Update on Idiopathic Hirsutism: Diagnosis and Treatment

July 2013 in “ Acta Clinica Belgica ”

Cihangir Erem

idiopathic hirsutism 5α-reductase androgen receptor gene polymorphisms androgen suppression peripheral androgen blockade oral contraceptives antiandrogen drugs spironolactone cyproterone acetate finasteride flutamide bicalutamide drospirenone combination therapy electrolysis laser epilation teratogenic risks Propecia laser hair removal

From the encyclopedia

Spironolactone →

powerful topical and oral anti-androgen used mostly by women

Cyproterone →

a synthetic anti-androgen and weak progestogen that inhibits DHT binding to androgen receptor

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This review discusses idiopathic hirsutism and suggests that combination treatment, including androgen suppression and cosmetic methods, is most effective, but notes that its pathogenesis remains unclear.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

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Research cited in this study

25 / 25 results

Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

research Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

378 citations , November 2011 in “Human reproduction update”

This review discusses the epidemiology, causes, diagnosis, and management of hirsutism in women, noting that effective treatment requires addressing the root cause as well as the hair growth.

research The Prevalence of Idiopathic Hirsutism and Polycystic Ovary Syndrome in the Tehran Lipid and Glucose Study

51 citations , November 2011 in “Reproductive Biology and Endocrinology”

In this study of reproductive-aged women in Tehran, idiopathic hirsutism and polycystic ovary syndrome were reported to be prevalent, with rates influenced by the screening methods used.

research Laser Hair Reduction And Removal

14 citations , May 2011 in “Facial Plastic Surgery Clinics of North America”

This review discusses the use of laser and intense light sources for hair removal and reports no new clinical results; the authors highlight the potential for aesthetic medicine to include these technologies.

research Hirsutism: Diagnosis and Management

41 citations , April 2010 in “Gender Medicine”

This review discusses the causes, clinical features, diagnostic approach, and treatment options for hirsutism in women, but reports no new findings.

Best Practice Options for Hair Removal in Patients with Unwanted Facial Hair Using Combination Therapy with Laser: Guidelines by an Expert Working Group

research Best Practice Options for Hair Removal in Patients with Unwanted Facial Hair Using Combination Therapy with Laser: Guidelines by an Expert Working Group

32 citations , January 2010 in “Dermatology”

This review discusses the combination of laser hair removal and topical eflornithine for managing resistant hirsutism, providing guidance based on existing clinical data, but reports no new results.

research European Consensus on the Evaluation of Women Presenting with Excessive Hair Growth

31 citations , November 2009 in “European journal of dermatology/EJD. European journal of dermatology”

This paper presents a consensus-driven diagnostic evaluation form for assessing hirsutism in premenopausal women, developed by The Skin Academy for use in clinical practice.

research Spironolactone Versus Placebo or in Combination with Steroids for Hirsutism and/or Acne

112 citations , April 2009 in “Cochrane library”

This review found some evidence suggesting that spironolactone can effectively reduce hirsutism in women but did not support its use for treating acne vulgaris.

research The Clinical Evaluation of Hirsutism

67 citations , September 2008 in “Dermatologic therapy”

This paper reviews causes of hirsutism in women and emphasizes the importance of identifying underlying conditions for risk assessment, though it reports no new clinical findings.

research Medical Treatment of Hirsutism

66 citations , September 2008 in “Dermatologic therapy”

This review discusses medical treatments for hirsutism, focusing on oral contraceptives and other therapies, but reports no new results; the authors emphasize the lack of evidence for insulin sensitizers in treating hirsutism alone.

research Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline

502 citations , February 2008 in “The Journal of Clinical Endocrinology & Metabolism”

This review discusses hirsutism management guidelines, recommending androgen testing only for women with abnormal hirsutism scores and advocating for combined therapy approaches depending on severity and underlying conditions, but it reports no new clinical results.

research Idiopathic Hirsutism: Excessive Bodily and Facial Hair in Women

11 citations , February 2008 in “British journal of nursing”

This article reviews idiopathic hirsutism, focusing on its definition, diagnosis, causes, and treatment options, without presenting new clinical findings.

research A Randomized Bilateral Vehicle-Controlled Study of Eflornithine Cream Combined with Laser Treatment Versus Laser Treatment Alone for Facial Hirsutism in Women

125 citations , February 2007 in “Journal of the American Academy of Dermatology”

This study found that adding topical eflornithine to laser hair removal significantly improved the reduction of unwanted facial hair in women over a 6-month period, compared to laser treatment alone.

research Use of Cyproterone Acetate, Finasteride, and Spironolactone to Treat Idiopathic Hirsutism

56 citations , April 2003 in “Fertility and Sterility”

This study found that while cyproterone acetate, finasteride, and spironolactone had similar short-term effects in treating idiopathic hirsutism, spironolactone provided more lasting benefits one year after treatment.

research The Benefits of Finasteride for Hirsute Women with Polycystic Ovary Syndrome or Idiopathic Hirsutism

40 citations , January 2003 in “Gynecological Endocrinology”

This study found that finasteride significantly reduced hirsutism in women with idiopathic hirsutism or polycystic ovary syndrome over six months, suggesting its potential effectiveness for this condition.

research A Comparative Study of a Gonadotropin-Releasing Hormone Agonist and Finasteride on Idiopathic Hirsutism

10 citations , January 2000 in “PubMed”

This study found that GnRH agonist treatment improved hirsutism scores more than finasteride after six months in women with idiopathic hirsutism, with both treatments causing no menstrual abnormalities or side-effects.

research Comparison of Finasteride and Flutamide in the Treatment of Idiopathic Hirsutism

32 citations , July 1999 in “Fertility and Sterility”

This study found that both finasteride and flutamide effectively reduced hirsutism, with flutamide being more effective than finasteride in decreasing hirsutism scores and hair diameter over 12 months.

research Androgen Receptor Polymorphisms (CAG Repeat Lengths) in Androgenetic Alopecia, Hirsutism, and Acne

186 citations , July 1998 in “Journal of Cutaneous Medicine and Surgery”

This study found that shorter CAG-repeat lengths in the androgen receptor may be associated with the development of androgen-mediated skin disorders like androgenetic alopecia, acne, and hirsutism in both men and women.

research Comparison of Finasteride Versus Spironolactone in the Treatment of Idiopathic Hirsutism

76 citations , December 1997 in “Fertility and Sterility”

This study found that spironolactone was significantly more effective than finasteride in reducing hirsutism scores over 9 months, despite more side effects occurring in the spironolactone group.

Outcome of Long-Term Treatment with the 5α-Reductase Inhibitor Finasteride in Idiopathic Hirsutism: Clinical and Hormonal Effects During a 1-Year Course of Therapy and 1-Year Follow-Up

research Outcome of Long-Term Treatment with the 5α-Reductase Inhibitor Finasteride in Idiopathic Hirsutism: Clinical and Hormonal Effects During a 1-Year Course of Therapy and 1-Year Follow-Up

75 citations , November 1996 in “Fertility and Sterility”

This study found that finasteride effectively reduced hirsutism in women during 12 months of treatment, with some effects persisting in the majority after stopping the medication.

research Predominant Expression of 5 Alpha-Reductase Type 1 in Pubic Skin from Normal Subjects and Hirsute Patients

11 citations , May 1996 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study reported that 5 alpha-reductase type 2 is the predominant enzyme in pubic skin fibroblasts across normal men, women, and hirsute patients, suggesting potential treatment options for idiopathic hirsutism.

research Comparison of Flutamide and Spironolactone in the Treatment of Hirsutism: A Randomized Controlled Trial

165 citations , February 1994 in “Fertility and Sterility”

This study found that flutamide was more effective than spironolactone in reducing symptoms of hirsutism and related conditions in premenopausal women, with fewer discontinuations due to side effects.

research Flutamide in the Treatment of Hirsutism

27 citations , October 1991 in “International journal of gynaecology and obstetrics”

This study observed that flutamide treatment reduced hair growth and improved acne and seborrhea in hirsute women, with increased androstenedione levels and no side effects noted.

research Comparison of Sequential Cyproterone Acetate/Estrogen Versus Spironolactone/Oral Contraceptive in the Treatment of Hirsutism

68 citations , May 1991 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study found that both cyproterone acetate and spironolactone effectively reduced hair diameter and plasma testosterone levels in hirsute women, with no significant differences between the two treatments.

research Spironolactone Is an Effective and Well-Tolerated Systemic Antiandrogen Therapy for Hirsute Women

78 citations , May 1989 in “The Journal of Clinical Endocrinology & Metabolism”

This study found that in hirsute women, daily treatment with 200 mg spironolactone significantly reduced hair growth rates and hair shaft diameters on various body areas over 12 months.

research Side Effects of Spironolactone Therapy in the Hirsute Woman

80 citations , January 1988 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study observed that high-dose spironolactone frequently caused metrorrhagia in women with idiopathic hirsutism, leading the authors to suggest lower starting doses or additional hormonal therapy.