Hirsutism and Hypertrichosis

January 2023

Clio Dessinioti, Andreas Katsambas

hirsutism hypertrichosis polycystic ovary syndrome PCOS idiopathic hirsutism congenital adrenal hyperplasia Cushing syndrome hormonal imbalances oral contraceptives metformin eflornithine hydrochloride laser hair removal intense pulsed light IPL endocrine disorders Vaniqa birth control pills laser

TLDR Hirsutism in women is mostly due to PCOS and can be managed with oral contraceptives and hair removal methods.

Hirsutism in women is often linked to polycystic ovary syndrome (PCOS), accounting for 75% to 80% of cases, while idiopathic hirsutism makes up 15% to 20%. Less than 5% of cases are due to rare conditions like congenital adrenal hyperplasia or Cushing syndrome. Treatment should focus on addressing hormonal imbalances and reducing excessive hair growth. Oral contraceptives are effective for managing hirsutism in PCOS, whereas metformin and lifestyle changes are not. Eflornithine hydrochloride 13.9% cream is approved for facial hirsutism. For idiopathic cases and those causing distress, hair removal methods such as laser or IPL are recommended. A multi-disciplinary approach involving endocrinologists and gynecologists is advised for cases with underlying endocrine disorders.

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Research cited in this study

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19 citations , March 2018 in “JAMA”

Treat hirsutism in premenopausal women with oral contraceptives and consider additional treatments if needed.

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Effective hirsutism treatment for women with PCOS should be personalized and may include lifestyle changes and medication.

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Experts made a guide to help doctors evaluate women with too much hair growth.

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The document concludes that diagnosing and treating Congenital Adrenal Hyperplasia is complex and requires a team approach due to its effects on the skin and other symptoms.

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The report concludes that PCOS is mainly a condition of excess male hormones and its definition may change as new information is discovered.

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Polycystic Ovary Syndrome should be seen mainly as a condition of excess male hormones, with a focus on this in its definition.

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