All women have body hair, but it may be more noticeable in some than in others and include growth on the face. Hirsutism in women is when this hair growth becomes excessive.
Treatment for hirsutism in women begins by doctors determining if the hair growth is due to an underlying condition or other reasons. In all cases, some women may find it helpful to use shaving, tweezing, waxing, and hair removal creams.
Hirsutism may be because of an underlying medical condition such as:
- polycystic ovary syndrome (PCOS), which is a hormonal disorder
- adrenal hyperplasia, a disorder that affects the production of steroid hormones
- idiopathic hyperandrogenemia, a condition where the body produces too much androgen
- tumors that release additional hormones
- thyroid disorders that affect hormone levels
Unless the cause is due to an underlying health condition, excessive or unwanted hair is not of concern to doctors for medical reasons.
Hormones called androgens are the main reason that body hair develops. Doctors refer to androgens as male hormones, though both men and women produce them.
When the female body produces too many androgens, it may develop more body hair than is typical. Several medical conditions can cause the body to produce too many androgens.
PCOS is the most common cause of excess body hair in women. PCOS is a hormone imbalance that causes the body to produce too many androgens.
According to a 2012 study in the journal American Family Physician, PCOS accounts for 72 to 82 percent of cases of hirsutism in women.
Doctors do not fully understand the causes of PCOS, but people can manage the symptoms with birth control pills or other hormonal treatments.
Less common causes of excess body hair in women include the following:
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia is a rare group of disorders that affect the adrenal glands and can cause severe symptoms. The body may produce too many androgens when the adrenal glands do not work correctly.
Doctors screen for conditions that cause adrenal hyperplasia, but mild cases may not be possible to diagnose until puberty.
The body hair appears rapidly in these cases and may include other symptoms, such as a mass in the stomach or pelvis.
Some medications can cause additional hair growth. A woman who notices new hair growth after trying a new prescription drug should tell her doctor.
Some drugs with links to hirsutism include:
- some antibiotics
- sleeping medications
- hormones, such as estrogen and testosterone, plus drugs that alter hormone production
Prolactin is primarily responsible for producing breast milk in breastfeeding women. Women with this condition may lactate even if they are not nursing.
Some people with hyperprolactinemia may experience infertility or not have their periods.
The thyroid produces hormones that help regulate metabolism and body temperature. When the thyroid malfunctions, it may create an imbalance of hormones that may cause excess body hair.
Sometimes hirsutism has no obvious cause, and doctors can find no clear evidence of an underlying disorder. When a condition has no clear cause, a doctor may refer to it as idiopathic.
Idiopathic hyperandrogenemia is a condition where the body produces too much androgen for no apparent reason.
Idiopathic hirsutism happens when the body grows more hair than is typical with no obvious underlying cause.
When the cause of hirsutism is unknown, it may be genetic.
It can be difficult to determine what counts as excessive body hair. It is typical for females to have fine hair all over the body, including the face. Many women also notice thicker, darker hairs on the stomach, chin, and chest.
The Ferriman-Gallwey scale assigns a score to women, depending on how much hair growth they have on various areas of the body.
According to the scale, fine hair is 'normal,' as are a few coarse strays. It is more likely to be a problem when hair is thick on many areas of the body.
A 2011 study recommends that a simpler model can assess whether hair growth is typical or not. The study recommends looking at hair growth on the chin, upper abdomen, and lower abdomen.
Each of these areas is given a score of 0–4, with scoring as follows:
- 0: No hair growth
- 1: Fine hair growth or a few stray hairs
- 2: Thicker, more consistent hair growth
- 3: Very thick, consistent hair growth
- 4: Male-pattern hair growth
A doctor then tallies the scores, with a total greater than 8 indicating excessive hair growth or hirsutism.
If an initial exam suggests a woman has excessive hair growth, a doctor must then diagnose the cause.
Tests may include:
- bloodwork to measure androgen and other hormone levels
- charting of a person's periods and obtaining a detailed menstrual history
- imaging scans to check for tumors and other growths
- Diet changes: For women with insulin resistance, reducing their intake of sugars and carbohydrates can help. Some women also try specific PCOS diets, but there is little research on how well these diets work.
- Weight management: Losing weight can help control many symptoms of PCOS. For many women, the right combination of diet and exercise may be key.
- Mental health support: PCOS is a complex disorder that can change a woman's appearance, fertility, and health. Many women find that support groups, therapy, and positive self-talk help.
Hair removal methods, such as shaving or using hair removal creams, can be effective. However, these methods will not address the underlying cause of excess hair growth.
Women without a diagnosis or who have a diagnosis of an underlying medical condition should talk to their doctors about medical treatment.
Medical treatments can help with excessive or unwanted hair growth due to PCOS.
Another medical treatment that might be useful is spironolactone, a drug that can control the effects of specific hormones.
Women with PCOS who are trying to become pregnant may need artificial hormone treatments to induce ovulation.
When a woman has a condition other than PCOS, treatment depends on the disorder, the woman's medical history, and other factors.
Hormone treatments can restore hormonal balance, though a woman might also need additional treatments. For example, if there is a tumor that produces androgens, doctors may need to remove the tumor with surgery.
Hair removal methods make it possible to eliminate cosmetic concerns of excess hair growth quickly. For women whose primary worry is cosmetic, the outlook is excellent.
When hair growth is due to an underlying condition, the outlook depends on the cause. Most hormonal disorders, including PCOS, respond to medical treatments. Proper treatment can reduce the amount of body hair a woman experiences.
However, almost all females grow body hair. Even healthy women may grow much more body hair than they believe to be desirable. In such cases, they may need to continue removing the hair.