Excessive hair growth: the essential facts about hirsutism

Hirsutism literally means 'excessive hair growth' in an androgen-dependent (male distribution) pattern in women.

This condition refers to excess body hair in the beard area (chin and upper lip), on the stomach and around the nipples. It is thought to be prominent in 10% of the population, and is more common in women with dark hair, and those in certain racial groups, such as Mediterranean or Asian origin. It is also linked with the condition polycystic ovarian syndrome (PCOS).

Another word that can be used to describe excessive hair growth (but not in a male dependent pattern) is hypertrichosis.

What can your doctor do to help?

Hirsutism is very unlikely to be caused by a medical problem unless it commences before puberty. Your doctor may wish to check the hormone levels in your blood to be sure. You will need to see your doctor in the unlikely event of:

1. You have a sudden increase in body hair (rather than a gradual increase), especially if you are over 30

2. If you also develop other symptoms, including high blood pressure, thinning of the hair on your head or a deepening of your voice, rapid weight gain especially around your abdomen, with or without vivid stretch marks (striae) or a mass in your stomach (this is extremely rare)

3. If you are on any regular medications, because some, such as steroids, can increase hirsutism.

What treatments are available?

In rare cases where hirsutism is caused by an underlying hormonal disorder, the treatment is to correct the underlying disease. In most women, hirsutism increases very gradually over time and has no specific cause. It usually peaks following the menopause. For these women, treatment is to remove the unwanted hair or to make it less noticeable. All methods have their own limitations and can irritate the skin.

1. Self-care hair removal

Shaving: contrary to popular belief, shaving does not increase hair growth. It does however cause stubble on regrowth which may be undesirable. Waxing /epilation depilatory creams: these dissolve the hair shaft, but can irritate the skin. Bleaching: this method will lighten the hair colour, but may not suitable for darker skin types.

Other hair removal options:

Electrolysis: an electrical current is passed into a hair follicle through a needle. The aim is to destroy the hair root permanently, but this method can be expensive and time-consuming

Laser removal : this can be effective for larger areas, but is costly. Its effects can be long-lasting in some people, but it is not usually permanent. It works better on individuals with dark hair.

2. Medical treatments

Eflornithine cream is licensed to be used in women with hirsutism and is thought to slow hair growth down. It is available on the NHS in some areas, but only in certain situations.

Anti-androgen medications

Some combined oral contraceptive pills (these are not suitable for everyone)

Some women try other medications, including cyproterone,finasteride and spironolactone, usually on the advice of a specialist.

An important side effect of all anti-androgen drugs is that they can harm an unborn male baby if you take them while you are pregnant. For this reason, they must not be taken unless you are using effective contraception.

Hirsutism is rarely a medical worry, but due to social pressures, it often causes a lot of distress to the individual. Please speak to your GP if you are struggling, or feeling down or need more advice.

References/sources:
Information taken from the British Association of Dermatologists: Healthy skin for all


Dr Jennifer Kelly is a GP and founder of the Grace Kelly Ladybird Trust (for awareness and research into childhood cancers).