Hirsutism (Excess Hair)

Hirsutism is a condition in which too much hair grows on the face or body. Although hirsutism can occur in both men and women, usually only women consider it a problem.

Women who have hirsutism have dark, thick hair on their face, chest, abdomen and back. This thick, dark hair is different from the hair that some women have on their upper lip, chin, breasts or stomach, or the fine "baby" hair all over their body. Women from certain ethnic groups tend to have more body hair than others. This does not mean that they have hirsutism.

Causes

Hirsutism can be caused by abnormally high levels of male hormones (called androgens). Other symptoms associated with a high level of male hormones include acne, irregular menstrual periods, deepening of the voice and increased muscle mass. The following are some of the conditions that may increase a woman's normally low levels of male hormones:

Polycystic ovary syndrome
Cushing's disease
Tumors in the ovaries or adrenal gland, formed when abnormal cells grow out of control and clump together

Hirsutism can also be caused by hair follicles that are overly sensitive to male hormones. Doctors don't know why this occurs.
Some medicines can cause hirsutism. These medicines include birth control pills, hormones and anabolic steroids.
Hirsutism also seems to run in families. If you have hirsutism, your family doctor may want to do some tests to find out what is causing it.

When should I see my doctor about hirsutism?
See your doctor if you have a sudden increase in facial or body hair, if your periods have become irregular or if your voice has become deeper.

What can I do to get rid of the excess hair?
If you're overweight, lose weight. Losing weight reduces the amount of hormones in your body that cause increased hair growth. Other ways to eliminate or hide excess facial and body hair include the following:

Shaving is the safest and easiest method of removing hair. However, you will have stubble unless you shave every day. Your skin may become irritated with frequent shaving. If your skin becomes irritated, apply a small amount of 1% hydrocortisone cream.

Depilatories, or creams that remove hair, can be used. They leave no stubble. However, these creams may irritate your skin. To test how sensitive your skin is, apply a small amount of cream to the inside of your wrist. Wait for one day before applying the cream to other parts of your body. If you don't have a bad reaction to the cream on your wrist, it's probably okay to use it.
Bleaching paste may also be used. Use this product according to the directions on the label. Bleaching products may irritate your skin.

Plucking and waxing can cause skin irritation and make the hair grow faster by increasing the blood supply to the follicle. These methods aren't recommended for women who have hirsutism.
Electrolysis gets rid of hair permanently by delivering a small electrical current through a needle placed into the hair follicle. Electrolysis is expensive and time-consuming. If you choose to have electrolysis, make sure the operator is qualified and licensed. Home electrolysis products and electronic tweezers don't work well and are not recommended.

Laser hair removal uses a laser light to damage hair follicles so unwanted hair falls out. This also prevents the hair from growing back. You'll probably need multiple laser treatments over a number of weeks, and the results may not be permanent. Laser hair removal is very expensive and can only be done by a licensed practitioner. Side effects of the procedure may include redness, darkening or lightening of the skin, and scarring.

Are there medicines to treat hirsutism?
Yes, your doctor may prescribe a medicine called an anti-androgen to help control the male hormones that cause hirsutism. Anti-androgens usually take at least 3 to 6 months to work. They can decrease the amount of new hair growth, but they are less likely to change the amount of hair you already have.

There is also a medicine made specifically to slow down the growth of facial hair. It is a prescription cream that you apply to the affected skin on your face and chin. This medicine may start to work as soon as 4 to 8 weeks after you begin treatment.

Adapted from American Academy of Family Physicians