Last week, a mother aged about 40 years brought her daughter, who is around 17 years with a mustache (hair that grows on the top lip, between the mouth and nose and a beard (hair that grows on the chin, cheeks, and jaw lightly. Mother was so worried about this condition, and her daughter also asked me why it is happening like this to her. She also said that in college, many of her contemporary boys and girls are teasing and mocking her.
This condition is called Hirsutism. It is characterized by excessive growth of dark, coarse hair in a male-like pattern in women, typically on the face, chest, and back. It’s often caused by an excess of androgens, or male hormones, like testosterone, and can be a symptom of underlying conditions like Polycystic Ovary Syndrome (PCOS). Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder in women of reproductive age.
It’s characterized by irregular periods, excess androgen levels, and or polycystic ovaries. PCOS can lead to a variety of health issues, including infertility, insulin resistance, and an increased risk of type 2 diabetes, heart disease, and Hirsutism. PCOS is primarily caused by an imbalance of reproductive hormones, specifically an excess of androgens (male hormones). Many women with PCOS experience infrequent, irregular, or prolonged menstrual cycles due to the hormonal imbalance. High androgen levels can lead to symptoms like excessive hair growth (hirsutism), acne, and male-pattern baldness.
Prevalence in India
Studies on hirsutism in India show varying prevalence rates, ranging from 2.4% to 38%. South Indian studies, particularly in Kerala, have reported higher prevalence rates when clinical examination or verification of self-assessment was used. Idiopathic hirsutism is a common cause, but PCOS and other factors like hyperandrogenism (excess androgen production) are also implicated. A study in South India found that 30% of patients with hirsutism were obese, and 31.8% of those had features of metabolic syndrome. Menstrual irregularities and elevated testosterone levels are also frequently observed in women with hirsutism.
Social stigma
Adolescents are often more concerned about hirsutism than older women, particularly regarding facial hair. Social stigma surrounding hirsutism can negatively impact quality of life. A study in India found that hirsutism can affect the quality of life, especially in women with PCOS, according to a study by the International Journal of Research in Dermatology.
Hirsutism is the term for the excessive growth of terminal hair (thick, dark hair) in women in areas where hair growth is typically more prominent in men, such as the face, chest, back, and abdomen. The primary cause is an excess of androgens, which can be due to various factors like PCOS, adrenal gland disorders, or tumors. It can also run in families. Certain medications, like anabolic steroids or corticosteroids, can also trigger hirsutism. To elaborate on the symptoms in addition to excessive hair growth, there can be a male-like pattern, acne, irregular menstrual cycles, weight gain, infertility, balding, and deepening of the voice are also noticed.
Medications
Depending on the cause, medications like anti-androgens or birth control pills can help manage hirsutism. Hair removal is advised based on the interest of the victim, in which various methods like shaving, waxing, electrolysis, or laser hair removal can be used to manage the excess hair.
An important note to readers is that it’s crucial to consult a qualified medical expert for proper diagnosis and treatment, as hirsutism can be a symptom of other underlying conditions.
Treatment
Treatment of hirsutism may be accomplished pharmacologically or by mechanical means of hair removal. No pharmacological treatments can be considered in all patients, either as the only treatment or as an adjunct to drug therapy. Non-pharmacologic treatments include facial hair bleaching, which lightens dark facial hair, making it less noticeable, and can also brighten the skin’s appearance.
This is achieved by applying a cream or powder (mixed with an activator) that lightens the hair by breaking down melanin. It’s a quick and relatively painless way to manage unwanted facial hair, but it doesn’t remove the hair, just changes its color. Secondly, depilatory creams and laser treatments are common options for facial hair removal.
Depilatory creams, also known as hair removal creams, offer a convenient, temporary solution by breaking down hair with chemicals at the skin’s surface. Depilatory creams contain alkaline ingredients that dissolve the keratin protein in hair, causing it to break down and be wiped away.
Hair removal from the skin surface, such as shaving and chemical treatments, is also in use, and another method is epilating in which removes the hair, including the root, such as plucking, waxing, electrolysis, and laser therapy. Despite perceptions to the contrary, shaving does not increase the rate or density of hair growth.
Chemical depilatory treatments may be useful for mild hirsutism that affects only limited skin areas, though they can cause skin irritation. Wax treatment removes their wax temporarily but is uncomfortable. Electrolysis is effective for more permanent hair removal, particularly in the hands of a skilled electrologist. Laser phototherapy appears to be efficacious for hair removal. It delays hair regrowth and causes permanent hair removal in most patients. Laser treatments, on the other hand, target hair follicles with concentrated light beams to inhibit hair regrowth, providing longer-lasting results.
The long-term effects and complications associated with laser treatment are being evaluated. General management and specific management and a combination of different therapies for Hirsutism will be discussed in the coming issue.
