations are meant to identify hirsutism?

If hirsutism is present, your physician may perform a variety of tests on you, such as:

• Tests to measure your blood's hormone levels.
• Examine your uterus and ovaries using an ultrasound.
• X-rays to assess your adrenal glands and ovaries and rule out other medical conditions.

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Treatment Of Hirsutism

If there are no signs of an endocrine problem, treating hirsutism is not necessary. If a woman determines she needs therapy, she may treat the root cause of the problem, experiment with various therapies and medications, and establish a self-care routine for unwanted hair.

Medications

If you've tried self-care or cosmetic hair removal methods and they haven't helped, talk to your doctor about taking medication to treat hirsutism. Since hair follicles typically have a six-month life cycle, it may take up to that amount of time with these treatments before you see a noticeable difference in the growth of new hair. Options include:

• Oral contraceptives: Birth control pills, which are hormonal contraceptives that contain progesterone and estrogen, are used to treat hirsutism caused by the production of androgen. Women who don't want to be pregnant are often treated for hirsutism using oral contraceptives
• Hormonal contraceptives, like birth control tablets that include both estrogen and progestin, are used to treat androgen-induced hirsutism. Women who choose to delay having children are often treated for hirsutism with oral contraceptives. Possible adverse effects include nausea and headaches.

• Anti-androgen medications: These medications prevent androgens from binding to the right body receptors. A prescription might be written if, after six months of use, oral contraceptives aren't effective enough.

When treating hirsutism, spironolactone (Aldactone, CaroSpir) is the most commonly used anti-androgen. It takes at least six months for the minor results to appear. Menstrual cycle irregularities are one of the potential adverse effects. It is essential to utilize contraception while taking these medications because they can result in birth abnormalities.

• Topical lotion: The only people who are advised to use the moisturizing drug eflornithine (Vaniqa) are women with thick facial hair. It is immediately applied twice daily to the facial area that is afflicted. Rather than shaving off existing hair, it aids in limiting the growth of new hair. It can improve the reaction when used in conjunction with laser therapy.

Procedures

The following hair removal treatments can be used in conjunction with medical therapy, and their results may be more durable than those of self-care methods:

• Laser treatment: Your skin is exposed to a high-concentration laser beam to damage hair follicles and prevent the development of new hair (photoepilation). You could need more than one therapy session.
  • The advantages and disadvantages of various lasers used for this hair removal technique should be discussed with your physician. Those with skin types that are darker in color or more tanned are more susceptible to severe laser side effects such as blistering, inflammation, and changes in skin tone.
• Electrolysis: Each hair follicle receives a small needle during this procedure. The follicle is harmed by the electric current pulse the needle provides, which ultimately results in its damage. It could be required for you to attend multiple therapies. The better choice than laser therapy for people with naturally blond or white hair is electrolysis. Even if electrolysis works, it can be uncomfortable. Applying numbing cream to your skin before therapy may help you feel less pain.

Prevention Of Hirsutism

Generally speaking, hirsutism cannot be prevented. If you have polycystic ovarian syndrome and are overweight, losing weight may help minimize hirsutism.

Complications Of Hirsutism

Having hirsutism may cause emotional stress. Some women feel self-conscious when they have unwanted hair. Some people experience depression. Furthermore, an underlying hormone imbalance might cause medical problems even though hirsutism by itself does not always cause them.

Polycystic ovarian syndrome, which can result in infertility, is indicated by irregular menstruation and hirsutism. Expectant women using certain medications related to hirsutism should refrain from becoming pregnant due to the possibility of birth defects.

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