Advising women with hirsutism

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The Pharmaceutical Journal
Vol 280 No 7504 p663-666
31 May 2008

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Continuing professional development

Advising women with hirsutism

Hirsutism is estimated to affect up to 15 per cent of women.
Christine Clark gives an overview of its diagnosis and management

Continuing professional development articles

Christine Clark, PhD, FRPharmS, is a freelance pharmaceutical writer and consultant

Causes of hirsutism

Mechanical methods of hair removal

Hirsutism is the excessive growth of terminal hairs in women

SUMMARY

Hirsutism is defined as excessive growth of thick, dark hair in women and although it is rarely caused by serious illness, this symptom can undermine confidence and self-esteem and have a profound impact on a woman’s quality of life.

For example, some hirsute women spend several hours each day applying cosmetics to camouflage excess hair growth, while others become reclusive.

Hirsutism can also be a cause of bullying, social isolation and poor educational performance in teenagers and young women.

Many women are unaware of the treatment options available and by the time they seek professional advice they have reached the point of desperation.

The condition, therefore, calls for sensitive handling and provision of clear information.

Full article PDF 80K

Panel 1: Causes of hirsutism

• Genetics
• Polycystic ovarian syndrome
• Menopause
• Drugs
• Congenital adrenal hyperplasia
• Androgen-secreting tumour of adrenal or ovarian origin
• Idiopathy
• Other (including Cushing’s syndrome)

Panel 2: Mechanical methods of hair removal

Method	Advantages	Disadvantages
Shaving	Cheap and effective (many dermatologists assert that shaving does not make hair grow more thickly) Electric razors are less likely to irritate or damage skin	Masculine image makes shaving unacceptable to many women Early stubble during initial days following shaving
Bleaching	Excessive hair looks less obvious Especially good for facial hair Hydrogen peroxide-based products are widely available	Some hydrogen peroxide products can irritate skin
Plucking	Good for removal of long hairs on chin, chest and breasts	Can lead to folliculitis and subsequent scarring
Waxing	Acceptable to many women Pulls hairs out from the roots Can lead to ingrown hairs, folliculitis and scarring	Needs to be repeated regularly
Chemical depilatories	Widely available	Can cause skin irritation (especially on the face)
Electrolysis	Can result in permanent hair loss	Unskilled treatment can cause scarring Individual needles must be used to eliminate HIV and hepatitis risk Painful and expensive Time-consuming (a small area is treated every few weeks)
Laser hair removal	More effective for dark hair than for blond or red hair	Requires qualified operator Expensive and time-consuming May not be as permanent as electrolysis (there is little long-term follow-up data)