HIRS

Hirs, short for hirsutism in some medical contexts, refers to a condition characterized by excessive male-pattern hair growth in women and, less commonly, in men. This pattern typically involves the face (upper lip, chin), chest, abdomen, back, and inner thighs, reflecting increased androgen effects or sensitivity of hair follicles rather than a general increase in body hair.

Common causes include hyperandrogenism, with polycystic ovary syndrome being the most frequent association in reproductive-age individuals. Other causes are congenital adrenal hyperplasia, androgen-secreting tumors, certain medications, and idiopathic hirsutism where no cause is found. Ethnicity and genetics influence the severity and distribution of hair growth.

Diagnosis relies on clinical assessment and the exclusion of other conditions. A Ferriman-Gallwey score is commonly used to quantify hair growth. Laboratory evaluation may include measurements of total and free testosterone, DHEAS, LH and FSH, prolactin, and thyroid function, with pregnancy testing as appropriate. Imaging is guided by suspicion of ovarian or adrenal pathology.

Management aims to reduce androgen effects and address any underlying cause. Lifestyle interventions such as weight loss can improve symptoms, particularly in PCOS-related cases. Pharmacologic options include combined estrogen-progestin oral contraceptives to regulate androgens, anti-androgens such as spironolactone (often used with contraception due to teratogenic risk), and finasteride in selected cases. Local cosmetic treatments—shaving, waxing, depilatory creams, laser hair removal, or electrolysis—provide targeted relief. Topical eflornithine cream can slow facial hair growth. Regular follow-up is recommended to monitor response and side effects.

Etymology: from Latin hirsutus meaning hairy. See also hypertrichosis and androgen excess.