Hirsutism
What Is Hirsutism?
Hirsutism is excessive growth of terminal hair in a typical male pattern in a female. It is typically a sign of excessive androgen levels. Hirsutism has been reported in 5% to 15% of women and is often associated with decreased quality of life and significant psychological stress.
Types Of Hair And Hair Cycle
There are three types of hairs:
Lanugo – which is soft hair on the skin of the fetus that disappears in utero or in the first few weeks of life.
Vellus Hairs – which are soft, small, and non-pigmented.
Terminal Hairs – which are longer, larger, coarser, and pigmented.
The hair follicle cycles through three phases: anagen, a period of rapid growth; catagen, a period of involution; and telogen, a period of rest and shedding of hair.
The duration of the anagen phase and rate of growth determine the length of hair and vary by type of hair and body region.
Hair type and distribution are dependent on androgens that cause transformation of vellus hairs to terminal hairs.
Androgens have a paradoxical response on the face and scalp: stimulating beard growth and inhibiting scalp hair growth lead to androgenic alopecia (male pattern baldness).
Causes of Hirsutism
- Polycystic ovary syndrome
- Idiopathic hyperandrogenism
- Idiopathic hirsutism
- Adrenal hyperplasia
- Androgen – secreting tumors
- Hyperprolactinemia
- Thyroid disorders
- Acromegaly
- Cushing syndrome
- Drugs – steroids, danazol, testosterone, cyclosporine
How To Diagnosis Hirsutism?
Hirsutism is a clinical diagnosis and diagnosed using the modified Ferriman – Gallwey scoring system consisting of nine androgen-sensitive body areas. A complete history and physical examination helps in detect signs of specific etiology. Women with hirsutism and menstrual dysfunction, infertility, or any physical examination findings suggestive of endocrine disorders should undergo further hormonal workup.
How Hirsutism Can Be Treated?
Lifestyle changes should be encouraged for patients with obesity, including those with PCOS.
Hormonal therapy – for those patients who have hormonal irregularities
Pharmacologic therapy should be avoided if the patient is pregnant or trying to become pregnant.
For idiopathic causes – shaving, plucking, waxing
These physical therapies may irritate the skin and cause dermastitis, scarring, folliculitis, and hyperpigmentation.
Laser for hair removal – the most popular procedure for long-term hair removal which destroys pigmented terminal hair follicles through thermal damage. Recent trials have shown that laser will help to reduce the hair growth upto 80%. These are simple procedure which are scheduled once in 4-6weeks for upto minimal 5-8 session.
Minimal side effects are there which can be avoided by following your dermatologists advice.
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