Hairiness

Hirsutism usually results from high levels of male hormones (androgens, such as testosterone) or from increased sensitivity to normal levels of male hormones in the body. Testosterone stimulates hair growth in the pubic area and underarms. Dihydrotestosterone stimulates hair growth in the beard area and hair loss at the scalp.

Conditions that tip the hormonal balance in favor of male hormones can cause hirsutism. The balance may be tipped by excess production of male hormones. However, in hirsutism that runs in families (familial hirsutism), women's hair follicles simply appear to be more sensitive to normal levels of male hormones.

The most common cause of hirsutism is

There are many less common causes of hirsutism ( see Table: Some Causes and Features of Hirsutism Some Causes and Features of Hirsutism ):

When hirsutism is caused by increased levels of androgens, women often have virilization.

Virilization Virilization Virilization is the development of exaggerated masculine characteristics, usually in women, often as a result of the adrenal glands overproducing androgens (male sex steroid hormones such as... read more is the development of other masculine characteristics in addition to excess face and body hair. For example

Hypertrichosis is caused by disorders that do not affect the levels of male hormones.

The most common causes of hypertrichosis are

Rarely, hypertrichosis is caused by a gene mutation. In such cases, it is usually present at birth.

In women with excess body hair, certain symptoms are cause for concern:

The sudden appearance of excess hair may suggest cancer.

If warning signs are present, people should see a doctor promptly. If excess hair appears gradually without warning signs, people should see a doctor, but the visit does not need to be scheduled as quickly.

In general, women without warning signs do not need to see a doctor if they have always had excess hair, they otherwise feel well, they have regular menstrual periods and no other masculine characteristics, and have family members who also have excess hair. Such women have excess body hair because it runs in their family.

Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause and the tests that may need to be done ( see Table: Some Causes and Features of Hirsutism Some Causes and Features of Hirsutism ).

Women are asked when hair began to grow excessively and where it is located, whether they have menstrual periods, and, if so, whether periods are regular. Doctors also ask whether women have had problems conceiving a child and whether any family members also have excess hair.

Doctors ask people about all the drugs they are taking, particularly anabolic steroids Anabolic Steroids Anabolic steroids are synthetic (man-made) versions of testosterone that are used to increase muscle size. Anabolic steroids are hormones that promote muscle growth and increase strength and... read more and other drugs known to cause hair growth.

During the physical examination, doctors note the pattern of hair growth and look for other masculine characteristics and for other features that suggest a cause. For example, a lump felt during the pelvic examination may suggest a tumor in an ovary.

Men who have no other signs of illness do not undergo further testing.

Women have blood tests to measure levels of various hormones and thus help identify the cause:

Ultrasonography and/or computed tomography (CT) or magnetic resonance imaging (MRI) of the pelvis is usually done to rule out pelvic or adrenal cancer, particularly if a lump is found in the pelvis or if testosterone or DHEAS levels are high. If a pituitary disorder is suspected, MRI of the head is done.

If Cushing syndrome Cushing Syndrome In Cushing syndrome, the level of corticosteroids is excessive, usually due to taking corticosteroid drugs or overproduction by the adrenal glands. Cushing syndrome usually results from taking... read more is suspected or an adrenal tumor is detected with imaging studies, urine tests are also done.

Several methods are available.

Depilation removes the part of the hair above the surface of the skin. Methods include shaving and over-the-counter creams, which may contain barium sulfate and/or calcium thioglycolate.

Epilation involves removing intact hairs with their roots. Methods to temporarily remove hairs include tweezing, plucking, waxing, and epilating devices used at home. Some methods have longer-lasting, sometimes permanent effects, but the treatments often must be repeated. These methods include electrolysis, thermolysis, and laser treatments Other methods In men, the amount of body hair varies greatly (see also Overview of Hair Growth), but very few men are concerned enough about excess hair to see a doctor. In women, the amount of hair that... read more .

Usually, hormones used to treat hirsutism must be taken for a long time because most of the disorders that cause high male hormone levels cannot be cured. These hormones include birth control pills and drugs that block the effects of male hormones, such as finasteride or spironolactone. Women who are pregnant or who could become pregnant should not take a drug that blocks male hormones because it can cause feminine characteristics to develop in a male fetus.

Gonadotropin-releasing hormone agonists (such as leuprolide) can be used if the ovaries are producing extremely high levels of male hormones, but use of these drugs requires close supervision by a gynecologist or an endocrinologist. Corticosteroids can be used to reduce levels of male hormones produced by adrenal gland tumors.

Bleaching is an alternative to hair removal. It is inexpensive and works well when women have only a small amount of excess hair. Bleaches lighten the color of the hair, making it less noticeable. Several types of hair-bleaching products are available. Most products contain hydrogen peroxide.

Eflornithine cream, applied twice a day, slows the rate of hair growth and, with long-term use, may increase the amount of time between hair removal treatments.