Hirsutism: Identifying and Addressing the Issue

Diagnosing Hirsutism

To identify the cause of hirsutism, doctors may conduct tests to measure specific hormone levels in your blood, such as testosterone and other androgen-like hormones. This helps determine if elevated androgen levels are responsible for your hirsutism.

In addition, your doctor might perform an abdominal examination and a pelvic exam to check for any masses that could indicate a tumor.

Addressing Hirsutism

If there is no evidence of an endocrine disorder, hirsutism treatment may not be required. However, for women who need or want treatment, options may include managing any underlying disorder, developing a self-care routine for hair removal, and exploring various therapies and medications.

Medication Options

If you’ve tried cosmetic or self-care hair removal methods without success, consider discussing medication options with your doctor. Typically, it takes up to six months for these medications to show significant changes in hair growth. Available options include:

  1. Oral contraceptives: Birth control pills or other hormonal contraceptives containing estrogen and progestin help treat hirsutism caused by androgen production. They are commonly used for hirsutism in women who don’t want to become pregnant. Side effects may include nausea and headaches.
  2. Anti-androgens: These drugs prevent androgens from binding to their receptors in the body. They may be prescribed if oral contraceptives aren’t effective enough after six months. The most commonly used anti-androgen for hirsutism is spironolactone (Aldactone, CaroSpir). Results are typically modest and take at least six months to become noticeable. Possible side effects include menstrual irregularities. Contraception is necessary while taking these drugs due to the risk of birth defects.
  3. Topical creams: Eflornithine (Vaniqa) is a prescription cream designed specifically for excessive facial hair in women. Applied twice a day to the affected area, it slows new hair growth without eliminating existing hair. It can be used alongside laser therapy for enhanced results.

Long-Lasting Hair Removal Procedures

Procedures that offer longer-lasting results than self-care methods and can be combined with medical therapy include:

  1. Laser therapy: A highly concentrated laser light damages hair follicles and prevents hair growth (photoepilation). Multiple treatments may be required. Photoepilation is usually more effective than electrolysis for individuals with black, brown, or auburn hair. Consult your doctor about the risks and benefits of different lasers for hair removal. Individuals with tanned or dark skin may experience side effects, such as changes in skin tone, blistering, and inflammation.
  2. Electrolysis: This procedure involves inserting a tiny needle into each hair follicle, emitting an electric current to damage and eventually destroy the follicle. Multiple treatments may be necessary. Electrolysis is preferred over laser therapy for people with naturally blond or white hair. Although effective, electrolysis can be painful. Applying a numbing cream before treatment may help alleviate discomfort.

Lifestyle and Home Remedies

Temporary self-care methods for removing or reducing the visibility of unwanted facial and body hair include:

  1. Plucking: Useful for removing a few stray hairs, but not large areas of hair. Plucked hair typically regrows. Tools for plucking include tweezers, thin threads (threading), or other specially designed devices.
  2. Shaving: A quick and inexpensive method that needs to be repeated regularly.
  3. Waxing: Involves applying warm wax to the skin where unwanted hair grows, then removing the wax once it hardens. Waxing is fast but may cause temporary stinging, skin irritation, and redness.
  1. Depilation: Chemical depilatories dissolve hair when applied to the affected skin. These products come in various forms, such as gels, creams, or lotions. They may irritate the skin and cause dermatitis. Regular depilation is necessary to maintain the effect.
  2. Bleaching: Lightens hair color, making it less noticeable on people with light skin. Hair-bleaching products usually contain hydrogen peroxide and may cause skin irritation. Test any product on a small patch of skin before using it.

Preparing for Your Appointment

When scheduling your appointment, ask if you should avoid hair removal so the doctor can better assess your condition. Prepare a list of:

  1. Key personal information, including other medical conditions and changes in your menstrual cycle or sex drive.
  2. All medications, vitamins, and supplements you take, including doses.
  3. Questions to ask your doctor.

For hirsutism, consider asking your doctor the following questions:

  1. What is likely causing my symptoms?
  2. What are other possible causes for my symptoms?
  3. What tests do I need?
  4. Is my condition likely temporary or chronic?
  5. What is the best course of action?
  6. What are the alternatives to the primary approach you’re suggesting?
  7. How can I best manage my other health conditions alongside this one?
  8. Should I see a specialist?
  9. Are there brochures or other printed materials I can have? What websites do you recommend?

Feel free to ask any other questions that come to mind.

What to Expect from Your Doctor

Your doctor may ask you questions like:

  1. When did your symptoms begin?
  2. Has your menstrual cycle changed, or have you stopped having your period?
  3. Have you gained weight?
  4. Have you developed new acne?
  5. Has the size of your breasts changed?
  6. Have others commented on changes in your voice?
  7. Are you planning to become pregnant soon?


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