Excess Hair
Hypertrichosis – This is the term used for excessive hair growth, on any part or the whole body, as compared to other persons of the same age, sex and race.
Hirsutism – Hypertrichosis must not be confused with hirsutism, which is defined as androgen-induced growth of terminal (thick dark hair) hair in women, in male pattern distribution (on the side locks, chin, and neck on the face, hair on torso around the naval and increased hair on the body). Hirsutism is androgen-dependent while Hypertrichosis is not.
What is Hirsutism?
The normal amount of body hair for women varies. Most of the time, a woman only has fine hair or peach fuzz, above the lips and on the chin, chest, abdomen or back. If you have coarse, dark hairs in these areas, the condition is called hirsutism. Such hair growth is more typical of men.
Women normally produce low levels of male hormones (androgens). If your body makes too much of this hormone, you may have unwanted hair growth. In most cases, the exact cause is never identified. It tends to run in families. In general, hirsutism could be a harmless condition but women find it bothersome and embarrassing.
Causes
A common cause of hirsutism is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormone conditions causing unwanted hair growth, may also have acne, problems with menstrual periods, trouble losing weight, and high insulin levels (as seen in diabetics).
Other rare causes of unwanted hair growth may include –
- Hirsutism which can be genetic in nature, that is, it can run in families.
- Tumour or cancer of the adrenal gland or ovary
- Hyperthecosis (a condition in which the ovaries produce excessive male hormones)
- Use of certain medicines, including testosterone, danazol, anabolic steroids, glucocorticoids, minoxidil, and phenytoin
Symptoms
In addition to excess hair growth, many women and girls approaching puberty who suffer from hirsutism also might suffer with some common symptoms
- Absent infrequent or irregular menstrual periods
- Persistent acne and oily skin
- Deepening of the voice
- Obesity-increased muscle mass
- Hair loss associated with frontal thinning.
Home Care
Hirsutism is generally a long-term problem. There are a number of ways to remove or treat unwanted hair. Some treatments are more effective than others.
- Weight loss in overweight women can reduce hair growth.
- Bleaching or lightening hair may make it less noticeable.
Temporary hair removal options include
- Shaving, which does not cause more hair to grow, but may make the hair look thicker.
- Plucking and waxing are fairly safe and inexpensive. However, they can be painful and there is a risk for scarring, swelling, and skin darkening.
Diagnostic tests
The doctor needs to conduct a detailed medical history, including menstrual cycle patterns, family history of certain diseases, onset of symptoms and medication used. A physical examination may also be required to determine the extent of excess hair growth and to evaluate other signs of excess androgen production. Blood tests can help determine the level of certain hormones, like testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), Dihydroepiandrosterone sulfate (DHEA-S) and SHBG to name a few. Your consulting physician might even need an ultrasound to check the status of the ovaries to rule out polycystic ovarian syndrome.
Treatments
Oral contraceptives – Birth control pills or other hormonal contraceptives, which contain the hormones estrogens and progestin, treat hirsutism by inhibiting androgen production by the ovaries. This especially can be adopted by women who have hirsutism and also don't want to become pregnant. Possible side effects include dizziness, nausea, headache and stomach upset.
Anti-androgens – These types of drugs block androgens from attaching to their receptors in the body. The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone)/flutamide. Possible side effects include drowsiness, nausea, irregular menstrual periods, electrolyte disturbances and diarrhoea. Because these drugs can cause birth defects, it's important to use good contraception while taking them.
Topical cream – Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women. It's applied directly to the affected area of your face and helps slow new hair growth, but is ineffective in getting rid of existing hair. Eflornithine may take up to two months to work, and hair growth returns to pre-treatment levels within eight weeks of discontinuing the medication. Side effects may include stinging, tingling or a skin rash.
- Note – After beginning a medication for hirsutism, it usually takes a month before you notice a significant difference in hair growth. It's recommended that you continue taking the medication for six months before changing or adding medications or changing doses.
Laser hair removal – Lasers are non-invasive, rapid in action, less painful and are more effective than other methods of hair removal. Laser hair removal uses laser aimed at the dark color (melanin) in the hairs. This method is best for small and large areas that need treatment. Hormonal tests can be prescribed before the treatment. A normal hormonal profile or girls on hormonal medications with hormones under control status can benefit from laser hair removal.
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