Hirsutism: Diagnosis and management

Hirsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women, which grows in a typical male distribution pattern. Hirsutism is a common clinical problem in women, and the treatment depends on the cause. The condition is often associated with a loss of self--esteem. Hirsutism reflects the interaction between circulating androgen concentrations, local androgen concentrations, and the sensitivity of the hair follicle to androgens. Polycystic ovary syndrome and idiopathic hirsutism are the most common causes of the condition. A woman's history and, physical examination are particularly important in evaluating excess hair growth. The vast majority of women with hirsutism have the idiopathic variety, and the diagnosis is made by exclusion. Serum testosterone level > 200 ng/dL is highly suggestive of adrenal or ovarian tumor. Treatment of hirsutism should be based on the degree of excess hair growth presented by the patient and in the pathophysiology of the disorder. Treatment includes lifestyle therapies, androgen suppression, peripheral androgen blockage, and cosmetic treatments. The current review discusses definition, pathogenesis, physiopathology, differential diagnosis, diagnostic strategies, and treatment. Arq Bras Endocrinol Metab. 2014;58 (2) PATHOGENESIS OF HIRSUTISMH irsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women. Hair appears in a masculine distribution pattern and is coarse. Hirsutism is more than a cosmetic problem. It may be linked to significant underlying diseases, and is often associated with a decreased quality of life, and an impaired self-image of the patient feminine identity (1). The causes of hirsutism may be divided into androgenic factors, non-androgenic factors, and idiophatic hirsutism. Non-androgenic factors are relatively rare, while androgenic causes account for more than 80% of patients, and include polycystic ovary syndrome (PCOS), which affects about 70-80% of hirsute women.Hirsutism must be distinguished from hypertrichosis, which is characterized by increased hair growth in a generalized nonsexual distribution and is independent of androgens. Usually, hypertrichosis presents generalized or localized growth of vellus type (non-terminal) http://dx

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“…The vast majority of women with hirsutism have the idiopathic variety, and diagnosis is made by exclusion (14).…”

Section: Diagnosismentioning

confidence: 99%

“…More ominous signs of virilization, including clitoromegaly, deepening voice, malepattern alopecia (fronto-temporal and vertex thinning of the hair on the scalp), and loss of female body contour, should also be noted (14).…”

Section: Diagnosismentioning

confidence: 99%

Hirsutism: diagnosis and treatment

Hohl

Ronsoni

Oliveira

2014

Arq Bras Endocrinol Metab

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“…It is a particularly important diagnosis to make, because it often significantly affects a woman's perception of her femininity and less commonly can be a sign of an underlying malignancy or a cutaneous manifestation of a condition with significant cardiovascular or other morbidity. A variety of treatments exist to help minimize the appearance of unwanted hair [18]. In this part, treatment modalities are summarized in (Table 1).…”

Section: Treatmentmentioning

confidence: 99%

“…Most patients require at least 5 to 7 sessions at least 1 month apart to permanently reduce hair growth on any single area. Hair growth is delayed when shock waves induced by thermal energy damage the germinal cells of the hair follicle [45]. Compared to electrolysis, laser treatment was shown to be a more expensive yet much less painful method that is 60 times faster.…”

Section: Shavingmentioning

confidence: 99%

Hirsutism: Diagnosis and Treatment

Öner¹

2012

J Metabolic Synd

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Hirsutism, which is a common clinical problem in women of reproductive age, is characterized by excessive growth of terminal hair in the androgen-sensitive skin regions. It is the result of either androgen excess or increased sensitivity of the hair follicles to normal levels of androgens. The therapeutic options of hirsutism can be divided into systemic, topical, and dermato-cosmetic therapies. Patients should be informed that the response to systemic agents is slow; occurring over 3-6 months after therapy has begun. In this review, the diagnosis and treatment of hirsutism were summarized with update literature.

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“…En cuanto al componente psicológico, el hirsutismo está asociado con detrimento de la calidad de vida, alta prevalencia de desórdenes ansiosos y baja autoestima en adolescentes (2,16,17). El hirsutismo, junto con el acné, la alopecia y la oligomenorrea son expresiones clínicas del hiperandrogenismo, uno de los desórdenes endocrinos más frecuentes en mujeres en edad fértil (18).…”

Section: Introductionunclassified