Excess Hair Growth
Hirsutism, commonly known as excess hair growth, is an undesirable medical condition characterized by the growth of dark, coarse hair in women, following a male pattern. This typically includes hair growth in areas usually seen in men, such as the face, chest, abdomen, and back. It is important to note that what constitutes ‘excess’ hair can vary based on ethnicity and culture.
Causes of Excessive Hair Growth
The development of excessive hair is linked to various factors, and in some instances, it may occur with no identifiable cause. This variation is often attributable to ethnic differences: for example, women from the Middle East and South Asia are more susceptible to hirsutism without any particular medical condition. Below are some clear causes of increased hair growth:
- Genetic Factors: Excessive hair growth can be hereditary, with women more likely to experience it if their mother or sister has the condition. This is associated with genetic medical issues that impact hormone levels.
- Hormonal Imbalances: During puberty, females produce both female hormones and a smaller amount of male hormones, which can lead to hair growth in the genital area and underarms. If the balance of these hormones is disrupted, particularly with elevated levels of androgens, excessive hair can occur. This imbalance may also lead to other symptoms, such as acne and breast reduction. Common causes for hormonal imbalance include:
- Polycystic Ovary Syndrome (PCOS): This is the most common cause of excessive hair growth, characterized by hormonal imbalance, the formation of small fluid-filled cysts on the ovaries, irregular menstrual cycles, weight gain, and sometimes infertility.
- Cushing’s Syndrome: This condition arises from prolonged exposure to high cortisol levels, which may be due to excessive adrenal gland hormone production or prolonged use of prednisone medication.
- Congenital Adrenal Hyperplasia: A hereditary disorder where the adrenal glands produce abnormal amounts of steroid hormones, including androgens and cortisol.
- Tumors: Although rare, malignant tumors in the ovaries or adrenal glands can lead to excessive hair growth.
- Medication Use: Certain medications can exacerbate hair growth, including:
- Hormonal medications.
- Hair growth stimulants, such as Minoxidil.
- Danazol, used for treating endometriosis.
- Systemic corticosteroids.
- Fluoxetine, prescribed for depression.
- Obesity: Increased body fat is associated with higher androgen levels.
- Elevated Insulin Levels: Insulin resistance, commonly seen in type 2 diabetes, can stimulate ovaries to produce androgens.
Treatment Options for Excessive Hair Growth
The primary step in managing excessive hair growth is weight loss, as this can lead to reduced androgen production. Treatment for this condition is divided into two categories: cosmetic treatments for hair removal and medical therapies aimed at addressing the underlying cause.
Cosmetic Treatments
Excessive hair growth may cause embarrassment and discomfort, leading some individuals to seek various hair removal methods, including:
- Bleaching: This technique minimizes the visibility of hair.
- Hair Removal Creams: These typically contain thioglycolate, applied to the skin for a short period before being removed.
- Shaving: Importantly, shaving does not result in denser hair growth.
- Waxing: This procedure is generally performed every 4-6 weeks.
- Hair Removal Devices: These machines cut and remove excess hair.
- Laser Treatment: This method uses laser energy to generate heat in hair follicles, inhibiting future growth. It is particularly effective for individuals with light skin and dark hair but requires multiple sessions over time and can be costly. It is essential to have this procedure performed by a qualified professional, such as a dermatologist or cosmetic surgeon.
- Electrolysis: Although less common than laser therapy, electrolysis exposes hair follicles to electrical heat. There is a risk of scarring associated with this method.
Medical Treatments
Prescription options include:
- Birth Control Pills: Widely recognized as an effective treatment for excessive hair growth, these pills reduce ovarian androgen production, with results typically visible within 6-12 months.
- Anti-androgen Medications: This category includes spironolactone, finasteride, and flutamide, which can be used alone or in conjunction with birth control pills.
- Low-dose Steroids: These may be prescribed if adrenal gland hyperactivity is identified as the cause of excess hair growth.
- Eflornithine Hydrochloride Cream: This cream slows hair growth and shows results within 6-8 weeks of application, though hair regrowth will resume upon discontinuation.
- Insulin-sensitizing Medications: Metformin may be recommended for women with polycystic ovary syndrome, particularly those who are overweight.