Although many people have seen the manifestations of it, not too many have heard for the medical condition called Hirsutism. What exactly is Hirsutism? Well, it is defined as the excessive growth of thick dark hair in locations where hair growth in women normally is absent. In other words- it represent a male-pattern growth of terminal body hair seen in women. What%26rsquo;s also characteristic- it usually occurs in androgen-stimulated locations, such as the face, chest, and areolae. Good thing to know is that it represents a benign condition with only cosmetic complications. However, it is also important to point out that sometimes this condition isn't isolated! It can be a sign of some serious hormonal disorders, especially when it is accompanied by masculinizing signs. What's also characteristic- this condition is difficult to evaluate in women who have blond hair or who already have had cosmetic treatments such as depilation or hair whitening.
Hirsutism and hypertrichosis
Many people, even doctors, use terms hirsutism and hypertrichosis as synonyms but this isn't exactly right. Although the terms hirsutism and hypertrichosis often are used as two same things, the fact is that hypertrichosis actually refers to excess hair in areas that are not predominantly androgen dependent. That%26rsquo;s the main difference although the areas covered with hair can match; in which case- these two would really be the two same things.
Incidence of the condition
Several researches done in the past have shown that, when talking about women in the US, hirsutism is common and is estimated to occur in 1 in 20 women of reproductive age. When we talk about international proportions, then we should know that inherited familial hirsutism is found mostly in southern European and South Asian. How come? Well, the fact is that in these cases hirsutism is nothing more than a symptom of underlying endocrinopathy. Because hirsutism is a symptom, rather than a disease we simply can%26rsquo;t talk about mortality. Like we have already mentioned- it represents primarily a cosmetic and psychological concern.
If we talk about the age onset of the condition/disease, then we should know that it typically begins during puberty. In the case of underlying disease (such as congenital adrenal hyperplasia), this type of hirsutism begins early in childhood. It is also important to point out that the growth of facial hair commonly observed in postmenopausal women may be caused by unopposed androgen.
If we talk about the age onset of the condition/disease, then we should know that it typically begins during puberty. In the case of underlying disease (such as congenital adrenal hyperplasia), this type of hirsutism begins early in childhood. It is also important to point out that the growth of facial hair commonly observed in postmenopausal women may be caused by unopposed androgen.
Normal hair growth
Now, let we hear some interesting facts about the normal body hair growth. Like we already know, human body is almost completely covered with hair. Exceptions are: the lips, the palms of the hands and the soles of the feet. How many hair follicles we have depends only on our genetic predisposition. Important thing to point out is that there are 2 types of hairs:
%26middot; Terminal hairs %26ndash; these hairs are usually thicker and found on eyebrows and head hair
%26middot; Vellus hairs %26ndash; these hairs are fine, light and later transformed into terminal hairs when exposed to androgens
Although it sounds impossible- the fact is that women have the same number of hairs on their bodies and faces as men do. There is only one difference. Later in life, male hormone, testosterone, makes hairs grow thicker, darker and longer, so that they appear more noticeable. Although even women produce small amounts of testosterone, this low level of this male hormone allows terminal hairs to appear in the pubic, axillary and nipple areas. This is completely normal and happens around puberty.
Possible causes of Hirsutism
Although most women always look at this condition as a sigh of something much more serious, this is far from correct! Several researches done in the past have confirmed that women with mild hirsutism and regular periods rarely have any underlying serious medical problem. Some of the most common possible causes of hirsutism are listed below.
1. Inherited condition
What's very important to know is that, in the great majority of hirsutism cases- the condition is simply inherited and may be present in other female relatives in the same family trait. It is also interesting to point out that most of these women have normal amounts of testosterone. How come? Well, it%26rsquo;s simple- problem isn't in the hormone, but in hair! In these cases- the hairs are more sensitive to small amounts of male hormone and so grow more quickly and thicker.
2. Racial
A racial causes of hirsutism are also noted because, some races, for example dark haired women from Mediterranean countries, have the highest incidence of this condition.
3. Polycystic Ovarian Syndrome (PCOS)
Well, like it is already mentioned, a very common cause of hirsutism is also a PCOS or Polycystic Ovary Syndrome. It is well known that this condition is also associated with other symptoms such as acne, irregular periods, infertility and obesity.
4. Drugs
Some of the most common medications which can cause hormonal imbalances and hirsutism are:
Phenytoin (Epanutin) %26ndash; most common medication used in the treatment of epilepsy
Cyclosporine %26ndash; one of many medication commonly used after some organ transplant
Anabolic Steroids - used all around the world by athletes and body-builders
Minoxidil %26ndash; This is famous medication used in the treatment of high blood pressure and baldness
5. Hormonal imbalances- overproduction of androgens
Although women in generally produce small amounts of androgens. Locations of this androgen production are:
%26middot; the adrenal glands
%26middot; the ovary
%26middot; fat and muscle tissue
Any problem with these organs can cause hormonal imbalance and hirsutism!
6. Congenital Adrenal Hyperplasia
Congenital Adrenal Hyperplasia is one hereditary condition which affects the adrenal glands and makes them produce male-type hormones in big quantities! In generally, it is a problem with producing the Cortisol. Problem is also that it is often not diagnosed until teenage years or later in adult life.
Hirsutism treatment
Several researches done in the past have shown that simple weight losing reduces the amount of hormones in woman%26rsquo;s body that cause increased hair growth. There are also some other successful ways to eliminate the excess hair. Some of the most common are:
%26middot; Shaving %26ndash; definitely the safest and easiest method of removing hair
%26middot; Depilatories, or creams that remove hair
%26middot; Bleaching paste
%26middot; Electrolysis
%26middot; Laser hair removal
Medications
Important thing to point out is that, in fact, there really are some medications that doctor can prescribe in order to control male hormones that cause hirsutism. These medications are called anti-androgens! The fact is that these anti-androgens usually take at least 3 to 6 months to work. Besides these anti-androgens, there is also a drug made specifically to slow down the growth of facial hair and it can be bought as a prescription cream that you apply to the affected skin on your face and chin.
%26middot; Dianette
This medication contains estrogen. Everyone has heard about it because it is normally found in contraceptive pills. Beside estrogen it also contains low dose of Cyproterone. However, it should be noted that this medication may not suit everyone, especially older women. Side effects are possible like with any other drug and they are: bleeding between periods, tender breasts, nausea and headaches%26hellip;
%26middot; Cyproterone
It is important to know that this medication is chemically and anti-androgen, which means that it normally counteract male hormones. There is one thing that every woman should know if she%26rsquo;s planning to use this drug; it is necessary to prevent pregnancy during and for up to 6 months following treatment with anti-androgens as they have potential to damage a developing baby. This is important to know! To avoid this from happening- Cyproterone must be used along with an oral contraceptive pill.
%26middot; Spironolactone
Almost everyone has heard about Spironolactone which belongs to the group of is a weak diuretic medications! Diuretics are medications used in order to stimulate the kidneys to excrete water! It is also found that this drug has some anti-androgen activity. It should also be taken along with an oral contraceptive pill to avoid pregnancy.
%26middot; Metformin
This is also one very famous drug used in controlling the symptoms of diabetes- one very serious hormonal disorder. Some recent studies have showed that Metformin, beside anti-diabetic properties has also some useful properties beneficial in women with polycystic ovarian syndrome. It should be noted also that there are some side effects that could occur and the main side effects of Metformin are nausea, abdominal cramps, flatulence and constipation.
%26middot; Eflornithine
This medication comes in a form of cream which should be applied twice daily. Several patient-based studies have showed that it can slow the growth of facial hair by inhibiting a key enzyme involved in hair growth.
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