hirsuteness

Hirsuteness refers to noticeable hairiness in humans. In medical contexts, hirsutism denotes excessive growth of coarse terminal hair in androgen-dependent areas—most often the face, chest, abdomen, and thighs—predominantly in women and children. The term is sometimes used more broadly, but clinical assessment usually focuses on patterns associated with elevated androgens.

Hirsutism is distinct from hypertrichosis, which is generalized or localized hair growth not specifically linked to androgens. Hypertrichosis can be congenital or drug-induced and may affect any region, whereas hirsutism implies a hormonal influence.

Causes include increased circulating androgens or heightened tissue sensitivity to androgens. Conditions such as polycystic ovary syndrome, Cushing's syndrome, and androgen-secreting tumors are important. Medications, obesity, ethnic background, and genetics also influence hair distribution; in some people no cause is found.

Diagnosis combines history and physical examination. The Ferriman-Gallwey score assesses hair growth in multiple areas to quantify severity. When hyperandrogenism is suspected, tests may include total and free testosterone, DHEA-S, and 17-hydroxyprogesterone; imaging is reserved for suspected tumors.

Management depends on the underlying cause and on cosmetic goals. Options range from depilatory methods, shaving, waxing, and laser or electrolysis to medical therapy, including combined oral contraceptives and anti-androgens such as spironolactone; topical eflornithine can slow facial growth. Lifestyle changes may help in some cases.

Prevalence varies by population and diagnostic criteria. Hirsutism affects a meaningful share of women of reproductive age and can impact quality of life; with careful assessment and tailored treatment, symptoms are often controllable.