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* [http://www.hairchick.com/excess_hair/hirsutism.php/ Why the Bearded Lady Was Never a Laughing Matter: Hirsutism]
* [http://www.hairchick.com/excess_hair/hirsutism.php/ Why the Bearded Lady Was Never a Laughing Matter: Hirsutism]
* [http://www.margencero.com/montoya/barbuda_english.html The Bearded Lady]
* [http://www.margencero.com/montoya/barbuda_english.html The Bearded Lady]
* [[http://www.conqueryourpcosnaturally.com/_blog/Blog/tag/hirsutism/ PCOS is the leading cause of female hirsutism] Discover how to overcome excessive hair growth]


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Revision as of 16:15, 20 December 2012

"Hirsute" redirects here. For the botanical term, see indumentum.
Hirsutism
SpecialtyDermatology Edit this on Wikidata

Hirsutism is the excessive hairiness[1] on women[2] in those parts of the body where terminal hair does not normally occur or is minimal - for example, a beard or chest hair. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern. Hirsutism is a medical sign rather than a disease and may be a sign of a more serious medical condition, especially if it develops well after puberty. The amount and location of the hair is measured by a Ferriman-Gallwey score.

Signs and symptoms

Hirsutism affects women and sometimes men, since the rising of androgens causes a male pattern of body hair, sometimes excessive, particularly in locations where women normally do not develop terminal hair during puberty (chest, abdomen, back and face). The medical term for excessive hair growth that affect both men and women is hypertrichosis.

Causes

Hirsutism can be caused by either an increased level of androgens, the male hormones, or an oversensitivity of hair follicles to androgens. Male hormones such as testosterone stimulate hair growth, increase size and intensify the growth and pigmentation of hair. Other symptoms associated with a high level of male hormones include acne, deepening of the voice, and increased muscle mass.

Growing evidence implicates high circulating levels of insulin in women for the development of hirsutism. This theory is speculated to be consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.

It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Again, the result is increased androgen production.

Signs that are suggestive of an androgen-secreting tumor in a patient with hirsutism is rapid onset, virilization and palpable abdominal mass.

The following may be some of the conditions that may increase a woman's normally low level of male hormones:

Diagnosis

One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.[5]

Diagnosis of patients with even mild hirsutism should include assessment of ovulation and ovarian ultrasound (because of the high prevalence of polycystic ovary syndrome), as well as 17-hydroxyprogesterone (because of the possibility of finding nonclassic 21-hydroxylase deficiency[6]).

Other blood value that may be evaluated in the workup of hirsutism include:

If no underlying cause can be identified, the condition is considered idiopathic.

Treatment

Many women with unwanted hair seek methods of hair removal. However, the causes of the hair growth should be evaluated by a physician, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the treatment.

The most effective treatment that was tested is the oral Flutamide for one year. Seventeen of eighteen women with hirsutism treated with combination therapy of Flutamide 250 mg twice daily and an oral contraceptive pill had a rapid and marked reduction in their hirsutism score. Amongst these, one woman with pattern hair loss showed remarkable improvement.[medical citation needed]

Pharmacological[4]

  • Spironolactone: Antialdosterone antiandrogenic compound.[7]
  • Cyproterone acetate: A progestin that also has strong antiandrogenic action. In addition to single form, it is also available in some formulations of combined oral contraceptives.
  • Finasteride: 5 alpha reductase inhibitor that inhibits conversion of testosterone to more active 5 alpha hydroxy testosterone.
  • Metformin: Antihyperglycemic drug used for diabetes mellitus. However, it is also effective in treatment of hirsutism associated with insulin resistance (e.g. polycystic ovary syndrome)
  • Eflornithine: Blocks putrescine that is necessary for the growth of hair follicles.
  • Flutamide: Androgen receptor antagonist.
  • Combination oral contraceptives

Other methods

  • Spearmint tea: Twenty-one female hirsute patients, 12 with polycystic ovary syndrome and 9 with idiopathic hirsutism were included to the study in which they drank one cup of spearmint tea a day for 5 days, after which there was significant decrease in free testosterone and increase in luteinizing hormone, follicle-stimulating hormone and estradiol[8][9]

See also

References

  1. ^ "Hirsutism" at Dorland's Medical Dictionary
  2. ^ "Merck Manuals online medical Library". Merck & Co. Retrieved 2011-03-04.
  3. ^ Somani N, Harrison S, Bergfeld WF (2008). "The clinical evaluation of hirsutism". Dermatol Ther. 21 (5): 376–91. doi:10.1111/j.1529-8019.2008.00219.x. PMID 18844715.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ^ a b c d Unluhizarci K, Kaltsas G, Kelestimur F (2012). "Non polycystic ovary syndrome-related endocrine disorders associated with hirsutism". Eur J Clin Invest. 42 (1): 86–94. doi:10.1111/j.1365-2362.2011.02550.x. PMID 21623779.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Ferriman D, Gallwey JD (1961). "Clinical assessment of body hair growth in women". J. Clin. Endocrinol. Metab. 21 (11): 1440–7. doi:10.1210/jcem-21-11-1440. PMID 13892577. {{cite journal}}: Unknown parameter |month= ignored (help)
  6. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/j.fertnstert.2009.02.056, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1016/j.fertnstert.2009.02.056 instead.
  7. ^ Karakurt F; Sahin I; Güler S; et al. (2008). "Comparison of the clinical efficacy of flutamide and spironolactone plus ethinyloestradiol/cyproterone acetate in the treatment of hirsutism: a randomised controlled study". Adv Ther. 25 (4): 321–8. doi:10.1007/s12325-008-0039-5. ISBN [[Special:BookSources/1232500800395|1232500800395[[Category:Articles with invalid ISBNs]]]]. PMID 18389188. {{cite journal}}: Check |isbn= value: invalid character (help); Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
  8. ^ http://news.bbc.co.uk/2/hi/6376599.stm
  9. ^ Akdoğan, M; Tamer, MN; Cüre, E; Cüre, MC; Köroğlu, BK; Delibaş, N (2007). "Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism". Department of Clinical Biochemistry, School of Medicine, Suleyman Demirel University, Isparta, Turkey. PMID 17310494. {{cite journal}}: Unknown parameter |month= ignored (help)