Hirsutism is the excessive growth of coarse hair on various body parts, which usually mimics the distribution of hair seen on men (e.g moustache, beard, chest, inner thigh, between the belly button and pubic bone).

It occurs in about 5 per cent of the female population.

Family history or ethnicity can play a role in developing hirsutism. Certain ethnic groups tend to have more body hair than others, so it isn’t unusual for women of Mediterranean, Middle Eastern or South Asian heritage to have mild hirsutism. This is generally more of a cosmetic concern in North America than in countries where hirsutism is commonly seen in women.

Hirsutism can be caused by hormonal activity when hair follicles are overly sensitive to normal amounts of testosterone, instead of an actual excess of testosterone. Less commonly, hirsutism is due to an imbalance such as the overproduction of androgens (male androgens), particularly testosterone.

Obesity can also cause hirsutism, because it causes increased androgen production.

A woman’s first step in dealing with excess hair growth is having a doctor’s assessment. The doctor will take a gynecologic history and do a physical exam to check sites for evidence of hirsutism. If necessary, further procedures may also be performed including blood tests to measure androgen levels and imaging (e.g. ultrasound) to examine ovariesand adrenal glands for abnormalities.

Often there is no identifiable underlying reason (idiopathic hirsutism).

However, some conditions marked by high androgen levels that can result in hirsutism include:

Polycystic ovary syndrome (PCOS) — the most common underlying medical reason for hirsutism; symptoms include irregular periods, obesity, infertility and ovarian cysts.

Benign adrenal hyperplasia — a condition whereby the adrenals produce too much cortisol, a steroid hormone in response to stress; abnormal levels of cortisol can affect levels of other sex hormones.

Tumours — may be present in the ovaries or adrenal glands. This is a rare occurrence. When present, these tumours can overproduce androgens.

A combination of approaches helps you manage hirsutism, including: treating any underlying disorder, self-care, hair-removal therapies and medications.

As with any unwanted hair, removal options usually involve plucking, shaving, threading, waxing or use of depilatory creams. Electrolysis and laser hair removal can be used to permanently remove hair, but often they reducehair. Bleaching can make hair less visible.

Eflornithine in a cream form (e.g. Vaniqa*) may be prescribed to slow the cycle of hair growth.

Medications may be used to control excess hair growth if the underlying cause is related to a hormonal imbalance. Oral contraceptives (particularly those containing drospirenone or cyproterone acetate) and/or anti-androgens (spironolactone, cyproterone acetate, finasteride) may be prescribed.

All medications can have unwanted side effects which you should discuss with your doctor before starting any treatment.

* Please note the mention of a brand name does not constitute formal recommendation of the product by the Canadian Dermatology Association.