Excessive Hair Growth (Hirsutism)

Hirsutism is when women experience excessive hair growth on parts of the body where men usually grow hair. About 8 percent of women in the United States have some form of excessive hair growth.

Women of Middle Eastern, South Asian, and Mediterranean ancestry are more likely to develop hirsutism than women of other ethnicities. About half of women with hirsutism produce high levels of male hormones called androgens from their ovaries and adrenal glands. Hormonal disorders, such as polycystic ovary syndrome (PCOS), may cause this to happen.

Hirsutism occurs in 80 percent of women who have PCOS.

What are the symptoms of hirsutism?

  • textured, pigmented hair where men typically grow hair, such as the face, chest, and back.

If the hirsutism is caused by excessive levels of the male hormone testosterone, your daughter may experience:

  • deepening voice
  • irregular menstrual periods
  • acne
  • increased muscle mass
  • decreased breast size

If the hirsutism is caused by Cushing's syndrome, you daughter may show:

What causes hirsutism?

Many women with hirsutism don't have a hormonal imbalance or they have hair that is more sensitive to small amounts of hormones. About half of women with excessive hair growth do have an underlying hormonal condition that makes hair grow thicker and faster. Some medications can stimulate excessive hair growth as well.

Causes of hirsutism may include:

  • congenital adrenal hyperplasia
  • Cushing's syndrome
  • polycystic ovary syndrome
  • tumors on the adrenal glands or ovaries
  • severe insulin resistance
  • medications like phenytoin, minoxidil, diazoxide, cyclosporine, and hexachlorobenzene
  • anabolic steroids
  • Danazol, a substance used to treat endometriosis

How does a doctor know that my daughter has hirsutism?

Your daughter should have a blood test to detect possibly elevated androgen levels and diagnose a hormonal condition that could be causing the hair growth.

A CT scan, MRI, or pelvic ultrasound may be used to catch tumors on the adrenal glands or ovaries.

How we treat hirsutism

Boston Children's Hospital's Reproductive Endocrinology and PCOS Program, part of the Division of Adolescent/Young Adult Medicine, provides expert evaluation and treatment of adolescents and young women with excessive hair growth.

Treatment of hirsutism depends on the underlying cause influencing your daughter's hair growth. She may be advised to stop taking a certain medication. Or, if she has a condition such as polycystic ovary syndrome, she may need to start one of the excellent long-term treatments available to control the irregular periods and acne along with the hair growth.

If hirsutism is caused by a hormonal condition, she may be prescribed:

  • oral contraceptives, such as birth control pills, which treat excessive hair growth because the estrogen and progestin they contain prevent the ovaries from producing androgens
  • anti-androgens, drugs that stop androgens from attaching to receptors in the female body and prevent their effects. The most common anti-androgen is spironolactone (Aldactone).
  • topical creams, which work directly on the skin to slow down the growth of female facial hair. Eflorinthin (Vaniqua) takes up to two months to have an effect.

Other options may include bleaching, waxing, depilatories, electrolysis, and laser treatment. A young woman may require help finding a local salon that provides high quality, cost-effective services.