Hirsutism - What Is It?

Hirsutism - this is the excessive conversion of vellus hair into terminal hair in women. This is found in the androgen to testosterone dependent sites such as the beard area, neck, chest, abdomen and inner thighs.

Hypertrichosis is a term used to describe excessive hair growth in non androgen dependent areas.

Hirsutism is related to hormonal factors normally related to increased androgen levels. Androgens such as testosterone are usually produced in the adrenal gland and in the ovaries. Many cases of familial or constitutional hirsutism have no such abnormalities. In hirsutism it is important to rule out underlying abnormalities. The treatment will be based on the administration of anti-androgens as well as newer topical medications and physical treatments.

Hirsutism is not observed before puberty. At puberty, the secondary sexual characteristics develop in men leading to increased hair in the beard and moustache areas, the chest, shoulders, back, arms, thighs, pubic skin and on the lower abdomen and buttocks. In women, if these changes are present it means an increased secretion of androgens from the ovaries or the adrenal gland to an increase in sensitivity of the hairs that are present to the testosterone. At the time of menopause the androgen oestrogen ratio changes with relatively more androgens available. 70% of post menopausal women will develop hirsutism.

Hirsutism is common. A study from the UK suggested that at one point 2% of women in London have a problem with hirsutism.

Excessive hair growth is really determined by the woman herself. If it is thought to be a problem then it is. It is self defining. There is often a feeling of embarrassment, self-consciousness, obsession with removal, unfeminity, inhibition, etc.