Excessive or unwanted hair that grows on a woman’s body and face is caused by hirsutism, a common condition that affects 5-10% of women. Hirsutism is defined as the presence of disproportionate male-type hair in some areas of a woman’s body (known as androgen-contingent parts of the body).

Having excess body hair can often generate a sense of self-consciousness and even guilt, but does not pose any immediate danger. Still, a woman’s health may be at risk due to the underlying hormonal imbalance that causes the condition.

Background

The presence of facial and body hair is normal for women. However, the texture of the hair is usually very fine and light in color. With hirsutism, hair sprouts in a thick, dark, and coarse male-type pattern and can be seen on a woman’s:

  • face
  • chin
  • sideburns
  • chest and periareolar area
  • lower abdomen
  • upper and lower back
  • upper inner thighs

Why Do Women Develop Excessive Hair?

Women are born with all the hair follicles they will have. This amount varies depending on the racial or ethnic group to which you belong. Hirsutism represents the change from vellus (soft, fine, light-colored hair) to terminal (dark, coarse hair) in male-pattern areas. Once the hair follicle is stimulated by the hormone DHT (dihydrotestosterone), it changes the hair from vellus to terminal.

The hair follicle will never convert back to vellus and can only be removed by laser or electrolysis. Testosterone (T) is converted to DHT, so any condition that increases your testosterone levels will cause hirsutism:

COMMON CAUSES OF HIRSUTISM:
Polycystic Ovarian Syndrome (PCOS) Most common; 5-10% of all reproductive-aged women have PCOS (hormonal imbalance), and 60-70% of these women have hirsutism
Unknown No explainable reason (known as idiopathic hirsutism)
Enzyme deficiency (17 hydroxylase deficiency, a form of adrenal hyperplasia) A deficient enzyme causes an increase in male hormone production
LESS COMMON CAUSES OF HIRSUTISM:
Medications Bodybuilding steroids, testosterone, and DHEA (dehydroepiandrosterone)
Androgen-producing tumors Tumors that produce male hormones
Cushing’s Syndrome An adrenal gland disease

When Should Excessive Hair Growth Be a Concern?

Any cosmetically disturbing hair growth may be a cause for concern, particularly if the onset is rapid and is associated with masculinizing signs such as:

  • A deepening of the voice
  • An increase in muscle mass
  • An enlargement of the clitoris
  • Male pattern balding

What Roles Do Age and Genetic Predisposition Play?

Hirsutism before puberty and after menopause is much more uncommon and requires prompt evaluation. Hirsutism tends to run in families and is more common in specific ethnic groups including women of Mediterranean, South Asian, and Middle Eastern descent; it is less pervasive in women of Asian and Native-American heritage.

What Can You Do to Prevent or Treat It?

For PCOS, the birth control pill along with anti-male hormone medication will reduce and, eventually prevent any new terminal hairs. For women who are overweight or obese, embarking on a weight-loss program may help since obesity can alter the way the body produces and processes hormones.

If you want to get rid of existing terminal hair, laser or electrolysis is typically needed. Plucking, pulling, or shaving can worsen hirsutism by irritating the skin.

Questions or comments? Please feel free to contact us, and we’ll be happy to address any of your concerns.