What is hirsutism?

Hirsutism is excess hair growth on the body or face. For women, the hair may grow in areas where men often have a lot of hair but women often don’t. This includes the upper lip, chin, chest, and back. It’s caused by an excess of male hormones called androgens. All women naturally produce small amounts of androgens. But high levels of these hormones can lead to hirsutism.

What causes hirsutism?

Hirsutism can run in families. It may also be caused by:

• Polycystic ovary syndrome (PCOS). This is the most common cause of hirsutism in women. It is a disorder that causes hormone problems.

• Disorders of the pituitary gland, adrenal gland, or thyroid gland

• Tumor on the ovary that makes extra androgens

• Severe insulin resistance

• Changes in hormones from menopause

• Use of anabolic steroids or corticosteroids

• Use of medicine to treat endometriosis

• Certain other medicines

In some cases, the cause isn’t known. This is called idiopathic hirsutism.

Who is at risk for hirsutism?

You are more at risk for hirsutism if you have any of these:

• Polycystic ovary syndrome (PCOS)

• Parents or siblings with excess hair growth

• Disorders of the pituitary gland, adrenal gland, or thyroid gland

• Severe insulin resistance

• Changes in hormones from menopause

• Use of anabolic steroids or corticosteroids

• Use of medicine to treat endometriosis

What are the symptoms of hirsutism?

Symptoms can occur a bit differently in each person. They include darker or thicker hairs growing on parts of the body such as:

• Upper lip

• Chin

• Jawline

• Chest

• Back

• Buttocks

The symptoms of hirsutism can look like other health conditions. See your healthcare provider for a diagnosis.

How is hirsutism diagnosed?

Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. You may also have blood tests to check for increased androgen levels. These tests can also check for other problems that may cause excess hair growth.

How is hirsutism treated?

Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person.

Methods to remove or reduce unwanted hair include:

• Shaving. Hair will start growing back right away, so shaving needs to be repeated often.

• Depilatory lotion. This is a type of hair removal done with chemicals put on the skin. It softens hair above the skin so it can be wiped away.

• Waxing. Hot or cold wax can be used to pull out hair from the root. This treatment needs to be done every 2 to 3 weeks.

• Bleaching. Chemicals can lighten the color of the hair and make it harder to see.

• Electrolysis. A very thin needle is put into a hair follicle. Electricity is sent through the needle. This damages the hair follicle. This method is done over several sessions. This can reduce and remove hair for months or longer.

• Laser hair removal. A special laser is pointed at the skin. The light from the laser is absorbed by color (pigment) in the hair and destroys the hair. This works best on people with dark hair and light skin. This method is done over several sessions. This can reduce and remove hair for months or longer.

• Medicated cream. Skin cream with eflornithine can slow hair growth. Results show up in 6 to 8 weeks. The hair will regrow in about 8 weeks if you stop using the cream.

Other medicines can reduce the hormones that cause hair growth. It can take 6 months or longer for you to see results from these medicines. This is because hair grows, rests, falls out, and regrows in cycles that last for months. And not all hairs are in the same part of the cycle at the same time. Because of this, treatments that affect the hair you have now may need to be repeated over time. Medicines that can change hormones to affect hair growth include:

• Birth control pills. These are different kinds of hormone pills that prevent pregnancy. They can reduce the amount of androgens in your body. Most women will notice a change in body hair growth when taking birth control pills.

• Antiandrogen medicine. This type of medicine can reduce your body’s androgen levels. Or it may stop the effects of androgens on hair follicles. The most common type is spironolactone. The medicines can cause birth defects, so a woman must use birth control while taking them.

Other factors that can lessen excess hair growth include:

• Treating another condition. Treating disorders of the pituitary gland, adrenal gland, or thyroid gland can lessen excess hair growth.

• Weight loss. In some women, losing weight can reduce androgen levels and cause hair growth to slow.

• Aging. Women age 30 and older have decreasing androgen levels. Hair growth may lessen over time.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What can I do to prevent hirsutism?

In some cases, hirsutism may be prevented by not taking a medicine that can cause excess hair growth.

How to manage hirsutism

Hirsutism is often a long-term (chronic) condition. But you can manage it by working with your healthcare provider to create a treatment plan.

When should I call my healthcare provider?

Call the healthcare provider if you have:

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about hirsutism

• Hirsutism is excess hair growth on the body or face. It’s caused by excess hormones called androgens.

• For women, the hair may grow in places where men often have a lot of hair but women often don’t. This includes the upper lip, chin, chest, and back.

• It can run in families. It may also be caused by polycystic ovary syndrome (PCOS) or other problems. In some cases, the cause isn’t known.

• Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person.

• Methods to remove unwanted hair include shaving, waxing, laser hair removal, birth control pills, and other medicines.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.