This refers to the growth of excess body hair in females in a male pattern. The term differs from “hypertrichosis”, a more general term which refers to excessive body hair in areas in which hair growth is not hormone dependent.
Hirsutism is characterised by excess hair growth in areas such as the chin and upper lip, around the nipples, abdomen and inner thighs. What is considered “hirsute” or unwanted hair is generally determined by cultural factors.
People often seek dermatologist advice because the excess hair growth is of cosmetic concern. Usually no underlying cause for the excess hair is found, this is known as idiopathic hirsutism. Occasionally, the excess hair growth is due to an underlying medical condition or hormonal imbalance. If there is an underlying cause, polycystic ovary syndrome (PCOS) is the most common cause and is characterised by irregular periods, hirsutism, acne and multiple cysts seen on ultrasound scanning of the ovaries. Very rarely, a tumour that secretes male-type hormones can lead to hirsutism; this is more likely to be the case if the excess hair growth has occurred severely and suddenly.
At The Skin Hospital
Hirsutism is diagnosed by examination, and does not need any special tests to confirm the diagnosis. The specialist may request blood tests to rule out an underlying hormonal imbalance, though this is not always necessary.
- If, rarely, an underlying cause is found, treating this is the first step.
- Once an underlying cause has been ruled out, hirsutism can be treated symptomatically. Hirsutism cannot be cured, but medications and physical therapies can reduce the severity of hair growth and the appearance of the excess hair.
- Physical therapies:
- At home: hair removal can be done with various methods including shaving, waxing and the use of depilatory creams; bleaching may reduce the appearance of dark hairs.
- At The Skin Hospital: both intense pulsed light (IPL)/ broadband light (BBL) and laser therapies can be used to reduce unwanted hair in the nurse-led hair reduction clinic at Darlinghurst and Westmead. These therapies may not be appropriate in all skin types and may not be effective for those with fair hair; the dermatologist can assess suitability for these treatments.
- Medical therapies:
- Topical. Eflornithine hydrochloride is a cream applied twice daily to the face after hair removal to minimize hair re-growth.
- Oral. “Anti-male hormone” types of the oral contraceptive pill can be tried. Others, such as spironolactone and finasteride can have a beneficial effect. These medications cannot be used during pregnancy and can have side-effects, so the potential risks and benefits must be weighed up.
- Physical therapies:
Dermatologists at The Skin Hospital to consult about hirsutism:
- Dr Penny Alexander (Darlinghurst)
- Dr Keng Chen (Darlinghurst)
- Dr Monisha Gupta (Darlinghurst)
- Dr Esther Hong (Darlinghurst)
- Dr Joseph Krivanek (Darlinghurst and Westmead)
- Dr Hanna Kuchel (Darlinghurst)
- Dr Eddie Lobel (Darlinghurst)
- Dr Roland Nguyen (Darlinghurst)
- Dr Sarvjit Sohal (Darlinghurst and Westmead)
- Dr Nicholas Stewart (Darlinghurst and Westmead)
- Dr Kavita Enjeti (Westmead)
- A/Professor Pablo Fernandez-Penas (Westmead)
- Dr Claire Koh (Westmead)
- Dr Brian Wallace (Westmead)
- Dr Supriya Venugopal (Westmead)
Further information about hirsutism can be obtained from the following trusted site: