Hirsutism and hypertrichosis

Hirsutism is often used to describe androgen-dependent hair growth in women, with hypertrichosis being used for androgen-independent hair growth

Polycystic ovarian syndrome is the most common causes of hirsutism. Other causes include:

• Cushing's syndrome
• congenital adrenal hyperplasia
• androgen therapy
• obesity: thought to be due to insulin resistance
• adrenal tumour
• androgen secreting ovarian tumour
• drugs: phenytoin, corticosteroids

Assessment of hirsutism

• Ferriman-Gallwey scoring system: 9 body areas are assigned a score of 0 - 4, a score > 15 is considered to indicate moderate or severe hirsutism

Management of hirsutism

• advise weight loss if overweight
• cosmetic techniques such as waxing/bleaching - not available on the NHS
• consider using combined oral contraceptive pills such as co-cyprindiol (Dianette) or ethinylestradiol and drospirenone (Yasmin). Co-cyprindiol should not be used long-term due to the increased risk of venous thromboembolism
• facial hirsutism: topical eflornithine - contraindicated in pregnancy and breast-feeding

Causes of hypertrichosis

• drugs: minoxidil, ciclosporin, diazoxide