Hirsutism is a condition that most often affects women. It’s classified by excessive dark, course hair on the face and areas of the body that you’d more often see in males. This can include hair on the back, neck, face, chest, and other areas that you wouldn’t typically expect in females. This is because the excess hair is caused by the female body over producing male hormones, called androgens.
Whilst all humans are covered in fine and almost invisible vellus hairs, hirsutism causes terminal hair growth which is often far more noticeable, and can have a negative impact on a woman’s self-esteem and mental health.
Hair removal methods such as shaving and waxing are commonly used amongst women who suffer with hirsutism, though these can be time consuming and need regular maintenance, leading many to consider the use of prescription medications.
Hirsutism in pre-menopausal women is most commonly caused by polycystic ovary syndrome, and in these cases, your doctor will want to treat the underlying condition rather than the symptom of excess hair growth. However, many treatments for PCOS can also reduce the appearance of excess hair, and can be used in conjunction with some other treatments.
"Hirsutism isn’t a serious condition, but it can be chronic and have a negative effect on a woman’s mental health. There are several treatment routes that a patient might choose, and these can be used alongside home hair removal methods. Hirsutism is usually caused by an underlying condition, so do see your GP for blood tests as you may need other treatment."
What is Hirsutism?
Hirsutism is the growth of excess hair in certain areas of the body. It mostly affects women, leaving them with male-pattern hair growth. Whilst the condition isn’t life threatening, it can have a serious impact on a woman’s mental health, often leading to body dysmorphic disorder (BDD), where a person spends a lot of time worrying about their appearance.
Whilst everyone has fine, light, almost invisible vellus hairs all over their body, women experiencing hirsutism grow thick, course and dark terminal hairs in areas you’d expect on a male. For example, the most common areas a woman with hirsutism may grow hair are the face, arms, neck, chest, abdomen, nipples, upper lip, back, buttocks and thighs.
Hirsutism is different to just being hairy. It’s a medical condition which is diagnosed from a physical examination and often blood tests to check for underlying conditions. Many women have more body hair than they would like, and genetics do play a part in this, but not all women who perceive themselves to be hairy have hirsutism.
What are the symptoms of Hirsutism?
The main symptom of hirsutism is noticing dark, course hair on places where you wouldn’t usually expect to see it on a woman. This can include the face, neck, chest, and other areas. Depending on the underlying cause of your hirsutism, you may also experience:
- Hair loss on the scalp
- Warts within skin folds
- Unexplained increase in sex drive
- Deepened voice
- Increased muscle mass
- Irregular or absent periods
- High levels of insulin
There’s nothing to say you will experience all of the above symptoms, but if you notice any of them alongside excess face and body hair, it may indicate another condition which your GP will need to determine before you begin treatment.
What causes hirsutism?
Hirsutism is caused by the overproduction of androgens (male hormones), and it’s the most common underlying condition that causes the excess hair is polycystic ovary syndrome (PCOS). All women produce a small amount of androgens in their body, but when these levels are elevated, or there’s an overproduction of hormones such as testosterone, this is where you may start to notice symptoms including excess hair. To determine whether this is the underlying cause, a doctor will refer you for a blood test to check the amount of male hormones your body is producing, and they may also request an ultrasound scan of your pelvis to see if there are any cysts on your ovaries.
Other common causes of hirsutism include:
- Cushing’s syndrome
- Congenital adrenal hyperplasia
- Anabolic steroids
- A tumour that increases the production of androgens
Several hormones are produced by the adrenal glands, so any disorder that affects these and makes them overproduce androgens can cause hirsutism.
Sometimes, hirsutism might not have a definite cause as some women just seem to grow excess hair with age. The condition is fairly common in post-menopausal women, possibly due to the production of oestrogen slowing down and causing a new balance of hormones in the body.
Treatments for Hirsutism
There are several different ways to treat hirsutism, and each method has its benefits and downfalls. Most women just want to reduce the appearance of their excess facial hair, so home removal methods such as waxing, shaving, plucking and bleaching are often used for this purpose. However, these methods don’t remove the problem itself, and only temporarily solve the problem. Home hair removal methods need to be carried out regularly, and for some women it can be an added stress to their daily routine, especially when regrowth begins to show.
Prescription treatments are also available to reduce the appearance of excess hair:
- Vaniqa cream (eflornithine): Vaniqa cream has the active ingredient Eflornithine, which reduces the rate of hair growth. Vaniqa should only be used on the face, and whilst it can’t remove hair that’s already there, many women find that it reduces the appearance of their unwanted facial hair and are satisfied with the results. You can buy Vaniqa cream online through Doctor4U, subject to doctor approval.
- Contraception: for women that don’t want to conceive, prescribed contraceptive pills may be the way forward. Dianette is often a suitable treatment, as co-cyprindiol blocks the effects of androgens in the body, treating the cause behind the hirsutism. Many women using this treatment find that it solves the problem, but it’s only recommended until the symptoms disappear, as long-term use of Dianette can increase your risk of blood clots. If your symptoms return, your GP may suggest a different kind of contraceptive.
- Metformin: for women with PCOS, metformin may be prescribed. Although metformin isn’t licenced for the treatment of hirsutism, it can combat insulin resistance; something that’s often present in women with PCOS.
Other medications that may treat hirsutism include:
- Gondatrophin-releasing hormone
Like with metformin, many of these are unlicensed for hirsutism, but some doctors believe they could be effective at targeting the problem, and may prescribe them if a patient hasn’t responded to all other avenues of treatment and only if it’s absolutely appropriate.
How long will it take to see results?
With a lot of medications, it can take several weeks to a few months to notice any changes in your condition. Whilst this may be disheartening, it shouldn’t be a reason to stop treatment within the first few weeks. Patience is needed with a condition like this, but the good news is that whilst you’re waiting for the prescription medicine to start showing results, you can use traditional removal methods as mentioned above.
Another effective way of reducing the appearance of excess body hair is through IPL treatment. This involves pulses of light from a machine being directed at the hair follicles. However, IPL only works with certain skin tones and hair types, and again, the results may be long-lasting but unfortunately not permanent.