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Hirsutism

What is hirsutism?

Hirsutism is the term used when a woman grows too much body or facial hair in a pattern seen normally occurring only in men.

What causes hirsutism?

Androgens are often thought of as 'male hormones' but, in fact, both men and women produce them - men usually in greater amounts than women. Testosterone is the best-known androgen, but there are several others too. Hirsutism can be caused either by abnormally high levels of androgens, or by the hair follicles being more sensitive than usual to normal androgen levels. 

A small minority of women with hirsutism produce too much androgen and sometimes this is due to an underlying medical condition. In addition, some medicines can cause hirsutism - these include hormones, anabolic steroids, and sometimes oral contraceptive pills.

In fact, most women with hirsutism have no hormone imbalance or underlying medical condition. Many women develop more facial or body hair gradually as they get older, especially after the menopause. Few realise how common this is - but at least 25% of normal middle-aged women remove unwanted facial hair. In addition, women from different ethnic backgrounds have different patterns of hair growth, in which it can be normal to have some hair on the face, nipples or stomach.

Is hirsutism hereditary?

A tendency to hirsutism does run in some families and is not associated with an excess of androgens. It is normal in some families with Mediterranean or Middle Eastern ancestry.

What are the symptoms of hirsutism?

Having too much hair can be highly embarrassing and cause great distress.

What does hirsutism look like?

The excess of thick, often dark, hair may be seen on the face, chest, abdomen and upper back. Women from certain ethnic groups tend to have more body hair than others and for them it may be quite normal to have some hair in these areas. 

How will hirsutism be diagnosed?

Women with mild hirsutism and regular menstrual cycles seldom have an underlying medical problem. However, if a medical problem exists, your doctor should be able to detect it by asking you questions and then, if necessary, by performing blood tests. 

It is important to see your doctor if your hirsutism is:

  • Severe 
  • Developing quickly (over 1-2 years), or before puberty 
  • Accompanied by menstrual problems 
  • Associated with features suggesting an increase in androgens such as thinning of the scalp hair, baldness, or deepening of the voice 
  • Accompanied by obesity or diabetes 

Can hirsutism be cured?

Although a ‘cure’ is unlikely, local areas of excessive hair growth can often be cleared by electrolysis or laser therapy. The treatment of hirsutism with medication is usually less satisfactory as the problem often comes back when treatment stops. 

For information about available treatments please go to this page on the website of the British Association of Dermatologists

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