Hirsutism
What is it?
This is excessive hair growth in areas of the female body that are sensitive to male hormones (androgens). These areas include the face (particularly the area above the upper lip and chin), breasts, breast areolas, abdomen (particularly the midline, or white line of the abdomen), back, buttocks, thighs, arms (from shoulder to elbow) and genital area.
Causes and risk factors
One of the most common causes of hirsutism is polycystic ovaries, which leads to excessive production of testosterone and other androgenic hormones by the ovaries, which often appear enlarged on ultrasound and contain numerous follicles in various stages of degeneration (hence the incorrect term "polycystic ovaries"). Polycystic ovaries are a benign condition, but they can, in addition to cosmetic problems, cause infertility.
Which are the symptoms?
Hirsutism can occur in isolation, but is often associated with disorders such as irregular or disappearing menstrual flow, hair loss, acne, overweight or obesity. In rare cases, there may be signs of virilization, such as an enlarged clitoris, a lowered tone of voice, loss of a feminine silhouette, or blackish skin discoloration, especially in the neck or armpits (acanthosis nigricans). It usually results from overproduction of androgens (known as male hormones, but also present in women) by the ovaries or adrenal glands. In other cases, hirsutism occurs when androgen levels are normal due to excess sensitivity of the skin to their action.
How is it diagnosed?
Suggested exams
How is it treated?
Therapy includes primarily behavioral norms aimed at normalizing body weight (these patients are often overweight). Pills containing cyproterone acetate, a compound capable of blocking the action of androgenic hormones, play a central role among drugs. Treatment must be prolonged, and results can be unsatisfactory, especially in patients with poor dietary adherence. Electrocoagulation or laser therapy can provide valuable therapeutic support.
It is important that the treatment of hirsutism is not entrusted to a cosmetologist, whose task is to support rather than replace the work of a gynecologist and endocrinologist.
Where do we treat it?
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