Hirsutism, or intense growth of coarse, pigmented body hair due to excess production of androgens, develops in women in those areas of the skin where inconspicuous fluff hairs usually grow. This condition can be due to many reasons – from genetic characteristics to the onset of menopause, but most often the impetus for the development of hirsutism is tumors, in particular of the adrenal glands or ovaries. For many women, unwanted hair with hirsutism causes more serious psychological complexes, interferes with the establishment of family and social life, therefore, hirsutism requires qualified help from doctors of various specialties – including cosmetologist, endocrinologist, gynecologist, psychotherapist.

The term “hirsutism” usually describe a condition in which in women the growth of hair on the face and body occurs in the same way as in men after puberty – that is, in androgen-dependent zones. We are talking about terminal hair growing on the upper lip and cheeks, on the chin, chest, back, in the lower abdomen, on the inner thighs and lower legs. In the normal state of the body, only vellus hair grows in these parts of the body in women.

Different regions have different ideas about what condition is considered hirsutism. So, for example, a condition that is considered normal for women in the Mediterranean region and the Caucasus, may be a pathology for residents of Northern Europe.

Causes of hirsutism and symptoms of the disease

In hirsutism, the essence of the problem that leads to excessive growth of coarse pigmented hair on areas of the body that are atypical for a woman, usually lies in the fact that under some conditions the body begins to produce too much male sex hormones – androgens or excessive sensitivity to these hormones of hair follicle receptors in certain areas. At the same time, under the influence of androgens, fluffy non-pigmented hairs are transformed into rod and dark ones.

Hirsutism can develop under the following conditions:

  • polycystic ovarian syndrome, ovarian tumors;
  • hyperplasia of the adrenal cortex and disorder of their functions, tumors of the adrenal glands;
  • disorders of the pituitary gland functions (Itsenko-Cushig's disease, acromegaly, some other diseases);
  • genetic hirsutism due to chromosomal features;
  • taking drugs that can stimulate increased production of androgens (corticosteroids, anabolics, some types of antibiotics, antiepileptic drugs);
  • idiopathic androgen excess syndrome, when there is increased sensitivity of hair follicle receptors and skin cells to androgens;
  • some physiological states of the body when the ratio of estrogens and androgens changes in it (pregnancy, menopause).

Among the most striking and characteristic symptoms of hirsutism are the following:

  • growth of coarse dark short hair on the body (according to the male type of hair growth);
  • disorder of menstrual function;
  • increased greasiness of hair and skin, development of acne;
  • alopecia.

Hirsutism can be complicated by infertility, anemia, and sometimes even pathological uterine bleeding.

Treatment of hirsutism: challenges, hopes and prognosis

Hirsutism is, as a rule, not an independent disease, but a manifestation of some internal pathology. Therefore, the treatment of hirsutism is aimed, first of all, at eliminating this primary factor – for example, removing an adrenal tumor, stopping a hair-growth drug, treating PCOS.

Hirsutism drug therapy is prescribed after the possibility of androgen-secreting tumors has been excluded. Systemic treatment includes corticosteroids, the use of – androgen receptor antagonists, as well as those that inhibit 5-alpha reductase, cause suppression of ovarian function.

In PCOS, oral contraceptives, clomiphene, spironolactone can be effective in suppressing excess secretion of androgens. In case of congenital adrenal hyperplasia and associated hirsutism, cortisol, prednisolone are prescribed.

It should be remembered that treatment can prevent or slow down the appearance of new hair, but does not get rid of existing ones. Some cosmetic methods help to fight unwanted hair with hirsutism:

  • discoloration;
  • photoepilation;
  • laser hair removal.

The patient should be warned that trying to get rid of unwanted hair in hirsutism by constantly plucking or shaving it can lead to scarring and is fraught with the possibility of infection.

The treatment of hirsutism is quite painstaking and lengthy, the effect of it becomes noticeable not earlier than after six months, and sometimes much later. It is impossible to completely get rid of the growth of excess hair with hirsutism, but it is quite possible to significantly slow down their growth and make them as invisible as possible.

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