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Hirsutism

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Hirsutism is a medical condition that affects 1 out of every 20 women in the United States to varying degrees. It is defined as the growth of thick body hair where it typically does not grow on women, such as the back, face, neck, chest, arms, legs, and abdomen. Hirsutism is an emotionally distressing disease as it can make women look unattractive and requires expensive therapies to manage. Extreme cases of hirsutism were once the foundation of werewolf exhibits in theme parks freak shows, although the condition rarely affects men to a distressing level.

Hirsutism is not classified as a disease, but is considered a condition, one that may very well have an underlying medical cause that can be life threatening. Women who develop the condition well after reproductive development may need to be examined for other diseases such as ovarian tumors and adrenal hyperplasia.

HIRSUTISM SYMPTOMS

Symptoms of hirsutism are likely to include the excessive growth of thick, dark, scraggly looking hair on the face, chest, areola, inner thigh, upper and lower back, the buttocks, linea alba, and the genitalia. The hair tends to grow in a masculine pattern.
Hirsutism
Image: Hirsutism

HIRSUTISM CAUSES

In some cases, the sudden development of hirsutism is an indication of an androgen secreting tumor which results in the sudden development of excessive hair growth. Women with Middle Eastern or Mediterranean ancestry are likely to have a very mild form of hirsutism. Other causes may include ovarian tumors, certain medication such as minoxidil, cyclosporine, and other growth stimulating drugs, ovarian neoplasms, adrenal related health problems, and diseases such as hyperthyroidism, anorexia, Cushing syndrome and porphyria. There are patients who develop the condition without any medical cause that has yet to be determined. These cases are known as idiopathic hirsutism.

HIRSUTISM COMPLICATIONS

There are no medical complications associated with hirsutism, however the medical causes which can stimulate the sudden onset need to be addressed. Hirsutism causes social and functional issues and can cause social complications. Society, especially American society, is not very forgiving when it comes to physical conditions that make a person different. Patients with hirsutism are likely to experience depression, and in severe cases of the condition, may even become hermits.

Conditions that are likely to coincide with hirsutism include obesity, which is suggested that the patient does not feel acceptable and hides themselves away instead of being an active part of everyday society in more extreme versions of the condition, acne, alopecia, pelvic masses, acanthosis nigricans, Cushing syndrome, and symptoms of virility.

HIRSUTISM DIAGNOSIS

Diagnosing hirsutism can be done via a physical examination. Diagnosing any underlying conditions calls for a detailed medical history and often tests which can help determine the various medical causes for hirsutism. Testing may include serum testosterone levels, a review of medications and familial ancestry, testing for DHEA-S levels in the blood, tests to indicate androstenedione, tests to indicate particular hormone levels such as luteinizing and follicle stimulating hormones, tumor work ups, tests which indicate the onset of Cushing syndrome like a 24 hour urinary cortisol or an overnight dexamethasone test, and tests to indicate the levels of 17-hydroxyprogesterone levels. Not all of these tests are typically indicate for every patient, however if a patient has absolutely no indication of any underlying medical cause, there may have to be a battery of tests done to rule out medical causes. Most tests can be done through blood work or through urine tests and do not need to be invasive to the patient.

HIRSUTISM TREATMENT

Treatment is typically not required for most cases of hirsutism, although cosmetically the patient may desire the removal of the excessive hair. In extreme cases, therapies are recommended in order to allow the patient to live a fairly normal life, as the excessive hair growth may become debilitating. Treating the underlying cause may require anything from tumor removal to medication to relieve the cause, which them relieves the symptom. Patients with no medical reason typically turn to plastic surgeons and electrolysis to remove the excess hair.

Hair bleaching can work for patients with mild hirsutism. Other forms of hair removal therapies may include epilation, chemical or mechanical hair removal, laser epilation, and electrolysis. With the exception of severe cases of hirsutism, most cases can be managed through regular hair removal therapies.
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