Hirsutism overview: Difference between revisions
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'''Hirsutism''' (from Latin ''hirsutus'' = shaggy, hairy) is defined as excessive and increased [[hair]] growth in women in locations where the occurrence of [[terminal hair]] normally is minimal or absent. It refers to a male pattern of body hair ([[androgenic hair]]) and it is therefore primarily of cosmetic and [[psychological]] concern. Hirsutism is a [[symptom]] rather than a [[disease]] and may be a sign of a more serious medical indication, especially if it develops well after [[puberty]]. | '''Hirsutism''' (from Latin ''hirsutus'' = shaggy, hairy) is defined as excessive and increased [[hair]] growth in women in locations where the occurrence of [[terminal hair]] normally is minimal or absent. It refers to a male pattern of body hair ([[androgenic hair]]) and it is therefore primarily of cosmetic and [[psychological]] concern. Hirsutism is a [[symptom]] rather than a [[disease]] and may be a sign of a more serious medical indication, especially if it develops well after [[puberty]]. | ||
It affects 5-15% of women . In most of the cases there is an underlying hormonal imbalance . Excessive amount of [[androgen]] plays a major role, as 70% of patients with excessive androgen will develop hirsutism. However in 5 to 15% of patients suffering from hirsutism , there is no increase in [[androgen]] level and are considered as [[idiopathic]] hirsutism. About 50% of hirsutism cases have high androgen level. Free [[testosterone]] is the main circulating [[androgen]] and is often elevated in hirsute women and the level of androgens and [[hair follicle]] sensitivity to androgens play the major role .<ref name="pmid10">{{cite journal |vauthors=Schmoldt A, Benthe HF, Haberland G, Voigt R, Krause W, Voigt P |title=Digitoxin metabolism by rat liver microsomes |journal=Biochem. Pharmacol. |volume=24 |issue=17 |pages=1639–41 |year=1975 |pmid=10 |doi= |url=}}</ref> Ovulatory dysfunction (PCOs), [[Diabetes mellitus|diabetes,]] [[thyroid]] [[hormone]] abnormalities are some of the underlying causes for hirsutism.<ref name="Rosenfield2005">{{cite journal|last1=Rosenfield|first1=Robert L.|title=Hirsutism|journal=New England Journal of Medicine|volume=353|issue=24|year=2005|pages=2578–2588|issn=0028-4793|doi=10.1056/NEJMcp033496}}</ref> | It affects 5-15% of women . In most of the cases there is an underlying hormonal imbalance . Excessive amount of [[androgen]] plays a major role, as 70% of patients with excessive androgen will develop hirsutism. However in 5 to 15% of patients suffering from hirsutism , there is no increase in [[androgen]] level and are considered as [[idiopathic]] hirsutism. About 50% of hirsutism cases have high androgen level. Free [[testosterone]] is the main circulating [[androgen]] and is often elevated in hirsute women and the level of androgens and [[hair follicle]] sensitivity to androgens play the major role .<ref name="pmid10">{{cite journal |vauthors=Schmoldt A, Benthe HF, Haberland G, Voigt R, Krause W, Voigt P |title=Digitoxin metabolism by rat liver microsomes |journal=Biochem. Pharmacol. |volume=24 |issue=17 |pages=1639–41 |year=1975 |pmid=10 |doi= |url=}}</ref> Ovulatory dysfunction (PCOs), [[Diabetes mellitus|diabetes,]] [[thyroid]] [[hormone]] abnormalities and [[CAH]] are some of the underlying causes for hirsutism.<ref name="Rosenfield2005">{{cite journal|last1=Rosenfield|first1=Robert L.|title=Hirsutism|journal=New England Journal of Medicine|volume=353|issue=24|year=2005|pages=2578–2588|issn=0028-4793|doi=10.1056/NEJMcp033496}}</ref> | ||
There is a scoring system which is called Ferriman–Gallwey scale, which quantitates the extent of hair growth in the most [[androgen]]-sensitive sites and patients with a score of 8 or more ,would be considered a hirstue . | There is a scoring system which is called Ferriman–Gallwey scale, which quantitates the extent of hair growth in the most [[androgen]]-sensitive sites and patients with a score of 8 or more ,would be considered a hirstue .Hirsutism must be distinguished from [[hypertrichosis]] which is a result of either [[heredity]] or the use of medications such as [[glucocorticoids]], [[phenytoin]], [[minoxidil]], or [[cyclosporine]]. [[Hypertrichosis]] is not caused by excess [[androgen]].<ref name="Rosenfield2005">{{cite journal|last1=Rosenfield|first1=Robert L.|title=Hirsutism|journal=New England Journal of Medicine|volume=353|issue=24|year=2005|pages=2578–2588|issn=0028-4793|doi=10.1056/NEJMcp033496}}</ref> | ||
[[Prognosis]] depends on underlying etiology. [[Pubertal]] onset hirsutism specially when it is mild ,points toward [[PCOS]] or idiopathic hirsutism but sever late onset hirsutim with other virlization signs can be due to [[ovarian]] or [[adrenal]] [[tumor]]<nowiki/>s. Hirsutism can lead to significant [[psychological]] distress for women and even [[depression]] if left untreated and based on the underlying cause other medical complications can occur (e.g. in cases of hirsutism due to [[PCOS]] , if the treatment doesn't address PCOS , it can lead to [[infertility]].) | |||
Treatment options include: Cosmetic and hormonal therapy .Cosmetic therapy includes shaving, waxing , laser hair removal therapy , etc. Hormonal therapy includes : [[oral contraceptive]]<nowiki/>s, finestride , [[spironolactone]] ,etc. | |||
==References== | ==References== | ||
Revision as of 15:36, 21 September 2017
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Hirsutism overview On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: ; Ogheneochuko Ajari, MB.BS, MS [2],Rasam Hajiannasab M.D.[3]
Overview
Hirsutism (from Latin hirsutus = shaggy, hairy) is defined as excessive and increased hair growth in women in locations where the occurrence of terminal hair normally is minimal or absent. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern. Hirsutism is a symptom rather than a disease and may be a sign of a more serious medical indication, especially if it develops well after puberty.
It affects 5-15% of women . In most of the cases there is an underlying hormonal imbalance . Excessive amount of androgen plays a major role, as 70% of patients with excessive androgen will develop hirsutism. However in 5 to 15% of patients suffering from hirsutism , there is no increase in androgen level and are considered as idiopathic hirsutism. About 50% of hirsutism cases have high androgen level. Free testosterone is the main circulating androgen and is often elevated in hirsute women and the level of androgens and hair follicle sensitivity to androgens play the major role .[1] Ovulatory dysfunction (PCOs), diabetes, thyroid hormone abnormalities and CAH are some of the underlying causes for hirsutism.[2]
There is a scoring system which is called Ferriman–Gallwey scale, which quantitates the extent of hair growth in the most androgen-sensitive sites and patients with a score of 8 or more ,would be considered a hirstue .Hirsutism must be distinguished from hypertrichosis which is a result of either heredity or the use of medications such as glucocorticoids, phenytoin, minoxidil, or cyclosporine. Hypertrichosis is not caused by excess androgen.[2]
Prognosis depends on underlying etiology. Pubertal onset hirsutism specially when it is mild ,points toward PCOS or idiopathic hirsutism but sever late onset hirsutim with other virlization signs can be due to ovarian or adrenal tumors. Hirsutism can lead to significant psychological distress for women and even depression if left untreated and based on the underlying cause other medical complications can occur (e.g. in cases of hirsutism due to PCOS , if the treatment doesn't address PCOS , it can lead to infertility.)
Treatment options include: Cosmetic and hormonal therapy .Cosmetic therapy includes shaving, waxing , laser hair removal therapy , etc. Hormonal therapy includes : oral contraceptives, finestride , spironolactone ,etc.
References
- ↑ Schmoldt A, Benthe HF, Haberland G, Voigt R, Krause W, Voigt P (1975). "Digitoxin metabolism by rat liver microsomes". Biochem. Pharmacol. 24 (17): 1639–41. PMID 10.
- ↑ 2.0 2.1 Rosenfield, Robert L. (2005). "Hirsutism". New England Journal of Medicine. 353 (24): 2578–2588. doi:10.1056/NEJMcp033496. ISSN 0028-4793.