HIRSUTISM

In the female, excessive hair growth (hirsutism) on the face, chest, abdomen, presacral area, etc. is usually a manifestation of excessive male sex hormone (androgen) levels or increased sensitivity of the hair follicle to normal androgen levels. In rare instances, the abnormal hair growth is a genetic disorder that is not related to male hormones.

The management of hirsutism requires the establishment of a specific diagnosis, determination of the site of male hormone production (the adrenals or the ovaries) and establishment of a proper therapeutic plan either to cure the underlying disease or to counteract the effects of the male hormones. During therapy, appropriate monitoring of the hormone levels is essential for determination of the effectiveness of the treatment. It must be remembered that even when treatment is successful, it will only result, in most instances, in prevention of progression of the hirsutism, not elimination of the existing excessive hair. The diagnostic evaluation is similar to that conducted in patients with acne. Therapy, however, may include additional modalities, antiandrogens (e.g.spironolactone), electrolysis, waxing, etc. The underlying etiologies and complications associated with elevated androgen levels are similar to those noted in patients with acne.

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