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Hirustism (
Unwanted Facial Hair)

 

 
What is unwanted hair?
Causes
Investigations & Diagnosis
Treatment
Response of treatment
Side effects of treatment
 

 

 

 


What is unwanted hair:
Hirsutism is called when there is development of excess unwanted facial hair growth over face & other parts of body in females & girls. It usually stars initially either on upper lip area or chin area. Then it spreads to other area of face & body. It leads to embarrassment or inferiority complex in the sufferers. There may be hair on chest of women as also around nipple which is very humiliating for women.

Causes of excess of facial hair: It may occur either due to increased male hormones (Testosterone, Androstenidione, free testosterone, 17OH-Progesterone, DHEAS, thyroid hormone disorder & others). It can also due to abnormally increased sensitivity of hair roots to normal level of male hormones so that they over-react & grow long & darkens or it may be due to certain drugs. For this all relevant hormone test & other test are done depending on history.

The following are the causes of unwanted hair are:

1) Excess male hormone production from ovaries: It can be due to Primary polycystic ovaries, Stromal hyperthecosis, Secondary polycystic ovaries, Androgen-producing ovarian       (tumor(lipoma, luteoma, hilar cell tumor, stromal tumor), Hilasr cell hyperplasia, Genetic defects in ovarian steroidigenesis,

2) Excess male hormone production from Adrenal Glands: It can be due to Cushing syndrome, disease, Androgen-producing adrenal Tumor (adenoma, carcinoma), Late-onset genetic defects in Adrenal sreoidogenesis, 21-Hydrozylase deficiency, 11-Hydroxylase deficiency, Isolated increased adrenal androgen-producing condition of andrenals, Undefined etiology

3) Polycystic Ovarian Disease:

4) Secondary PCOD: Excess male hormone production may also occurs due to Hyperprolactinemia, Hypothyroidism

5) Secondary to Aromatase deficiency

6) Idiopathic Hirsutism i.e. increased hair root sensitivity: It can also due to abnormally increased sensitivity of hair roots to normal level of male hormones so that they over-react & grow long & become dark.

7) Drug Induced: There are many drugs which when used wrongly may lead to development of unwanted hair in females. These drugs are steroids, Diazoxide, Minoxidil, Phenytoin, cyclosporine,& many more drugs.

8) Hypertrichosis

9) Genetic i.e. hereditary

                  Investigation& Diagnostic Tests:

Following tests will be required to diagnose the cause of unwanted facial & or body hair.

Complete hormone profile: LH, FSH, total testosterone, free testosterone, Androstenidione, SHBG, 17 HYDROXYPROGESTERONE, DHEAS, Estradiol, DH Male hormone Suppression Tests

Male hormone Stimulation Tests 

Synacthen test

High Resolution Ultrasound

Color Flow Doppler

MRI

CT abdomen

                                                TREATMENT

Treatment includes suppression of male hormone production & suppression of male hormone action at hair root levels. 

1.) For Unwanted Facial Hair:  

a.)    Cyproterone Acetate

b.)    Ethinostriadol

c.)    Finasteride

d.)    Dutasteride

e.)    Ketoconazole

f.)      Flutamide

g.)    Cimetidine

h.)    Cyproheptadine

i.)      GLUCOCORTICOID

j.)      Combined o. c. pills

k.)    LASER TREATMENT: Permanent cure for the facial hair is LASER TREATMENT at good laser centre.

l.)      I.P.L.

m.)  ELOS

n.)    DOUBLE SQUARE PULSE THERAPY

o.)    IPULSE

After accurate diagnosis it can be treated & cured in approximately one year time by medicine.

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