Hirsutism: See a Dermatologist for Best Treatment

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Dr. Romeo Morales with Advanced Dermatology PC offers Tips on Understanding Male-pattern Hair Growth Advises Women to Seek Medical Advice

Dr. Romeo Morales

Hirsutism is triggered by an abnormal level or action of male hormones called androgens.

Millions of women pluck, wax, shave and bleach unwanted hair – on their legs, under their arms, on their upper lips, and more. But millions more – about 10% of women – have a condition called hirsutism, in which hair appears in a typically male pattern on their faces, chests and backs. According to Dr. Romeo Morales of Advanced Dermatology, P.C., hirsutism sometimes refers broadly to excessive unwanted hair but clinically it is defined more specifically. “Most women who remove unwanted hair have what is called 'vellus' hair, which is fine, soft, and lightly pigmented. Women suffering from hirsutism have 'terminal' hair, which is stiff, heavily pigmented, and found on the body in places that are atypical for women.”

Hirsutism is triggered by an abnormal level or action of male hormones called androgens. While all women produce low levels of androgens, elevated levels can cause an increase in various male characteristics, including hair growth. “In the majority of cases, hirsutism is not caused by a serious medical condition,” says Dr. Morales, “but many women feel less attractive and it is often emotionally distressing. They often want to get rid of the hair as quickly as possible via home or spa remedies. But medical evaluation is important both to determine the best mode of treatment and to rule out the possibility of a more serious underlying problem.”

Causes of hirsutism
Hirsutism is most commonly associated to polycystic ovarian syndrome but in some cases there is no identifiable cause, in which case it is known as idiopathic hirsutism.

  • Polycystic ovarian syndrome (PCOS) typically begins in puberty and is found in about 5% of adolescent and adult women. It is characterized by an imbalance of sex hormones that may result in menstrual irregularities, acne, infertility and obesity along with hirsutism.
  • Idiopathic hirsutism has no identifiable cause. It is a chronic condition, also beginning at puberty, in which the gradual growth of coarse body hair is the only symptom.

Among less frequent underlying causes of hirsutism are other disorders of the ovaries and adrenal glands such as Cushing's syndrome and congenital adrenal hyperplasia that result in abnormal secretion of hormones. Ovarian and adrenal tumors, either benign or malignant, can also be responsible for hirsutism as can some medications. “With a wide range of causes for excessive hair growth, some of them serious, a thorough medical evaluation may help identify the problem,” says Dr, Morales. “A complete medical and family history, lab tests to determine hormone levels, and a physical examination may pinpoint the cause and quantify the severity of the condition in order to determine a course of treatment.”

Treating hirsutism
The decision of whether and how to treat hirsutism is a personal one. In the absence of a serious underlying disease, the severity of the condition and feelings about what is cosmetically acceptable determine each woman's choice. “Hirsutism can be treated both systemically – to address the underlying cause of the hormonal imbalance, or by mechanical means to remove the unwanted hair,” says Dr. Morales. “Often we do both. Systemic treatment can take months before any improvement is noticed. In the interim, we can remove the hair mechanically.”

Systemic treatment for hirsutism includes oral contraceptives, which suppress the production of androgen by the ovaries and other medications that suppress the production of androgen by the adrenal glands or block the action of androgen receptors in the hair follicles. Some of these medications may cause birth defects and should only be used along with oral contraceptives or in postmenopausal women.

Hair can be removed and made less noticeable by various mechanical and chemical means: electrolysis, laser hair removal, shaving, depilatories, waxing and bleaching. All have advantages and disadvantages, may irritate the skin to some degree, and need to be repeated at different intervals. “Consultation with a dermatologist can help determine the most effective method for each woman,” says Dr. Morales. “Hirsutism can be psychologically debilitating but with medication and removal techniques we can help women minimize its effects.”

Romeo Morales, M.D., F.A.A.D., specializes in many areas of medical and surgical dermatology with a particular interest in skin cancer screening and prevention.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. http://www.advanceddermatologypc.com

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Melissa Chefec
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