Hirsutism - Hair and nail disorders

Hirsutism

Definition

Hirsutism is the androgendependent growth of hair in a woman, which is in the same distribution as in males.

acne, seborrhoea, androgenic alopecia, deepening of the voice and clitoromegaly. The abdomen should be examined for masses.

Aetiology/pathophysiology

There is a wide geographical variation in the ‘normal’ body hair independent of androgen production. Hirsutism is caused by increased androgen production or, more rarely, increased sensitivity of hair follicles to androgens (see Table 9.6). There may be associated men- strual problems.

Clinical features

Patients present with male pattern hair growth on the lip, chin, chest, abdomen, back, arms and legs more than that expected for a woman of the same ethnic background.  Women with a normal menstrual cycle are unlikely to have an endocrine cause. Other features may include .

Investigations

Dependent on the level of virilisation and menstrual anomalies found; hormone profile and abdominal imaging may be required.

Management

Any underlying cause for excess androgen production should be identified and treated.

Physical methods of hair removal include shaving, chemical depilatories, bleaching, electrolysis and laser treatments.

Combined oral contraceptives may slow hair growth; antiandrogens may also be effective.