Hirsutism (excessive hair IN WOMEN) print home

WHAT IS hirsutism?

Hirsutism is excessive hair growth in women, in a male pattern. That means that the hairs grow in places where women normally have no hair, such as on the face (beard and mustache), in the neck, chest, around the nipples, on the lower abdomen between the navel and pubic region, and on the legs. The hairs are dark and thick, much more visible than the light-colored small downy hairs that normally occur on the face and body of women and hardly visible.

Hirsutism is common, approximately 5% of women of reproductive age are affected. It is seen by insurers as merely a cosmetic problem, but women who suffer from it have suffered very. It is caused by a disturbance in hormonal balance.

 Hirsutism (excessive hair growth in women, in a male pattern) (click on photo to enlarge) [Source: Internet] hirsutism (excessive hair growth in women, in a male pattern) (click on photo to enlarge) [Source: Internet] hirsutism (excessive hair at women in a male pattern) (click on photo to enlarge) [source: internet]
hirsutism hirsutism hirsutism


WHAT IS THE CAUSE?

The cause is usually excessive levels of testosterone (male hormone) in the blood. Testosterone causes beard and mustache growth and growth of hair on other parts of the body. Men have much testosterone in their bodies, but women also have a small amount of testosterone. If this is too high creates excessive hair growth in a male pattern.

When some of the women's hirsutism hereditary. It is their so in the family, all women suffer from excessive hair growth. This one sometimes sees in Turkish, Moroccan or Greek families. It may be that they have too much testosterone in the blood, but also prevents what is that the amount of testosterone is normal, but that the bristles there is increased susceptible.

There are also diseases in which excess testosterone is created. In women, it may happen that there are many cysts are formed in the ovaries, which produce too much testosterone. This is called polycystic ovary syndrome (PCOS). When PCOS women besides hirsutism also have irregular periods and in addition it may be associated with infertility. The polycystic ovary syndrome is often seen in combination with obesity and diabetes mellitus (diabetes).

Besides testosterone is also produced in the adrenal glands in the ovaries. At diseases adrenal glands may also occur hirsutism. There are medicines that can cause hirsutism (some oral contraceptives, anabolic steroids, testosterone, danazol, metoclopramide, methyldopa, valproate, reserpine, phenytoin, hydralazine, minoxidil, tamoxifen, cyclosporine, prasterone, et al).


Hirsutism WHAT DOES LOOK LIKE?

Hirsutism occur at dark and coarse hair on the upper lip, chin, neck, chest, around the nipples, on the abdomen, back and inside of the thighs. There are all kinds of gradations ranging from a few dark hairs to significant hair growth.

hirsutism scorecard

How is it diagnosed?

The diagnosis is made on the clinical picture, how it looks. It looks at what there parts of the body from excessive hair growth and whether it is down its (normal) or dark and coarse hair. The severity of the growth of hair at the various sites of the body can be expressed in terms of a score (see the scorecard above). Furthermore, it is examined whether there are complaints that indicate a hormonal disorder, such as menstrual irregularities, or signs consistent with an excessive testosterone (hair loss on top of the head in a male pattern, low voice, abnormalities of the genitalia).

If there are grounds to think of hormonal disorders such as irregular menstruation, then further research is needed. The dermatologist may do blood tests themselves, or refer you to a gynecologist or internist / endocrinologist. Usually the gynecologist because a common cause is polycystic ovarian syndrome (PCOS). And this is gynecological examination, plus need an ultrasound of the ovaries (ovarian).


HOW hirsutism TREATED?

The first step is to look for an underlying cause. If there is PCOS than the gynecologist will establish a cure for this. This is usually just a contraceptive pill such as Yasmin (drospirenone and ethinylestradiol it contains). For more information on PCOS leaflet about polycystic ovary syndrome of the Dutch Society of Obstetrics and Gynecology.

Treatment with a contraceptive pill often has a beneficial effect in hirsutism, and in addition, it can regulate the menstrual cycle. Preference will be given to treatment with a combination composition of ethinyl estradiol and cyproterone acetate (Diane 35). Sometimes it is necessary to add cyproterone acetate yet separate tablets to the treatment (50 or 100 mg per day), according to a fixed schedule. Cyproterone acetate is a hormone-like substance that is similar to the male hormone testosterone. Cyproterone acetate suppresses testosterone of the binding sites on the hair follicles, thereby the operation of the male hormone is inhibited.

The use of a birth control pill may have the following side effects: nausea, headache, tenderness or breast tenderness and an increased risk of thrombosis. Cyproterone acetate has in the usual dose (up to 100 mg per day, in accordance with a cyclic scheme) has no serious side effects. Sometimes women may experience weight gain, mood changes or irregular vaginal bleeding.

Diane-35 in the News

The pill Diane was unfavorable in 2013 in the news, dozens were killed by thrombosis have fallen by Diane pill. It is unfortunate that these scare stories circulated by the media and by Lareb because the pill Diane is needed for some conditions, such as severe acne, and hirsutism. The facts are that all contraceptive pills give an increased risk of thrombosis. The risk with Diane is two times as large as the other, but in absolute numbers, the incidence is very low. Because millions of women use contraceptives, or use, there are about 30 years obviously regretted some deaths. The Diane pill was examined by the Dutch and European Medicines authorities and saw no reason to ban the drug. The advice is that it should only be used for acne and hirsutism, and not for regular contraception, and that women should be counseled on the risk of thrombosis, which occurs primarily in the first year.

If there are objections to the hormonal treatment may be selected for treatment with the drug spironolactone. This drug blocks the action of male hormones, but can also have unpleasant side effects, such as increased urination, nausea, breast tenderness and menstrual disorders. Because of these side effects is not often used. There is a chance that spironolactone is not safe for the unborn child. Therefore, the drug is not suitable for women who want to conceive.

Removing hairs

If it is not possible to treat the hair growth with hormonal drugs, or if it is not sufficiently effective, then the excessive hair growth in a variety of ways can be combated.
Excessive hair can be treated with bleaching the hair, shaving cream, shaving, plucking, resin treatment or treatment with laser or flashlight. For more information on laser and flash lamp treatment refers to the folder laser treatments in dermatology.

Treatment with laser or flash lamp is usually performed by a skin therapist. In women with dark skin are at increased risk of developing pigmentation disorders and scarring as a result of plucking, waxing and laser or flash lamp treatment.


WHAT CAN YOU DO YOURSELF YET?

Hair you can remove yourself using hair removal cream, shaving, plucking and resin treatment. However, the effect will be short lived. The removal of the hair itself has no influence on the thickness of the hair. It is not so that the bristles are stiffer or will grow faster after shaving, waxing or plucking. In the case of obesity, it is advisable to lose weight. In women with PCOS leads 5% weight reduction though in a lower production of testosterone and reduced hirsutism; thereby increasing the chance of fertility.