What is this Condition?

Hirsutism is the excessive growth of body hair in women and children. Usually, hair grows in an adult male distribution pattern. This condition commonly occurs spontaneously but may be associated with various underlying diseases. The prognosis varies with the cause of the disorder and the effectiveness of treatment.

What Causes it?

Primary hirsutism probably stems from a hereditary trait. In most cases, the person has a family history of the disorder.

Causes of secondary hirsutism include endocrine abnormalities, such as dysfunction of the pituitary gland (acromegaly, precocious puberty) or dysfunction of the adrenal gland (Cushing’s disease, Cushing’s syndrome, or congenital adrenal hyperplasia). It may also be related to ovarian lesions (such as polycystic ovary disease) and to use of certain drugs, such as Loniten, androgen steroids, or testoster­one.

What are its Symptoms?

Hirsutism typically causes enlarged hair follicles as well as enlargement and excessive pigmentation of the hairs themselves. People usually seek medical help because of excessive facial hair growth.

The pattern of hirsutism varies widely, depending on the person’s race and age. An elderly woman, for example, commonly shows increased hair growth on the chin and upper lip. In secondary hirsutism, other signs of masculinization may appear - deepening of the voice, increased muscle mass, increased size of genitalia, menstrual irregularities, and decreased breast size.

How is it Diagnosed?

To diagnose primary hirsutism, the doctor may look for a family history of hirsutism, menstrual abnormalities, and signs of masculinization. Results of a pelvic exam are normal.

Tests for secondary hirsutism depend on symptoms that suggest an underlying disorder.

How is it Treated?

At the person’s request, treatment of primary hirsutism consists of eliminating excess hair by scissors, shaving, depilatory creams, or removal of the entire hair shaft with tweezers or wax. Bleaching with hydrogen peroxide also may be satisfactory. Electrolysis, a slow and expensive process, can destroy hair bulbs permanently, but it works best when only a few hairs need to be removed .

Hirsutism from elevated androgen levels may require low-dose Decadron, oral contraceptives, or antiandrogens. These drugs vary in effectiveness.

Treatment of secondary hirsutism varies depending on the nature of the underlying disorders