Hirsutism – Causes, Symptoms and Treatment

Hirsutism is also called hirsutes which is the term used for increased hair growth in women. This too much hair grows on the face or body. This hair may also be able to be growing on the chin, upper lip, and side of the face, breasts, stomach and thighs. Normal patterns of hair growth and hair distribution vary widely, determined mostly by racial background. Soft vellous hair is normally present all over the body and this type of hair on the face and elsewhere is ‘normal’ and is not sex-hormone dependant. Any excess in the latter regions is thus usually a mark of increased ovarian or adrenal androgen production. At least 25% and as much as 85% of normal middle-aged women remove unwanted facial and body hair, although few of these women are termed hirsute.


The cause of hirsutism has been identified as being due to medications, which cause excessive hair growth like phenytoin, minoxidil, diazoxixde, cydosporine and hexachlorobenzone. Its cause can also be attributed to HRT, anabolic steroids, birth control pills, danazol and anorexia. This growth is caused by male hormones. The most powerful of these male hormones is testosterone. All women normally have a certain level male hormones circulating in their blood.

It can also be caused by other factors like:

* Drugs (like cyclosporin, corticosteroids, diazoxide, streptomycin, interferon and acetazolamide.)
* Birth control pills
* Chemicals
* Injury
* Pressure
* Allergy and infections
* Cancer
* Genetic conditions


Patients with hirsutism due to hormonal causes will also have some
disturbances of menstruation, lack of ovulation, acne, deepening of voice, balding and overweight. It is more prominent on the areas of the face, which are androgen dependent. If hirsutism is caused by excessively high androgen levels, you may notice other signs. These may include:

* A deepening voice
* Balding
* Acne
* Decreased breast size
* Enlargement of the clitoris
* Increased muscle mass


Some women use depilating agents and wax on their face and other parts of the body. Remember, the face is particularly sensitive. Because hair is produced as a defense against chemical irritation of the skin, hirsutism is worsened.

Plucking, bleaching, depilatory cream or wax and shaving may all help and are often underused. Waxing is of especial value where the “bikini area is causing the concern. Electrolysis is slow and expensive.

Cyproterone acetate is an anti-androgen but is also teratogenic and a weak glucocorticoid and progestogen. Given continuously it produces amenorrhoea, and so is normally given for days 1-14 of each cycle. In women of child bearing age, contraception is essential.