Excessive or unwanted hair in women

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Definition

Most of the time, women have fine hair above the lips and on the chin, chest, abdomen, or back. The growth of coarse dark hairs in these areas (more typical of male-pattern hair growth) is called hirsutism.

Alternative Names

Hypertrichosis; Hirsutism; Hair - excessive (women); Excessive hair in women; Hair - women - excessive or unwanted

Causes

Women normally produce low levels of male hormones (androgens). If your body makes too much of this hormone, you may have unwanted hair growth.

In most cases, the exact cause is never known. The condition often runs in families.

A common cause of hirsutism is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormone conditions that cause unwanted hair growth may also have acne, problems with menstrual periods, trouble losing weight, and diabetes. If these symptoms start suddenly, you may have a tumor that releases male hormones.

Other, rare causes of unwanted hair growth may include:

  • Tumor or cancer of the adrenal gland
  • Tumor or cancer of the ovary
  • Cushing syndrome
  • Congenital adrenal hyperplasia
  • Hyperthecosis (a condition in which the ovaries produce too much male hormones)
  • Use of certain medicines, including testosterone, danazol, anabolic steroids, DHEA, glucocorticoids, cyclosporine, minoxidil, and phenytoin

Rarely a woman with hirsutism will have normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified.

Symptoms

The main symptom of this condition is the presence of coarse dark hairs in areas that are sensitive to male hormones. These areas include:

  • Chin and upper lip
  • Chest and upper abdomen
  • Back and buttocks
  • Inner thigh

Exams and Tests

  • Serum testosterone
  • Serum DHEA sulfate
  • Pelvic ultrasound if virilization is present
  • CT or MRI if virilzation is present
  • 17 hydroxyprogesterone level
  • ACTH stimulation test

Treatment

Hirsutism is generally a long-term problem. There are many ways to remove or treat unwanted hair. Some treatment effects last longer than others.

  • Medicines. Drugs such as birth control pills and anti-androgen medicines an option for some women.
  • Electrolysis. Electrical current is used to permanently damage individual hair follicles so they do not grow back. This method is expensive, and multiple treatments are needed. Swelling, scarring, and redness of the skin may occur. . Laser energy directed at the dark color (melanin) in the hairs. This method is best for a large of very dark hair. It does not work on blond or red hair.

Temporary options include:

  • Shaving. Although this does not cause more hair to grow, it may make hair look thicker.
  • Chemicals, plucking, and waxing. These options are safe and inexpensive. However, chemical products may irritate the skin.

For women who are overweight, weight loss may be able to reduce hair growth.

Outlook (Prognosis)

Hair follicles grow for about 6 months before falling out. Therefore, it takes many months of taking medicine before you will notice a decrease in hair growth.

Many women get good results with temporary steps to remove hair or lighten it.

Possible Complications

Most of the time hirsutism does not cause health problems. But many women find it bothersome or embarrassing.

When to Contact a Medical Professional

Call your health care provider if:

  • The hair grows rapidly
  • You also have male features such as acne, deepening voice, increased muscle mass, male pattern thinning of your hair, and decreased breast size
  • You are concerned a medicine you are taking may be making the growth of unwanted hair worse.

References

Camacho-Martinez FM. Hypertrichosis and hirsuitism. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 70.

Bulun SE. Physiology and pathology of the female reproductive axis. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 17.

Habif TP. Hair diseases. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 24.

Version Info

  • Last reviewed on 11/10/2013
  • Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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