Hirsutism (Constitutional or Male-Pattern Hirsutism)

Hirsutism is the medical term for excessive hair, or hairiness, particularly in women. When a woman grows hair on her face, trunk, and limbs that is similar to a man's, the condition is called male-pattern hirsutism. Humans appear to be fairly hairless, but in reality we have as many hair follicles as apes. However, most human follicles produce velius hair, which is colorless and fine. Some velius hair, though, is convened into the coarser, more visible terminal hair during puberty, when testosterone -- a male sex hormone -- stimulates its growth. Males produce more testosterone than females, thus, men normally have more visible facial and body hair.

Excessive hair growth does not always signal a medical problem. It may be seen instead as constitutional hirsutism, or hair growth that is normal for a person's age or racial and ethnic heritage. Women of Mediterranean and Near Eastern ancestry, for example, have more visible hair than their North European counterparts. Caucasians have more hair than Africans, and both Asians and Native Americans have less than other peoples.

Following menopause, women normally grow more facial hair. But the sudden development of male-pattern hirsutism in a younger woman often indicates an imbalance of sex hormones, especially if there are other signs of virilization, such as a deepening of the voice and increased muscle growth. Porphyria, a genetic disease marked by extreme sun sensitivity, can cause hirsutism, as can tumors of the ovaries or adrenal glands. If a cause cannot be identified the condition is called idiopathic hirsutism.

In both sexes, hirsutism may develop from certain medications. These include prednisone and other corticosteroids; phenytoin (Dilantin), an anticonvulsant medication; and minoxidil (Loniten), an antihypertensive agent.

Diagnostic Studies and Procedures

A general physical examination will reveal the extent and pattern of hairiness, as well as any signs of masculinization. Specific tests will be done to rule out an underlying medical cause. A gynecological examination, including a pap smear, should be done. The ovaries may be examined at that time for abnormalities, and vaginal and cervical cells may also be analyzed to determine whether normal amounts of female hormones are being produced. In addition, a urine analysis may be ordered, and blood tests to study hormone levels, especially testosterone.

If a hormone-producing tumor is suspected, ultrasonography and a CT scan may be recommended. When an ovarian tumor is a possibility, laparoscopy -- an examination using a viewing instrument inserted through a small incision near the navel -- may be ordered.

Medical Treatments

When constitutional hirsutism is the problem, no medical treatment is required. Treatment of male-pattern hirsutism depends upon the underlying cause. If there is excessive production of testosterone, spironolactone (Aldaclone) may be prescribed to block it. Surgery may be necessary if a hormone - producing tumor is present. When surgery is not possible, it may be destroyed by radiation therapy.

Removing the underlying cause of hirsutism will halt the conversion of velius to terminal hairs, but it will not eliminate existing unwanted hair. Physical removal is necessary.

Alternative Therapies

Electrolysis. This is the only permanent method of hair removal. It is a time-consuming procedure that requires a skilled operator, known as an electrologist. Each hair is removed by the insertion of a fine probe into the hair follicle. An electrical current of low voltage passes through the probe and destroys the hair root.

Nutrition Therapy. If obesity is contributing to a hormone imbalance that is causing excessive hair growth, a qualified nutritionist can devise a long-term weight-loss program.

Self-Treatments

There are numerous ways to remove unwanted hair temporarily or to make it less noticeable.

Bleaching. This makes hair less visible. Use a commercial product or make your own by mixing one ounce of 6-percent hydrogen peroxide, 10 drops of household ammonia, and enough baking soda to form a paste. Before using the mixture, do a small patch test on the inside of your wrist.

Depilatories. These chemicals dissolve hair into a gelatinous mass that can be removed with a washcloth. Do a patch test and follow instructions carefully.

Plucking. This is a quick way to remove small amounts of body hair temporarily. Use care, however, as plucking can injure follicles and trigger infection, especially on the face.

Shaving. This is the quickest and most widely used method for removing hair from the underarms and legs. Although men regularly shave their faces, women hesitate to do so, as they mistakenly think that shaving will stimulate the growth of their hair. It only appears to, because all of the shaved hair grows back at the same time.

Waxing. Warm melted wax is applied to the skin, allowed to cool, and then peeled off, taking with it any embedded hairs. Wax treatments are available in salons and there are also wax products for home use.

Other Causes of Hairiness

Thyroid disease, ovarian cysts, and pituitary tumors are among the endocrine disorders that can cause excessive hairiness.