What Is Hirsutism?

Human race, age, gender, nutrition, climate, and emotions can all affect the growth of hair. For example, Europeans have thicker hair than Asians, and males have longer, thicker, denser, and deeper hair than women. Even for people of the same ethnicity in the same area, normal males and females have hair growth differences such as morning and evening, speed, number, thickness, length, and shade. These belong to the normal range, just like there are people in the crowd who are tall, short, and thin.

Basic Information

English name: hirsutism
Visiting department: Endocrinology
Multiple groups: female

Common causes: Related to family genetics, adrenal gland, central, ovary and other factors
Common symptoms: Too much hair

Causes of hirsutism

1. Familial hereditary hirsutism.

2. Adrenal hirsutism

(1) Adrenal tumor.

(2) Cushing's disease.

(3) The virilization of congenital adrenal hyperplasia.

3. Central hirsutism

(1) Cerebral hirsutism.

(2) Hypothalamus and pituitary hirsutism.

4. Ovarian hirsutism

(1) Polycystic ovary syndrome.

(2) Ovarian tumors.

5. Drug-induced hirsutism.

6. Insulin resistance syndrome and hirsutism.

7. Idiopathic hirsutism.

8. Other hirsutism

Such as hypothyroid hirsutism, menopausal hirsutism and gestational hirsutism are mostly temporary hirsutism.

Clinical manifestations of hirsutism

Idiopathic hirsutism

(1) Idiopathic hirsutism Familial or constitutional hirsutism has an obvious tendency of familial disease. Hairy started in adolescence and continued to develop for the next 10 years. The patient had no other endocrine abnormalities, normal menstruation and normal androgen levels in the circulation. At present, it is thought that the disease is mainly caused by increased sensitivity of the hair follicles and sebaceous glands to androgens or increased local 5 reductase activity resulting in increased DHT.

(2) Other endocrine diseases Patients with acromegaly and all diseases that can cause hyperlactation may appear hairy. In patients with hyperthyroidism and anterior tibial myxedema, hairy areas may appear in the anterior tibial edema.

2. Androgenous hirsutism

The hirsutism caused by increased androgens accounts for 75% to 85% of the disease. Androgens in women are mainly derived from the adrenal glands and ovaries. Various diseases of these two organs may lead to elevated androgens in the circulation. Also accompanied by the performance of other organs: seborrheic dermatitis, hair loss, obesity, black acanthosis and so on. Common diseases include:

(1) Polycystic ovary syndrome.

(2) Ovarian tumors.

(3) Ovarian follicular membrane cell proliferation.

(4) Congenital adrenal hyperplasia.

(5) hypercortisolism.

(6) Insulin-resistant Acanthosis Syndrome.

3. Drug-induced hairy

It is relatively rare clinically, but in fact many drugs may cause hirsutism, such as testosterone, glucocorticoids, etc. Hair hormones can also be caused by hormones in replacement therapy for menopausal women.

Differential diagnosis of hirsutism

1. Too much hair and hirsutism

Too much hair refers to an increase in body surface hair. Most of them have a history of excessive hair at home, without virilization, and do not require treatment. And hirsutism refers to the excessive growth of hair in some parts of women, generally appearing in the upper and lower limbs, the face; the distribution pattern has a male tendency, increased hair in the jaw, above the lips, in front of the ears, forehead, and back neck, around the nipples, and under the umbilical foramen The midline is also accompanied by virilization. If there is a laryngeal knot, a low tone and a clitoral hypertrophy, etc., treatment is needed.

2. Other diseases

It should be differentiated from polycystic ovary syndrome, adrenal hyperplasia, adrenal cortical adenoma, adrenal cortical cancer, ovarian tumors, and ectopic ACTH syndrome. If it is polycystic ovary syndrome, there may be obesity, amenorrhea, infertility, clitoral hypertrophy, acne, breast hypoplasia, and hirsutism. If it is adrenal hirsutism, there can also be centripetal obesity, hypertension, acne, amenorrhea, blood quality, skin purple streaks, full moon face and osteoporosis, etc., its cortisol level increases, urine 17-KS and 17 -OHCS elevation and urinary cortisol can be differentially diagnosed.

The relatively rare congenital adrenal hyperplasia is more easily identified with an amphoteric deformity. However, late-onset and recessive patients tend to develop after puberty and have allelic mutations. The clinical manifestations are only hairy and clitoral mild hypertrophy, which is not easy to differentiate from idiopathic hirsutism.

Hirsutism treatment

Surgical treatment

It is clear that the cause of hirsutism is caused by each tumor. The tumor should be removed by surgery, and hirsutism can disappear.

2. Drugs that inhibit adrenal hyperplasia

For late-onset congenital adrenal hyperplasia, glucocorticoid drugs, such as prednisone or dexamethasone, can be used to inhibit androgen secretion, but it should not be taken in excess, as it can cause side effects.

3. Drugs that inhibit ovarian androgen secretion

(1) Oral contraceptives are mostly used to treat idiopathic hirsutism, and compound norethisterone tablets are available.

(2) Ketoconazoles Oral ketoconazole is beneficial for the treatment of polycystic ovary syndrome and idiopathic hirsutism.

4. Other drugs that antagonize the action of androgens

(1) Spironolactone (Antishutong) has the effect of antagonizing androgens.

(2) Cyproterone (Sepron) has the effect of antagonizing androgens, and can be used in combination with other drugs, such as combined with ethinylestrone, but side effects may occur, and should be discontinued when the side effects are large.

5.Symptomatic treatment laser hair removal

Treatment with ruby, laser or YAG laser. Hair follicles are destroyed primarily by thermal damage. Side effects: local swelling, erythema, bruising, pigmentation. The cause of hirsutism is different, and symptomatic treatment can be used. If the symptoms are mild, no treatment is required.

Hirsutism prevention

There are other aggravating factors in the onset and progression of hirsutism. These factors can aggravate hirsutism and bring many complications, and directly affect the treatment and recovery of hirsutism. There are a few things to note:

1. Discomfort, long-term anger and depression, anxiety, anxiety and other bad emotional stimuli.

2. The diet structure is unreasonable, has had bad habits of eating greasy, spicy food and excessive drinking, and often accompanied by long-term constipation.

3. Life rhythm disorder, has a long history of staying up late.

4. Inappropriate care of skin and hair, usually using cosmetics or toiletries that are not suitable for their own conditions.

5. Mistreatment, incorrect plucking or hair removal methods or too frequent plucking and hair removal.