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Hirsutism is a term defined as excessive and unwanted hair growth in women in a male-type pattern (hair on the face, beard area, chest, and abdomen). Hirsutism causes could be different.
Studies suggest that Constitutional Hirsutism affects 5% - 15% of women, varying according to characteristics and differ in different countries. At least 5% of women of reproductive age mentioned constitutional hirsutism.
All women have circulating male sex hormones but normally the level of female hormones (estrogen) is much higher (normal ration for females). In healthy women high levels of estrogens don’t let androgens to stimulate hair grown on face, breast, abdomen and hands.
Androgens are normally produced by the adrenal glands and ovaries. In women with excessive hair grow (hirsutism) three possibilities are discovered:
1) increased androgen levels in the blood (hormonal dysfunctions - overproduction of androgens due to changes in the pituitary gland, adrenal gland and ovaries);
2) hair follicles’ increased sensitivity to normal levels of androgens (constitutional hirsutism - increase in skin 5alpha-RA activity);
3) combined.
Excess androgen can be easily recognized because they also affects the skin causing acne, seborrhea (greasy red flaky areas around the nose, mouth and ears, and scalp), and male-pattern baldness.
Racial and genetic factors play the crucial role in hair growth. For example, Mediterranean women are known as women with higher hirsute score; in Afro-Americans and Orientals, chest and beard growth is greatly diminished.
Constitutional hirsutism is the most common form of hirsutism. During constitutional hair follicles are more sensitive to androgens and no excess androgens are discovered. Constitutional hirsutism often runs strongly in families. Certain ethnic backgrounds, i.e. Mediterraneans and East Indians, are particularly affected.
Constitutional Hirsutism Symptoms
| Hirsute Score |
High Hirsute Score
Excess terminal hair growth in androgen-sensitive body areas (face, beard area, chest, and abdomen). |
| Menstrual cycle |
Normal regular menstrual cycle
Hormonal and ultrasound tests show normal ovulation and normal hormonal changes during whole menstrual cycle. |
| Male hormones (androgens) |
Normal androgen level
Hormonal tests discovered normal levels of all kinds of androgens in the blood and urine. |
| Skin |
Increased skin sensitivity to androgens (hereditary)
Experts suggest that it is probable that genetic modifications of the androgen receptor function and possibly 5a-reductase functions can alter the manifestation of hirsutism. |
| Family |
Family history of hirsutism
In most cases female family members (mothers, grandmothers, sisters, ants) also have hirsutism. |
Ferriman-Gallway Hirsute Score can be the objective indicator for Constitutional Hirsutism (see next page for score calculations).
The average hirsute score for constitutional hirsurism is 1-9:
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Hirsute score
(sum)
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Suggestion
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Recommendation
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1-9
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Constitutional hirsutism
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Medical examination is not recommended. Avoid sun and creams. |
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10-16
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Transition period
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Evaluate during 3-6 months. If the growth will be noted – visit your doctor. |
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17-40
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Hirsutism
(symptom of diseases)
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It is strongly recommended to make hormonal tests and discover the main reason of hirsutism and treatment
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41-44
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Severe Hirsutism
(tumors?)
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Urgently visit your doctor. Some tumors could provoke severe hirsutism |
Constitutional Hirsutism can be cause of stress and at the same time it can be a problem for psychological health. Very often stress management tools should be recommended.
Treatment for Constitutional Hirsutism
Hair removal - Shaving
How It Works: Using a razor, a person removes the tip of the hair shaft that has grown out through the skin. Some razors are completely disposable, some have a disposable blade, and some are electric. Women often shave their underarms, legs, and bikini areas.
How Long It Lasts: 1 to 3 days
Pros: Shaving is fairly inexpensive, and you can do it yourself. All you need is some warm water, a razor, and if you choose, shaving gel or cream.
Cons: Razor burn, bumps, nicks, cuts, and ingrown hairs are side effects of shaving. Ingrown hairs can happen with close, frequent shaving. When the hair begins to grow, it grows within the surrounding tissue rather than growing out of the follicle. The hair curls around and starts growing into the skin, irritating it.
Tips: You'll get a closer shave if you shave in the shower after your skin has been softened by warm water. Go slowly, pulling looser areas of skin taut before running the razor over them. Change razors often to avoid nicks. Using shaving cream may also help protect sensitive skin, like the skin around the genitals. If you’re nervous about cutting yourself, you can try an electric razor instead.
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Hair removal - Plucking
How It Works: Using tweezers, a person stretches the skin tightly, grips the hair close to the root, and pulls it out.
How Long It Lasts: 3 to 8 weeks
Pros:Plucking is inexpensive (all you need are tweezers). But it can be time- consuming because you can only remove one hair at a time.
Cons: Plucking can be painful. If the hair breaks off below the skin, a person may get an ingrown hair. After plucking, you may notice temporary red bumps because the hair follicle is swollen and irritated.
Tips: Make sure you sterilize your tweezers or other plucking devices with rubbing alcohol before and after (to avoid infection).
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Hair removal - Waxing
How It Works: A sticky wax is spread on the area of skin where the unwanted hair is growing. A cloth strip is then applied over the wax and quickly pulled off, taking the hair root and dead skin cells with it. The wax can be warmed or may be applied cold. Waxing can be done at a salon or at home.
How Long It Lasts: 3 to 6 weeks
Pros: Waxing leaves the area smooth and is long lasting. Waxing kits are readily available in drugstores and grocery stores. Hair re-growth looks lighter and less noticeable than it is after other methods of hair removal, such as shaving.
Cons: Many people say the biggest drawback to waxing is the discomfort: Because the treatment works by pulling hair out at the roots, it can sting a bit as the hair comes off — luckily that part is fast. People may notice temporary redness, inflammation, and bumps after waxing. Professional waxing is more expensive than other hair removal methods. Teens who use acne medications such as tretinoin and isotretinoin may want to skip waxing because those medicines make the skin more sensitive. People with moles or skin irritation from sunburn should also avoid waxing.
Tips: For waxing to work, hair should be at least ¼ inch (about 6 millimeters) long. So skip shaving for a few weeks before waxing. Waxing works well on the legs, bikini area, and eyebrows.
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Hair removal - Electrolysis
How It Works: Over a series of several appointments, a professional inserts a needle into the follicle and sends an electric current through the hair root, killing it. A small area such as the upper lip may take a total of 4 to 10 hours and a larger area such as the bikini line may take 8 to 16 hours.
How Long It Lasts: Intended to be permanent, but some people have re-growth of hair
Pros: Some people have permanent hair removal.
Cons: Electrolysis takes big bucks and lots of time, so it's usually only used on smaller areas such as the upper lip, eyebrows, and underarms. Many people describe the process as painful and dry skin, scabs, scarring, and inflammation may result after treatment. Infection may be a risk if the needles and other instruments aren't properly sterilized.
Tips: Talk to your doctor if you're interested in this method.
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Hair removal - Laser Hair Removal
How It Works: A laser is directed through the skin to the hair follicle, where it stops growth. It works best on light-skinned people with dark hair because the melanin (colored pigment) in the hair absorbs more of the light, making treatment more effective.
How Long It Lasts: Intended to be permanent, but people often need to return every 6 months to a year for maintenance.
Pros: This type of hair removal is long lasting and large areas of skin can be treated at the same time.
Cons: A treatment session could be expensive. Side effects of the treatment may include inflammation and redness.
Tips: Using cold packs may help diminish any inflammation after treatment. Avoiding the sun before a treatment may make results more effective.
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Discover some effective Home Remedies for Hirsutism and Hirsutism Treatment with Spearmint.
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