What is Hirsutism?
Hirsutism is a condition found in women characterized by an excessive growth of dark hair in unwanted areas or more in male-pattern hair or the androgenic hair that is meant for male genders.
Hirsutism is not a disease itself but a manifestation of a serious medical condition especially when the development of excessive hair occurred after puberty. The excessive growth can be found in the areas of the face, chest and back. However, hirsutism is not a life-threatening condition that needs an immediate medical attention. It is more of a cosmetic and psychological concern among females affected.
The condition of hirsutism is common in dark-skinned white women of reproductive age and uncommon in African American. The incidence is commonly least in East Asian and Native American women. Clinical outlook is good as it is more of a symptom rather than a disease or disorder although it has a cosmetic and psychological effect while health concern is more on the nature of the underlying condition that brought about the manifestation of excessive hair growth. The onset in age varies depending on the cause whereas those that developed as a result of congenital adrenal hyperplasia occur early in childhood while facial hair growth in women usually develops postmenopausal as a consequence of unopposed androgen. Development right after puberty may be an alarming sign of ovarian tumor and adrenal hyperplasia although this incidence seldom or rarely happens.
The primary symptom of hirsutism is the excessive growth of unwanted and male-pattern hair characterized by coarse and dark pigmented hair. The growth may occur in 9 extensive sites utilized by Ferriman-Gallwey model in determining or measuring the extent and severity of hair growth. The 9 sites include:
- Face specifically in the areas of beard, moustache and the temple areas
- Linea alba or the fibrous structure that runs down the midline of the abdomen from the xiphoid process to pubic symphysis
- Upper and lower back
- External genitalia
- Inner thighs
Virilization is a process in which hirsutism is due to excessively high androgen levels causing other symptoms to develop over time and such signs of virilization includes:
- Acne growth
- Voice modulation is deepening similar to male voice
- Muscle mass is increasing
- Breast size decreasing
- Clitoris increasing in size or enlarged
Hirsutism may also be accompanied with other symptoms such as:
- Palpable pelvic mass
- Symptoms of Cushing syndrome
Androgen is being implicated for the cause of hirsutism among women. It is a male hormone that is also present in women and the relation to hirsutism may be the result of either an increased in the level of androgen or increased in the sensitivity to androgen. Testosterone is among the androgen type that is present in women although in minimal level. This type of androgen affects women with their sex drive, menstrual cycle and fertility while testosterone is vital in the development of male sexual characteristic giving relation to increased level in women adds to potential for hirsutism while the cause may be broadly classified into five categories:
Hormone related disorders are primarily implicated for hirsutism which has relevance with the levels of androgen when there is an alteration that may cause it to increase or decrease. Such hormone related disorder may include:
- Polycystic ovarian disease where there is the presence of multiple cyst in the ovary and increased level of blood androgen
- Cushing’s Syndrome is an excess in secretion of steroids that include androgens
- Hypothyroidism is characterized by a decrease in the level of thyroid hormone
- Congenital adrenal hyperplasia is a deficiency in the enzyme resulting to an overproduction of androgen
- Acromegaly is a condition of excessive growth hormone and a resistance to insulin
Tumor growth in the ovaries and adrenal glands result to an increase in the secretion of androgen and such condition of tumor growth includes:
- Ovarian tumor
- Adrenal adenoma
- Adrenal tumor
- Adrenal carcinoma
Medications that may be taken or presently taking is another factor in the cause of hirsutism and such therapeutic drugs include:
- Progesterone containing oral contraceptives
Menopausal stage in women makes them prone for hirsutism as a result in hormonal changes that leaves higher number of testosterone while women in post-menopausal ovarian hyperthecosis is responsible for the onset of hirsutism.
There is no definite treatment for hirsutism although it can be removed through self-care methods and hair removal procedures while pharmacological treatments are given to inhibit the production of androgen and to block its receptors.
Therapeutic drugs given for hirsutism include:
- Oral contraceptives containing estrogen and progestin act in inhibiting the production of androgen by the ovaries are usually given to treat hirsutism in women especially those who abhor pregnancy.
- Anti-androgen drugs such as the commonly prescribed spironolactone act by blocking the androgen from its receptors.
- Eflornithine is an alternative medication in form of cream applied in areas with growth of unwanted hair and especially prescribed for those who have mild facial hair growth or for those who underwent hair-removal procedures yet ineffective.
Medical treatment usually takes a month before a noticeable change that it is advisable for patient to continue medication or take the medication for a period of six months to achieve significant change.
Non-medical therapies or hair-removal therapies can help in physical improvements without taking in medication as a prerogative of patient. Such hair-removal therapies include:
- Laser hair-removal destroys hair with a powerful beam of light with effect lasting for several months.
- Electrolysis utilizes electricity in permanently destroying and removing the hair cells but the drawback is the painful process and may leave scar and skin discoloration.
- Bleaching does not remove hair but make it less visible b removing the dark color of the hair while the adverse effect is skin irritation and may always not work for everyone
Picture collection of Hirsutism…