Hirsutism or unwanted hair growth is a frustrating condition for many women. The unwanted hair growth, which is usually coarse and pigmented, may involve upper lip, chin, cheeks, abdomen, back, arms and thighs. Hirsutism in women occurs either because of increased levels of testosterone or increased sensitivity of hair follicles to normal testosterone levels. Commonest cause of hirsutism in young females is PCOD (polycystic ovarian disease). Drugs like phenytoin, certain progesterone preparations, diazoxide and a few anti-cancer medications may also cause hirsutism. Other endocrine conditions which need to be considered in hirsute women are hypothyroidism, hyperprolactinemia (increased prolactin levels) growth hormone excess state (acromegaly), Cushings syndrome (increased cortisol levels ) and late onset congenital adrenal hyperplasia (LOCAH), depending on the clinical scenario.
Hirsutism which progresses rapidly and of a severe variety or if associated with features like change in voice, excessive scalp hair loss and balding, loss of fat in breast and thigh regions, prominent muscles, severe acne over face needs to be thoroughly evaluated for tumors producing testosterone. Most such tumors arise from either ovaries or adrenal glands and can be visualized on various imaging modalities like ultrasonography, CT or MRI. Treatment of hirsutism depends on the underlying cause. Hormone contraceptives with or without agents that block action of testosterone are the main modality of treatment in PCOD. When hirsutism is secondary to a primary endocrine condition, the latter needs to be addressed. In case of tumors, surgical removal is the treatment of choice. Apart from the above-mentioned therapeutic modalities, women with hirsutism can opt for local hair removal methods like shaving, threading, epilation, LASER etc.
