Hormonal imbalances are linked to various medical conditions and uncomfortable symptoms. One of them is hirsutism or excessive facial and bodily hair growth. Though it doesn’t cause pain and isn’t life-threatening, hirsutism can have a damaging psychosocial impact and lead to anxiety and depression.
This article explains what hirsutism is, how to recognize the symptoms, and how to manage the condition.
Hirsutism is a relatively common condition in women (5-10%) that causes excessive growth of dark, coarse hair in areas where women typically have soft, non-pigmented, and undetectable vellus hairs or “peach fuzz.”
In most cases, hirsutism appears because of elevated levels of androgen (male) hormones, which cause hair follicles to grow faster. It also arises when hormonal levels are normal if a woman’s hair follicles are abnormally sensitive to androgens.
Hirsutism is a chronic disorder requiring long-term treatment.
Hirsutism predominantly affects women. It may exist in men, but it is difficult to recognize the condition because the patterns of hair growth are generally in line with what is considered typical for males.
Hirsutism affects women of all ages after puberty, but especially women of reproductive age.
The rate of incidence seems to be higher in some ethnic groups (Mediterranean, Middle Eastern, and South Asian) and overweight patients.
Excessive hair growth due to hirsutism appears in areas where women typically don’t have noticeable hair. They include:
Hirsutism is usually a sign of an underlying medical condition. It is often accompanied by other symptoms, including:
Most hirsutism patients have an underlying medical condition that causes excessive hair growth. Doctors also recognize idiopathic hirsutism – a condition without a known cause.
PCOS is the most common cause of hirsutism, present in three out of four hirsutism patients. It is a hormonal disorder causing cysts to grow on the ovaries. Symptoms also include irregular periods, and excess androgens, leading to male-pattern hair growth. Other PCOS symptoms are acne, weight gain, infertility, and thinning or balding hair on the scalp.
Often mistaken for PCOS, congenital adrenal hyperplasia is an inherited disorder of the adrenal glands caused by specific enzyme deficiency. It is characterized by low cortisol and high androgen levels. It is prevalent in Central European and Ashkenazi Jewish populations. Symptoms that often accompany hirsutism include acne, alopecia, infertility, and irregular or missing menstrual cycles.
Cushing’s disease is usually the result of a benign pituitary tumor causing excessive production of cortisol and androgens. Raised levels of these hormones also lead to weight gain (particularly in the face), high blood pressure, irregular periods, and abdominal striae.
Note: Learn how to lower cortisol levels naturally.
Ovarian and adrenal tumors may be responsible for excessive hair growth in women. They are rare and have potentially fatal consequences so it is important to do diagnostic tests to rule them out. Unlike common medical causes of hirsutism, androgen-secreting tumors cause sudden excessive hair growth that progresses quickly. Other symptoms include a deepening of the voice, increased muscle size, an enlarged clitoris, and breast atrophy.
Low estrogen and high testosterone production in perimenopause and menopause can lead to hirsutism, especially on the face.
Note: Learn how perimenopause and premenopause differ so you can recognize their stages and better care for your health.
Certain medications can cause excessive hair growth. They include:
About 10% of patients with excessive male-pattern hair growth experience idiopathic hirsutism. They have no other accompanying symptoms, and their androgen levels are normal. Scientists speculate that increased follicle sensitivity to androgens may explain idiopathic hirsutism. Doctors usually don’t prescribe treatment.
Some factors increase the risk of excessive hair growth. They include:
The evaluation of patients with excessive hair growth consists of a physical examination and tests, such as blood work and diagnostic tests. Doctors also take a detailed medical history and other relevant information from the patient.
The healthcare provider first examines the patient’s hair growth distribution to determine whether it grows in androgen-affected areas and whether it is hirsutism or some other condition (e.g., hypertrichosis). The doctor also considers the patient’s medical and medication use history, checks for accompanying symptoms, and inquiries about the onset rate. After establishing hirsutism, the doctor orders blood and diagnostic tests to determine the cause.
Blood tests measure the patient’s hormone levels, helping to establish medical conditions that often cause hirsutism (e.g., diabetes, PCOS, pituitary tumor, etc.). Evaluated hormones include testosterone, cortisol, TSH, prolactin, luteinizing, and follicle-stimulating hormones.
Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) scans examine the ovaries and adrenal glands, helping to detect cysts and tumors. Doctors order them if physical examination or lab tests indicate the potential presence of abnormal growths on reproductive or adrenal organs.
Losing weight and other lifestyle modifications may help improve hirsutism, but it is not possible to prevent it.
Some patients develop hirsutism due to hormonal imbalances influenced by lifestyle factors (weight gain, lack of exercise, stress, etc.). In such cases, a balanced diet, regular physical exercise, and improved lifestyle habits help manage the symptoms and potentially reduce the severity of excessive hair growth. However, other underlying causes, such as genetic and endocrine disorders, require medical intervention.
Treating hirsutism is a long process that requires patience and specific treatments that vary from patient to patient.
All treatments include a hair removal method. Patients with mild symptoms may not need other treatments besides an adequate hair removal procedure. More severe symptoms require a combined pharmacological and cosmetic approach.
Some hair removal treatments provide short-term relief from excessive hair growth, while others last longer but cost more.
Laser hair removal is one of the most effective ways to enjoy smooth, hairless skin over long periods. The treatment involves sending light from a laser device to hair follicles, damaging or destroying them when light turns to heat under the skin. Patients need at least six treatments over one or two years, after which the hair growth is significantly reduced. Laser hair removal is most effective in patients with dark hair and light skin.
At Vibrant Skin Bar, the treatment costs $150-$350, depending on the treatment area size.
Electrolysis is another long-term hair removal option. In some cases, the results are permanent. It involves inserting a tiny needle into each hair follicle and applying an electric current to destroy the hair root. This precise method targets individual hair follicles, so it is typically used on smaller areas. It is ideal for patients with light-colored hair.
Note: Compare electrolysis with laser hair removal to choose the right treatment for you.
Shaving involves removing unwanted hair with a razor. It is the quickest, cheapest, and most common hair removal method at home. However, shaving provides the shortest-living results. Some patients with hirsutism need to shave twice daily.
Plucking is another at-home hair removal method. It involves removing the hair from the root with tweezers. It is longer-lasting than shaving but not practical for larger body areas.
Waxing can be performed at home or in a cosmetic salon. The hair is removed with wax strips that are applied on the skin and pulled in the opposite direction of hair growth. This method is suitable for larger areas, but it is more painful than shaving and plucking.
Bleaching involves applying bleaching products on unwanted hairs, lighting their color and making them less noticeable. This method is suitable for light-colored people but may irritate the skin.
Depilatory creams or gels are applied on the target area and removed after a specific period, usually within ten minutes. The hairs fall off when the cream is removed. This is a painless but short-lived hair removal method. It may also cause skin irritation.
Patients with more severe hirsutism usually require medication therapy. The most common medications for excessive hair growth are birth control pills and anti-androgen medications. Sometimes, doctors prescribe medical creams that slow down hair growth.
Oral contraceptive pills contain estrogen and progesterone, helping balance the patient’s hormones and reduce hair growth. They are suitable for patients who are not planning pregnancy.
Note: Learn more about hormone therapy and how you may benefit from it.
These medications block androgen receptors and decrease androgen production, resulting in slower, reduced hair growth.
Doctors sometimes prescribe topical eflornithine to slow hair growth. The cream is licensed for use on facial hair, which it significantly shrinks. Note that it doesn’t remove hairs but makes them less coarse and visible.
These are some of the most asked questions about hirsutism.
The results of hirsutism treatments depend on the treatment type. Cosmetic procedures provide immediate results, but their longevity varies.
Medication therapy results are usually noticeable after at least three to six months and sometimes longer. In many cases, the medications don’t remove hair but stop, thin, or slow down new hair growth. These effects can be seen after several months.
In mild cases, especially when hirsutism is the only symptom and hormonal levels are normal, not treating the condition results only in continuous excessive hair growth.
However, most cases of hirsutism have an underlying medical condition, which can lead to the worsening of symptoms if left untreated. For example, not treating PCOS (the most common cause of hirsutism) can lead to infertility, diabetes, heart disease, and cancer.
Excessive hair growth in areas not typical for women is often a sign of a medical issue. Visit a dermatologist or endocrinologist to establish the cause of your hirsutism, especially if you notice a rapid progression of excessive hair growth and other symptoms that accompany hirsutism, such as hormonal acne, a deeper voice, decreased breast size, irregular or missing periods, etc.
Hirsutism isn’t a life-threatening symptom. However, it negatively impacts women’s psychological well-being and may lead to more severe health complications if left untreated.
Don’t wait to care for your health. Contact our medical team at Vibrant Vitality Clinic to help you manage excessive hair growth, treat any underlying health problems, and find a suitable hair removal method to feel good again.
4325 E Indian School Rd, Suite 130
Phoenix, AZ 85018
United States
(480) 422-2058
info@vibrantvitalityclinic.com
Monday - Friday: 9:00 am - 6:00 pm
Saturday: 9:00 am - 3:00 pm
Sunday: Closed
