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Hirsutism and hypertrichosis

Hirsutism and hypertrichosis

Hirsutism is often used to describe androgen-dependent hair growth in women, with hypertrichosis being used for androgen-independent hair growth

Polycystic ovarian syndrome is the most common causes of hirsutism. Other causes include:
  • Cushing's syndrome
  • congenital adrenal hyperplasia
  • androgen therapy
  • obesity: thought to be due to insulin resistance
  • adrenal tumour
  • androgen secreting ovarian tumour
  • drugs: phenytoin, corticosteroids

Assessment of hirsutism
  • Ferriman-Gallwey scoring system: 9 body areas are assigned a score of 0 - 4, a score > 15 is considered to indicate moderate or severe hirsutism

Management of hirsutism
  • advise weight loss if overweight
  • cosmetic techniques such as waxing/bleaching - not available on the NHS
  • consider using combined oral contraceptive pills such as co-cyprindiol (Dianette) or ethinylestradiol and drospirenone (Yasmin). Co-cyprindiol should not be used long-term due to the increased risk of venous thromboembolism
  • facial hirsutism: topical eflornithine - contraindicated in pregnancy and breast-feeding

Causes of hypertrichosis
  • drugs: minoxidil, ciclosporin, diazoxide
  • congenital hypertrichosis lanuginosa, congenital hypertrichosis terminalis
  • porphyria cutanea tarda
  • anorexia nervosa
+PassMedicine Notes

Hirsutism is often used to describe androgen-dependent hair growth in women, with hypertrichosis being used for androgen-independent hair growth

Polycystic ovarian syndrome is the most common causes of hirsutism. Other causes include:
  • Cushing's syndrome
  • congenital adrenal hyperplasia
  • androgen therapy
  • obesity: thought to be due to insulin resistance
  • adrenal tumour
  • androgen secreting ovarian tumour
  • drugs: phenytoin, corticosteroids
Assessment of hirsutism
  • Ferriman-Gallwey scoring system: 9 body areas are assigned a score of 0 - 4, a score > 15 is considered to indicate moderate or severe hirsutism
Management of hirsutism
  • advise weight loss if overweight
  • cosmetic techniques such as waxing/bleaching - not available on the NHS
  • consider using combined oral contraceptive pills such as co-cyprindiol (Dianette) or ethinylestradiol and drospirenone (Yasmin). Co-cyprindiol should not be used long-term due to the increased risk of venous thromboembolism
  • facial hirsutism: topical eflornithine - contraindicated in pregnancy and breast-feeding
Causes of hypertrichosis
  • drugs: minoxidil, ciclosporin, diazoxide
  • congenital hypertrichosis lanuginosa, congenital hypertrichosis terminalis
  • porphyria cutanea tarda
  • anorexia nervosa


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Hirsuitism
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