Hirsutism is excessive body hair on parts of the body where hair is normally absent or minimal. The word is from early 17th century: from Latin hirsutus meaning "hairy".[2] It may refer to a "male" pattern of hair growth that may be a sign of a more serious medical condition,[3] especially if it develops well after puberty.[4] Cultural stigma against hirsutism can cause much psychological distress and social difficulty.[5] Discrimination based on facial hirsutism often leads to the avoidance of social situations and to symptoms of anxiety and depression.[6]

Hirsutism
Barbara Vanbeck, a very hairy woman. Stipple engraving by G. Wellcome V0007287.jpg
Barbara van Beck, as depicted in an engraving by G. Scott.
SpecialtyDermatology, endocrinology
TreatmentBirth control pills, antiandrogens, insulin sensitizers[1]

Hirsutism is usually the result of an underlying endocrine imbalance, which may be adrenal, ovarian, or central.[7] It can be caused by increased levels of androgen hormones. The amount and location of the hair is measured by a Ferriman-Gallwey score. It is different from hypertrichosis, which is excessive hair growth anywhere on the body.[3]

Treatments may include birth control pills that contain estrogen and progestin, antiandrogens, or insulin sensitizers.[1]

Hirsutism affects between 5–15% of all women across all ethnic backgrounds.[8] Depending on the definition and the underlying data, estimates indicate that approximately 40% of women have some degree of facial hair.[9]


CausesEdit

Causes of hirsutism not related to hyperandrogenism include:

DiagnosisEdit

A complete physical evaluation should be done prior to initiating more extensive studies, the examiner should differentiate between widespread body hair increase and male pattern virilization.[14] 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.[15]

Diagnosis of patients with even mild hirsutism should include assessment of ovulation and ovarian ultrasound, due to the high prevalence of polycystic ovary syndrome (PCOS), as well as 17α-hydroxyprogesterone (because of the possibility of finding nonclassic 21-hydroxylase deficiency[16]). Many women present with an elevated serum dehydroepiandrosterone sulfate (DHEA-S) level. Levels greater than 700 μg/dL are indicative of adrenal gland dysfunction, particularly congenital adrenal hyperplasia due to 21-hydroxylase deficiency. However, PCOS and idiopathic hirsutism make up 90% of cases.[14]

TreatmentEdit

Medications consist mostly of antiandrogens, drugs that block the effects of androgens like testosterone and dihydrotestosterone (DHT) in the body, and include:[11]

Other methodsEdit

See alsoEdit

ReferencesEdit

  1. ^ a b c Barrionuevo, P; Nabhan, M; Altayar, O; Wang, Z; Erwin, PJ; Asi, N; Martin, KA; Murad, MH (1 April 2018). "Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis". The Journal of Clinical Endocrinology and Metabolism. 103 (4): 1258–1264. doi:10.1210/jc.2017-02052. PMID 29522176.
  2. ^ "hirsute adjective - Definition, pictures, pronunciation and usage notes | Oxford Advanced Learner's Dictionary at OxfordLearnersDictionaries.com". www.oxfordlearnersdictionaries.com. Retrieved 2021-07-22.
  3. ^ a b "Merck Manuals online medical Library". Merck & Co. Retrieved 2011-03-04.
  4. ^ Sachdeva S (2010). "Hirsutism: Evaluation and Treatment". Indian J Dermatol. 55 (1): 3–7. doi:10.4103/0019-5154.60342. PMC 2856356. PMID 20418968.
  5. ^ Barth JH, Catalan J, Cherry CA, Day A (September 1993). "Psychological morbidity in women referred for treatment of hirsutism". J Psychosom Res. 37 (6): 615–9. doi:10.1016/0022-3999(93)90056-L. PMID 8410747.
  6. ^ Jackson J, Caro JJ; Caro G, Garfield F; Huber F, Zhou W; Lin CS, Shander D & Schrode K (2007). the Eflornithine HCl Study Group. "The effect of eflornithine 13.9% cream on the bother and discomfort due to hirsutism". International Journal of Dermatology. 46 (9): 976–981. doi:10.1111/j.1365-4632.2007.03270.x. PMID 17822506. S2CID 25986442.
  7. ^ Blume-Peytavi U, Hahn S. "Medical treatment of hirsutism. Dermatol Ther. 2008 Sep-Oct; 21(5): 329-39. Review". {{cite journal}}: Cite journal requires |journal= (help)
  8. ^ Azziz R. (May 2003). "The evaluation and management of hirsutism". Obstet Gynecol. 101 (5 pt 1): 995–1007. doi:10.1016/s0029-7844(02)02725-4. PMID 12738163.
  9. ^ Blume-Peytavi U, Gieler U, Hoffmann R, Shapiro J (2007). "Unwanted Facial Hair: Affects, Effects and Solutions". Dermatology (Basel). 215 (2): 139–146. doi:10.1159/000104266. PMID 17684377. S2CID 9589835.
  10. ^ Somani N, Harrison S, Bergfeld WF (2008). "The clinical evaluation of hirsutism". Dermatol Ther. 21 (5): 376–91. doi:10.1111/j.1529-8019.2008.00219.x. PMID 18844715. S2CID 34029116.
  11. ^ a b c d Unluhizarci K, Kaltsas G, Kelestimur F (2012). "Non polycystic ovary syndrome-related endocrine disorders associated with hirsutism". Eur J Clin Invest. 42 (1): 86–94. doi:10.1111/j.1365-2362.2011.02550.x. PMID 21623779. S2CID 23701817.
  12. ^ Chellini PR, Pirmez R, Raso P, Sodré CT (2015). "Generalized Hypertrichosis Induced by Topical Minoxidil in an Adult Woman". Int J Trichology. 7 (4): 182–3. doi:10.4103/0974-7753.171587. PMC 4738488. PMID 26903750.
  13. ^ Dawber RP, Rundegren J (2003). "Hypertrichosis in females applying minoxidil topical solution and in normal controls". J Eur Acad Dermatol Venereol. 17 (3): 271–5. doi:10.1046/j.1468-3083.2003.00621.x. PMID 12702063. S2CID 23329383.
  14. ^ a b Sachdeva, Silonie (2010). "Hirsutism: Evaluation and treatment". Indian Journal of Dermatology. 55 (1): 3–7. doi:10.4103/0019-5154.60342. PMC 2856356. PMID 20418968.
  15. ^ Ferriman D, Gallwey JD (November 1961). "Clinical assessment of body hair growth in women". J. Clin. Endocrinol. Metab. 21 (11): 1440–7. doi:10.1210/jcem-21-11-1440. PMID 13892577.
  16. ^ Di Fede G, Mansueto P, Pepe I, Rini GB, Carmina E (2010). "High prevalence of polycystic ovary syndrome in women with mild hirsutism and no other significant clinical symptoms" (PDF). Fertil. Steril. 94 (1): 194–7. doi:10.1016/j.fertnstert.2009.02.056. hdl:10447/36367. PMID 19338993.
  17. ^ Karakurt F, Sahin I, Güler S, et al. (April 2008). "Comparison of the clinical efficacy of flutamide and spironolactone plus ethinyloestradiol/cyproterone acetate in the treatment of hirsutism: a randomised controlled study". Adv Ther. 25 (4): 321–8. doi:10.1007/s12325-008-0039-5. PMID 18389188. S2CID 23641936.
  18. ^ a b c d e Somani N, Turvy D (2014). "Hirsutism: an evidence-based treatment update". Am J Clin Dermatol. 15 (3): 247–66. doi:10.1007/s40257-014-0078-4. PMID 24889738. S2CID 45234892.
  19. ^ Bentham Science Publishers (September 1999). Current Pharmaceutical Design. Bentham Science Publishers. pp. 712–717.
  20. ^ Giorgetti R, di Muzio M, Giorgetti A, Girolami D, Borgia L, Tagliabracci A (2017). "Flutamide-induced hepatotoxicity: ethical and scientific issues". Eur Rev Med Pharmacol Sci. 21 (1 Suppl): 69–77. PMID 28379593.
  21. ^ Adam Ostrzenski (2002). Gynecology: Integrating Conventional, Complementary, and Natural Alternative Therapy. Lippincott Williams & Wilkins. pp. 86–. ISBN 978-0-7817-2761-7.
  22. ^ a b c d Ulrike Blume-Peytavi; David A. Whiting; Ralph M. Trüeb (26 June 2008). Hair Growth and Disorders. Springer Science & Business Media. pp. 181–, 369–. ISBN 978-3-540-46911-7.
  23. ^ Kenneth L. Becker (2001). Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. pp. 1196, 1208. ISBN 978-0-7817-1750-2.
  24. ^ a b c d van Zuuren, Esther J; Fedorowicz, Zbys; Carter, Ben; Pandis, Nikolaos (2015-04-28). "Interventions for hirsutism (excluding laser and photoepilation therapy alone)". Cochrane Database of Systematic Reviews (4): CD010334. doi:10.1002/14651858.CD010334.pub2. ISSN 1465-1858. PMC 6481758. PMID 25918921.
  25. ^ a b Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B (22 January 2009). Evidence-Based Dermatology. John Wiley & Sons. pp. 529–. ISBN 978-1-4443-0017-8.
  26. ^ a b Erem C (2013). "Update on idiopathic hirsutism: diagnosis and treatment". Acta Clinica Belgica. 68 (4): 268–74. doi:10.2143/ACB.3267. PMID 24455796. S2CID 39120534.
  27. ^ a b Müderris II, Bayram F, Ozçelik B, Güven M (February 2002). "New alternative treatment in hirsutism: bicalutamide 25 mg/day". Gynecological Endocrinology. 16 (1): 63–6. doi:10.1080/gye.16.1.63.66. PMID 11915584. S2CID 6942048.
  28. ^ a b Ekback, Maria Palmetun (2017). "Hirsutism, What to do?" (PDF). International Journal of Endocrinology and Metabolic Disorders. 3 (3). doi:10.16966/2380-548X.140. ISSN 2380-548X.
  29. ^ Taylor SI, Dons RF, Hernandez E, Roth J, Gorden P (December 1982). "Insulin resistance associated with androgen excess in women with autoantibodies to the insulin receptor". Ann. Intern. Med. 97 (6): 851–5. doi:10.7326/0003-4819-97-6-851. PMID 7149493.

External linksEdit