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Hirsutism - a Cosmetic Challenge

Author: Dr. Suvash Sahu - Skin and Beauty  

Contents


Hirsutism is the presence of excessive hair in androgenic dependent areas of the female body. The condition is a marker for androgen excess, although many women have no detectable hormone abnormalities. In addition to androgens secreted into the circulation by the adrenal glands and ovaries, peripheral fat also gets converted into circulating androgens, of which the most important is testosterone.

An individual may have other features of androgen excess along with hirsutism like acne vulgaris or androgenic alopecia and evidence of PCOS (Polycystic Ovarian Syndrome) such as irregular menses or infertility.

Causes of Hirsutism:

  1. Polycystic ovarian syndrome is seen in 60 % of cases.
  2. Idiopathic, which means no cause found out in 10 % of cases.
  3. Birth abnormalities like congenital adrenal hyperplasia.
  4. Other endocrine disorders like Cushing's disease and thyroid disease.
  5. Drug-induced such as oral contraceptive, anabolic and androgenic steroids, and antiseizure medicine.
  6. Gestational, which means pregnancy induced.

Investigation:

In case of mild hirsutism with regular menses and no other features of androgen excess such as acne vulgaris or androgenic alopecia or PCOS, no investigation is needed.

In case of moderate hirsutism with or without menstrual abnormalities - serum testosterone and SHBG (sex hormone-binding globulin) should be measured during the second day of menses as well as dehydroepiandrosterone (DHEA) level of LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone) should also be estimated. The ratio of LH and FSH more than 2:1 indicates PCOS.

Treatment of Hirsutism:

  1. Intense pulsed light and laser hair removal have dramatically altered the outlook of the patient.
  2. Topical agents like Eflornithine cream slows down the hair growth after six to eight weeks of twice daily use but may cause local irritation.
  3. Oral therapy such as oral contraceptive pills. Anti-androgens and 5-Alpha-reductase inhibitors are the mainstays of medical treatment.

Home Remedies:

You can try removing the excessive hair by plucking, shaving, or waxing it. Or you can try using commercially available hair removal creams. Some women choose to bleach unwanted hair, as bleaching makes the hair lighter and not visible.

To know more about hirsutism, consult a hirsutism specialist online --> https://www.icliniq.com/ask-a-doctor-online/endocrinologist/hirsutism

Image: Hirsutism - a Cosmetic Challenge Last reviewed at: 25.Dec.2018

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