Hirsutism – What Causes It?

Hirsutism – What Causes It?


By, Hairline International, Dermatology

Hirsutism is a condition where a female has excessive hair growth in the male pattern. It is seen mainly on the face, chest, and hands. Hair growth pattern is often determined by various factors, largely hereditary. However, hirsutism is due to excessive levels of male hormones in females. Androgens, which are the hormones responsible for male features including hair growth, cause increased hair growth in females too. There are other male features also which become obvious, but hair growth is very prominent.

Symptoms: In addition to increased hair growth, there are also other masculine factors including:

  • Deepening of the voice
  • Increased muscle mass
  • Roughening of the skin
  • Lack of breast development
  • Hair loss (on scalp)

Causes: While hirsutism is hormone related, there are specific causes which can lead to hirsutism.

  • Hereditary: Hirsutism runs in families, both in isolation and also due to the causes listed below.
  • Polycystic ovarian syndrome: There also could be menstrual irregularities, irregular bleeding, obesity, and infertility. A reduction in weight in these patients has shown to reduce hair density.
  • Medications: Prozac used for treating depression and danazol used to treat endometriosis can lead to hirsutism.
  • Cushing’s syndrome: Increased levels of adrenal hormones can lead to hirsutism.
  • Idiopathic: No known cause identified.

Complications: Hirsutism has no complications.

  • The concerns are more aesthetic, as facial hair is not something desirable for a woman. This could require advanced laser treatment and other hair removal measures.
  • It can also cause menstrual irregularities.
  • Polycystic ovaries, if present, can also lead to infertility.
  • If it is medication induced, there could also be birth defects in the newborn, which should be periodically monitored.

Diagnosis: While hirsutism does not require any diagnosis, tests are required to identify if there is an underlying cause such as Cushing’s, tumors, or polycystic ovaries. Blood tests and soft tissue scanning would be required to confirm these.

Management: This involves 3 aspects – removing the hair, managing the increased hormone levels, and treating the underlying condition. The excessive hair can be removed via multiple methods:

  • Shaving
  • Waxing
  • Bleaching
  • Electrolysis
  • Laser

While the first three are considered temporary measures, the last two are more permanent and can be done at slightly longer intervals of time. The hormone levels are managed using anti-androgens and oral contraceptives. Both these work at improving female hormone levels, thereby reducing facial hair growth. Topical creams are also available to control facial hair growth. While hirsutism is not something desirable, there is no reason to panic as there are very effective ways to manage it.