Hirsutism

From Ganfyd

Backgound

Hirsutism is when there is excess coarse body hair of an adult male distribution pattern, such as facial and chest areas in women. This male-pattern growth of terminal body hair usually occurs in androgen-stimulated locations, such as the face and chest.

Hirsutism can be caused by unusually high androgen levels or by hair follicles with an increased sensitivity to normal androgen levels. Therefore, increased hair growth often is observed in patients with endocrine disorders characterized by hyperandrogenism.

For more information see the eMedicine chapter.

Guidelines

• Laboratory guide for appropriate testing
• Hirsutism: Evaluation and Treatment
• Medical management of facial hirsutism supported by the Primary Care Dermatology Society

Treatments

• Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne Cochrane Systematic Review
• Cyproterone acetate for hirsutism Cochrane Systematic Review

Clinical Questions

• For women with hirsutism, is there any evidence of an association with the use of the levonorgestrel-releasing intrauterine system? [1]
• For women with hirsutism associated with polycystic ovary syndrome, can the combined oral contraceptive, Dianette, be used safely? [2]
• What effect does metformin have on hirsutism and acne in women with polycystic ovary syndrome? [3]
• In investigation of PCOS and hirsutism, above what level of serum testosterone would be considered abnormal or may warrant referral. [4]