Hirsutism
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| Hirsutism Classification and external resources | |
| ICD-10 | L68.0 |
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| ICD-9 | 704.1 |
| MedlinePlus | 003148 |
| eMedicine | med/1017 derm/472 |
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Ongoing Trials on Hirsutism at Clinical Trials.gov Clinical Trials on Hirsutism at Google
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US National Guidelines Clearinghouse on Hirsutism
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Patient resources on Hirsutism Discussion groups on Hirsutism Directions to Hospitals Treating Hirsutism Risk calculators and risk factors for Hirsutism
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Hirsutism (from Latin hirsutus = shaggy, hairy) is defined as excessive and increased hair growth in women in locations where the occurrence of terminal hair normally is minimal or absent. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern. Hirsutism is a symptom rather than a disease and may be a sign of a more serious medical indication, especially if it develops well after puberty.
Appearance and evaluation
Hirsutism only affects women, since the rising of androgens causes a male pattern of body hair, particularly in locations where women normally do not develop terminal hair within their puberty (chest, abdomen, back and face). The medical term for excessive hair growth that affect both men and women is hypertrichosis.
One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.
Diagnosis
Common Causes
The cause of hirsutism can be either an increased level of androgens (male hormones) or an oversensitivity of hair follicles to androgens. Male hormones such as testosterone stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass.
Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.
It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Again, the result is increased androgen production.
The following may be some of the conditions that may increase a woman's normally low level of male hormones:
- Polycystic ovary syndrome
- Cushing's disease
- Tumors in the ovaries or adrenal gland (cancer)
- Certain medications
- Congenital adrenal hyperplasia
- Insulin resistance
Physical Examination
Skin
Differential Diagnosis of Causes of Hirsutism
- Idiopathic:
- familial,
- possibly increased sensitivity to androgens.
- variant of normal menopause.
- Polycystic ovarian syndrome.
- obesity
- Drugs:
- androgens,
- anabolic steroids,
- methyltestosterone,
- minoxidil,
- diazoxide,
- phenytoin,
- glucocorticoids,
- cyclosporine.
- phenytoin,
- Congenital adrenal hyperplasia.
- Adrenal virilizing tumor.
- Ovarian virilizing tumor:
- arrhenoblastoma,
- hilus cell tumor.
- Pituitary adenoma.
- pregnancy
- Insulin resistance
- Cushing's syndrome.
- Hypothyroidism (congenital and juvenile).
- Acromegaly.
- Androgen-secreting tumors of the ovaries
- Sertoli-Leydig cell tumors,
- granulosa-theca cell tumors,
- hilus-cell tumors
- hyperprolactinemia
- Testicular feminization.
Treatment
Many women with unwanted hair seek methods of hair removal to control the appearance of hirsutism. But the actual causes should be evaluated by physicians, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the best course of treatment.
See also
References
- Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. Journal of Clinical Endocrinology 1961; 21:1440-1447.
External links
WikiDoc Research Resources for Hirsutism | |
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| Articles on Hirsutism | Most recent articles on Hirsutism • Most cited articles on Hirsutism • Review articles on Hirsutism • Articles on Hirsutism in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Hirsutism | Powerpoint slides on Hirsutism • Images of Hirsutism • Photos of Hirsutism • Podcasts & MP3s on Hirsutism • Videos on Hirsutism |
| Evidence Based Medicine Regarding Hirsutism | Cochrane Collaboration on Hirsutism • Bandolier on Hirsutism • TRIP on Hirsutism |
| Cost Effectiveness of Hirsutism | Cost Effectiveness of Hirsutism |
| Clinical Trials Involving Hirsutism | Ongoing Trials on Hirsutism at Clinical Trials.gov • Trial results on Hirsutism • Clinical Trials on Hirsutism at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Hirsutism | US National Guidelines Clearinghouse on Hirsutism • NICE Guidance on Hirsutism • NHS PRODIGY Guidance • FDA on Hirsutism • CDC on Hirsutism |
| Textbook Information on Hirsutism | Books and Textbook Information on Hirsutism |
| Pharmacology Resources on Hirsutism | Dosing of Hirsutism • Drug interactions with Hirsutism • Side effects of Hirsutism • Allergic reactions to Hirsutism • Overdose information on Hirsutism • Carcinogenicity information on Hirsutism • Hirsutism in pregnancy • Pharmacokinetics of Hirsutism • |
| Genetics, Pharmacogenomics, and Proteinomics of Hirsutism | Genetics of Hirsutism • Pharmacogenomics of Hirsutism • Proteomics of Hirsutism |
| Newstories on Hirsutism | Hirsutism in the news • Be alerted to news on Hirsutism • News trends on Hirsutism |
| Commentary on Hirsutism | Blogs on Hirsutism |
| Patient Resources on Hirsutism | Patient resources on Hirsutism • Discussion groups on Hirsutism • Patient Handouts on Hirsutism • Directions to Hospitals Treating Hirsutism • Risk calculators and risk factors for Hirsutism |
| Healthcare Provider Resources on Hirsutism | Symptoms of Hirsutism • Causes & Risk Factors for Hirsutism • Diagnostic studies for Hirsutism • Treatment of Hirsutism |
| Continuing Medical Education (CME) Programs on Hirsutism | CME Programs on Hirsutism |
| International Resources on Hirsutism | Hirsutism en Espanol • Hirsutism en Francais |
| Business Resources on Hirsutism | Hirsutism in the Marketplace • Patents on Hirsutism |
| Informatics Resources on Hirsutism | List of terms related to Hirsutism |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
