Unwanted Facial Hair

Diagnosing Hirsutism

Clinical Features of Hirsutism

Hirsutism can manifest in different ways, depending on the cause. For example, in women with PCOS of congenital adrenal hyperplasia hirsutism typically develops gradually, over time, whereas in women with familial hirsutism excessive terminal hair will often begin to manifest during puberty. By contrast if androgen-secreting tumours are present, the onset of hirsutism can be sudden.

Clinicians use the Ferriman-Gallwey Index to assess the severity of hair growth in 9 key areas on the body, including the sides of the breasts, the sides of the face and neck, and the abdomen.

Other accompanying signs and symptoms may include some of the following:

  • Acanthosis nigricans, which is a brown discolouration on the sides of the neck and armpits
  • An increase in acne
  • Alopecia
  • Obesity
  • Pelvic mass
  • Signs or symptoms of virility or androgenisation such as deepening voice or clitoromegaly
  • Signs or symptoms of Cushing syndrome

Clinical Features of Hirsutism

If you do experience a rapid or sudden increase in hair growth, signs of virilisation or signs of Cushing's syndrome, your physician may decide to do further tests to determine the presence of any underlying medical conditions. This includes taking a thorough medical history and undergoing a physical exam.

If your hirsutism is associated with significant acne, menstrual irregularities or signs of androgenization, your doctor may order tests to determine the presence and circulating levels of certain hormones.


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