hirsutism

Hirsutism
Classification and external resources
A woman with hirsutism, as depicted in the Nuremberg Chronicle (1493)
ICD-10	L68.0
ICD-9	704.1
DiseasesDB	20309
MedlinePlus	003148
eMedicine	med/1017 derm/472

Hirsutism (from Latin hirsutus = shaggy, hairy) is the excessive and increased hair growth on female humans in those parts of the body where terminal hair does not normally occur or is minimal - for example, a beard or chest hair. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern. Hirsutism is a symptom rather than a disease and may be a sign of a more serious medical condition, especially if it develops well after puberty.

Causes

Hirsutism can be caused by either an increased level of androgens, the male hormones, or an oversensitivity of hair follicles to androgens. Male hormones such as testosterone stimulate hair growth, increase size and intensify the growth and pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass.

Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.

It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Again, the result is increased androgen production.

A woman with hirsutism

The following may be some of the conditions that may increase a woman's normally low level of male hormones:

• Polycystic ovary syndrome
• Cushing's disease
• Tumors in the ovaries or adrenal gland (cancer)
• Certain medications
• Congenital adrenal hyperplasia
• Insulin resistance
• Stromal Hyperthecosis - in postmenopausal women
• Obesity: As there is peripheral conversion of estrogen to androgen in these patients, this is the same mechanism of PCOS
• Use of drugs like Tetrahydrogestrinone

Appearance and evaluation

Hirsutism affects women and sometimes men, since the rising of androgens causes a male pattern of body hair, sometimes excessive, particularly in locations where women normally do not develop terminal hair within their puberty (chest, abdomen, back and face). The medical term for excessive hair growth that affect both men and women is hypertrichosis.

One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.

Treatment

Many women with unwanted hair seek methods of hair removal. However, the causes of the hair growth should be evaluated by a physician, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the treatment. One of the few treatments is the antiandrogen drug Spironolactone.

See also

Look up hirsutism in Wiktionary, the free dictionary.

• androgenic hair
• pubic hair
• hypertrichosis
• hair removal
• bearded lady
• trichophilia

References

Bibliography

• Ferriman D, Gallwey JD (1961). "Clinical assessment of body hair growth in women". J. Clin. Endocrinol. Metab. 21: 1440–7. PMID 13892577. 

Notes

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External links

• Why the Bearded Lady Was Never a Laughing Matter: Hirsutism