Hirsutism (HUR-soot-iz-um) is a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern — face, chest and back.
With hirsutism, extra hair growth often arises from excess male hormones (androgens), primarily testosterone.
Self-care methods and effective treatment options are available for women who wish to treat hirsutism.
Hirsutism is stiff or dark body hair, appearing on the body where women don't commonly have hair — primarily the face, chest, lower abdomen, inner thighs and back. People have widely varying opinions on what's considered excessive.
When high androgen levels cause hirsutism, other signs might develop over time, a process called virilization. Signs of virilization might include:
If you think you have too much coarse hair on your face or body, talk with your doctor about treatment options.
Excess facial or body hair is often a symptom of an underlying medical problem. See your doctor for assessment if over a few months you experience severe or rapid hair growth on your face or body or signs of virilization. You may be referred to a doctor who specializes in hormone disorders (endocrinologist) or skin problems (dermatologist).
Hirsutism may be caused by:
Often hirsutism occurs with no identifiable cause.
Several factors can influence your likelihood of developing hirsutism, including:
Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some develop depression. Also, although hirsutism doesn't cause physical complications, the underlying cause of a hormonal imbalance can.
If you have hirsutism and irregular periods, you might have polycystic ovary syndrome, which can inhibit fertility. Women who take certain medications to treat hirsutism should avoid pregnancy because of the risk of birth defects.
Hirsutism generally isn't preventable. But losing weight if you're overweight might help reduce hirsutism, particularly if you have polycystic ovary syndrome.
Tests that measure the amount of certain hormones in your blood, including testosterone or testosterone-like hormones, might help determine whether elevated androgen levels are causing your hirsutism.
Your doctor might also examine your abdomen and do a pelvic exam to look for masses that could indicate a tumor.
Treatment of hirsutism with no sign of endocrine disorder is not necessary. For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications.
If cosmetic or self-care methods of hair removal haven't worked for you, talk with your doctor about drugs that treat hirsutism. With these medications it usually takes up to six months, the average life cycle of a hair follicle, before you see a significant difference in hair growth. Options include:
Anti-androgens. These types of drugs block androgens from attaching to their receptors in your body. They're sometimes prescribed after six months on oral contraceptives if the oral contraceptives aren't effective enough.
The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). The results are modest and take at least six months to be noticeable. Possible side effects include menstrual irregularity. Because these drugs can cause birth defects, it's important to use contraception while taking them.
Hair removal methods whose results may last longer than self-care methods — and which may be combined with medical therapy — include:
Laser therapy. A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing (photoepilation). You might need multiple treatments. For people whose unwanted hair is black, brown or auburn, photoepilation is usually a better option than electrolysis.
Talk with your doctor about the risks and benefits of the various lasers used for this hair removal method. People with tanned or darkly pigmented skin are at increased risk of side effects from certain lasers, including a darkening or lightening of their usual skin tones, blistering, and inflammation.
Electrolysis. This treatment involves inserting a tiny needle into each hair follicle. The needle emits a pulse of electric current to damage and eventually destroy the follicle. You might need multiple treatments. For people with naturally blond or white hair, electrolysis is a better option than laser therapy.
Electrolysis is effective but can be painful. A numbing cream spread on your skin before treatment might reduce discomfort.
Self-care methods such as the following temporarily remove or reduce the visibility of unwanted facial and body hair. There is no evidence that self-removal of hair leads to heavier hair growth.
When you make your appointment, ask if you should avoid removing your unwanted hair so the doctor can better evaluate your condition. Make a list of:
For hirsutism, some questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you questions, such as:
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