Hirsutism is excess male-pattern hair growth in women. The coarse, dark hair can occur in areas such as the face, chest, and back.
True hirsutism is often due to an increased level of a male sex hormone called androgen. The main circulating androgen is called testosterone. This hormone is normally found in both men and women. There are certain medical conditions or medications that may cause an elevation in the levels of this hormone in women.
The most common cause of hirsutism is
polycystic ovary syndrome
. Other less common include:
Congenital adrenal hyperplasia
Some forms of
Cushing syndromeAdrenal tumorsOvarian tumorsPituitary tumors
Certain medications, including:
MinoxidilCyclosporinePhenytoinAnabolic steroidsDiazoxideProgestin-containing medications (such as oral contraceptives)
Sometimes excess hair growth is due to the person's ethnic background or family tendencies. In some cases, the cause is not known.
There are no known risk factors for hirsutism.
Symptoms and signs of some disorders associated with hirsutism may include: Excess hair growth on the face, arms, back, armpits, groin, or chestAbnormal or absent menstrual periodsMale-pattern baldnessDeepened voiceIncreased size of clitorisHigh blood pressureIncreased muscle massAcneEnlarged ovariesEnlarged adrenal glandsAbnormal cholesterol levels and glucose intolerance
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You will be asked about your symptoms and medical history. A physical exam will be done. The diagnosis is made by the distribution and degree of hair growth.
Your bodily fluids may be tested. This can be done with blood tests.
Images may be taken of your brain or abdomen. This can be done with: UltrasoundCT scanMRI scan
Treatment is directed at hair removal, reducing hair growth, and the underlying cause of the hirsutism and may include:
Methods of removing hair include: ShavingBleachingChemical treatment (depilatories)WaxingElectrolysisLaser treatmentIntense pulsed light (IPL)—uses high-intensity pulses of light to remove hair; unlike laser treatment, IPL uses a range of wavelengths.
Medications that may help reduce hair growth include: SpironolactoneFinasterideFlutamideOral contraceptivesMetforminEflornithine
If you are diagnosed with a condition that may be causing hirsutism, proper treatment may resolve the hirsutism. Weight loss may also play a role in reducing underlying hormone imbalances.
Hirsutism may be prevented by treating the underlying cause.
Azziz R. The evaluation and management of hirsutism.
Hirsutism. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated June 13, 2013. Accessed December 9, 2014.
N Engl J Med.
Intense pulsed light therapy. DermNet NZ website. Available at:
http://dermnetnz.org/procedures/ipl.html. Updated December 29, 2013. Accessed December 9, 2014.
Lustberg ME. American Osteopathic College of Dermatology website. Available at:
http://www.aocd.org/skin/dermatologic_diseases/hirsutism.html. Accessed September 12, 2012.
DynaMed's Systematic Literature Surveillance
: Hamzavi I, Tan E, Shapiro J, Lui H. A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women.
J Am Acad Dermatol.
9/2/2010 DynaMed's Systematic Literature Surveillance
: Haak CS, Nymann P, Pedersen AT, et al. Hair removal in hirsute women with normal testosterone levels: a randomized controlled trial of long-pulsed diode laser versus intense pulsed light.
Br J Dermatol.
2010 Aug 20. [Epub ahead of print]
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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