Hirsutism: Symptoms, Causes, and Treatment

Hirsutism is the growth of thick hair in women in places where the area of ​​fine hair commonly grows. This excess hair can appear above the lips, on the chin, chest, stomach, and back. This condition occurs due to increased levels of male hormones (androgen). In most cases, this condition is not caused by a serious medical condition, but the cause of hirsutism and the underlying condition may need to be treated.

Symptoms of Hirsutism

When high androgen levels cause hirsutism, other signs may develop over time, this process is called virilization. Virilization is a condition in which women develop male hair patterns and other masculine physical traits.

Women with virilization often have imbalances in their sex hormones, including male sex hormones such as testosterone. Virilization signs may include:

  • Deepening sound (heavy)
  • Bald
  • Zits
  • Breast size shrinks
  • Increased muscle mass
  • Enlargement of the clitoris

When to see a doctor?

If you feel you have too much thick hair on your face or other body parts, consult your doctor about treatment options that can be done. You may be referred to a doctor who specializes in hormonal disorders (endocrinological) or skin problems (dermatological).

Causes of Hirsutism

Increased androgen levels or excessive sensitivity of hair follicles to androgens can cause hirsutism. The following are some other common causes of hirsutism, including:

  • Genes

Sometimes, hirsutism can run in families. If your mother or sister has it, you will most likely get it.

  • Hormone

Often, this condition is associated with high levels of androgen hormones. Androgens in a woman’s body are normal if they are at a low level. When the amount is too high, it causes hirsutism and other things, such as pimples, deep voice, and small breasts.

  • Polycystic Ovary Syndrome (PCOS)

This condition often starts at puberty and causes an imbalance of sex hormones. Over the years, a woman with PCOS can slowly produce excessive hair growth, irregular periods, obesity, infertility, and sometimes the appearance of cysts on the ovaries.

  • Cushing’s Syndrome

This condition occurs when a woman’s body is exposed to high levels of the hormone cortisol. This can develop from the adrenal glands that make too much cortisol, or from taking drugs such as prednisone for a long time.

  • Congenital Adrenal Hyperplasia

This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgens by the adrenal glands.

  • Tumor

Tumors that secrete androgens in the ovaries or adrenal glands can cause hirsutism. Even so, this condition is something that rarely happens.

  • Drugs

Some drugs can cause hirsutism such as minoxidil, danazol, testosterone, and dehydroepiandrosterone (DHEA). If your partner uses topical products that contain androgens, you can also be affected through skin-to-skin contact.

In some cases, cases of hirsutism occur without identifiable reasons.

Risk Factors

Several factors can influence your likelihood of developing hirsutism, including:

  • Family history. Several conditions that cause excess hair, including congenital adrenal hyperplasia and polycystic ovary syndrome occur in the family.
  • Race. Women of Mediterranean, Middle Eastern and South Asian descent are more likely to have more body hair for no reason.
  • Obesity. Being fat causes an increase in androgen production, a condition that can worsen hirsutism.

Diagnosis of Hirsutism

The diagnosis is made with a special test to measure the amount of certain hormones in the blood, including the hormone testosterone. This method can help determine whether androgen levels increase causing excess hair.

In addition, the doctor may also examine the abdomen and pelvic examination to look for masses that can show tumors. The doctor can also test levels of the hormone prolactin to check for signs of tumors in the pituitary gland, check blood sugar levels, and blood cholesterol.

To help identify tumors or physical irregularities that can cause hirsutism, you may be advised to do:

  • MRI to scan the brain.
  • CT scan for the adrenal gland.
  • Ultrasound for ovaries.

Treatment of Hirsutism

Treatment of excess hair without signs of endocrine disruption, so special measures are not needed, this condition makes hirsutism can be cured. As for women who need special care, that means treating the underlying disorder, developing self-care routines, and trying various therapies and medicines.

Home Care

  • Revoke

Pulling excess hair is a good method for removing a few strands of hair, but it is not useful for removing most of the hair. Pulled hair usually grows back. This method can be done with tweezers, thin threads (threading) or other devices designed to pull hair.

  • Shaving

Shaving is a quick and inexpensive procedure, but it needs to be repeated regularly.

  • Waxing

Waxing involves applying warm wax to the skin where unwanted hair is growing. After the wax has hardened, you pull it from the skin to remove hair. Waxing removes hair from large areas quickly, but this method causes temporary pain and sometimes causes irritation or redness of the skin.

  • Depilation

Depilation is the removal of strands of hair by leaving the hair roots intact. This procedure is carried out by applying special chemicals to the area of ​​the skin with excess hair. These products are available in various forms, such as gels, creams or lotions. Be aware, this technique can irritate the skin and cause dermatitis. You must repeat the extraction regularly to maintain its effect.

  • Bleaching

This method is done by brightening the hair color, making it less visible to people with light skin. Hair bleach usually contains hydrogen peroxide, which can cause skin irritation. Before using immediately in large quantities, test first on a small area in the skin.


If home care is not effective against excessive hair, talk with your doctor about medications that can be taken to treat hirsutism. Here are some drugs that can be used, including:

  • Oral contraception

Birth control pills or other hormonal contraceptives, which contain estrogen and progestin, can be used to treat hirsutism caused by androgens. Possible side effects include nausea and headaches.

  • Anti-androgen

These drugs block androgens from attaching to receptors in the body. This drug is sometimes prescribed after six months using oral contraceptives but is not effective enough to overcome hirsutism.

The most common anti-androgen used to treat hirsutism is spironolactone. The results are simple and require at least six months to be seen. Possible side effects include irregular menstruation. It is important to know, this drug can cause birth defects, so it is important to use contraception when taking it.

  • Topical Cream

Eflornithine is a special prescription cream for excess facial hair in women. This cream is applied directly to the affected area twice a day. Eflornithine helps slow the growth of new hair but does not eliminate existing hair. Usually, this cream is used with laser therapy to improve response.

Medical Procedure

  • Electrolysis

This method is done by inserting a small needle into each hair follicle. The needle emits pulses of electric current to damage and eventually destroy the follicle. In people with natural blonde or white hair, electrolysis is a better choice than laser therapy. This treatment may need to be done several times.

Electrolysis is effective but can be painful. Numb cream that is used on the skin before treatment can reduce discomfort.

  • Laser therapy

Laser light passes through the skin to damage hair follicles and prevent hair growth (photoepilation). For those of you whose excess hair does not want black, brown, or reddish brown, photoepilation is usually a better choice than electrolysis.

Talk to your doctor about the risks and benefits of various lasers used. People with tanned or dark pigmented skin have a higher risk of experiencing side effects from certain lasers, including darkening or lightening of the skin’s usual color, blisters, and inflammation.

Prevention of Hirsutism

Hirsutism generally cannot be prevented. But losing weight if you are overweight can help reduce excess hair, especially if you have polycystic ovary syndrome.


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