Hirsutism

Hirsutism is excess terminal hair growth with a male pattern distribution. It can be one of the most distressing conditions for women. Occasionally it is underlined by serious pathology, hence the importance of thorough history, examination and investigation. This article first examines the underlying physiology associated with human hair growth and relevant to the understanding of the causes and treatment of hirsutism. Causes of hirsutism are discussed, the most common being polycystic ovarian syndrome. Other causes of disordered androgen metabolism are also discussed. Treatment of hirsutism includes treatment of the underlying cause and often lifestyle modifications such as weight loss are needed. Cosmetic measures are helpful for existing hair while prevention of new hair growth often requires pharmacological intervention. This is most commonly achieved using the combined oral contraceptive pill, while anti-androgens are reserved for more severe and resistant cases.