Have you ever seen a woman with so much facial hair? Have you ever dated a lady with a dense growth of chest hairs? How shocked were you? Do you know the name of this condition? This excessive hairiness is called HIRSUTISM and sometimes HYPERTRICHOSIS.

Definition

Hirsutism is a medical condition in which there is excess body hair on parts of the body where hair is normally absent in a woman. It is usually a resultant of endocrine balance in the person.

Hirsutism is prevalent among 5-15% of all women irrespective of their ethnic backgrounds. It is more common in people from the Middle East, South Asia and the Mediterranean.
The amount and location of hair is measured by a Ferrimen-Gallwey score. This assesses the hair growth on the 19 body parts (as specified) or more on a scale of 0-4. A patient’s score can therefore range from 0-36.

EVALUATION AND DIAGNOSIS.

When one is suspected (or suspects) the existence of this condition, the chief complaint is the increased growth of hair. It is imperative that the examiner/ physician check the localization or distribution of the hairs. If they are localized in male distribution, hirsutism is suspected. If they are all over the body, hypertrichosis is suspected.

When the localization, and hence kind of condition is determined, the following can then be done:
1, Check for:

History of weight loss or gain,
Diabetes,
Signs of virilisation,
Drugs taken prior to the discovery of the condition,
History of age of onset, etc.

2, Tests could be carried out to know the level of concentration of hormones in the body of the patient.
These tests have serum makers:

Testosterone,
17 Hydroxy progesterone,
Prolactin,
24 Hour urine cortisol, etc.

3, Magnetic Resonance Imaging or Computed Tomography of the adrenal region can be used for diagnosis. There could also be physical examination of the abdominal area.

4, From the pre-condition drug history, if the drugs are the cause, withdrawal is advised and encouraged.

CAUSES
This condition is caused by:
• Genes
• Hormones and
• Medication

GENE
This disorder can be carried in human genes and hence can be transferred from parent to offspring. This particular factor is not easily checked and hence, it cannot be easily prevented.

HORMONES
This is linked with high level of male hormones (androgens) in women. It is normal for women’s bodies to make these androgens but an excess of it can cause hirsutism, acne, deep voice, small breasts, balding, large muscles, etc. insulin, for example, when in high circulation in women, can casue the development of hirsutism especially in obesed or insulin resistant hyperinsulinemic women.

MEDICATION.
Some drugs can change the hormone level in the system. These drugs mostly contain anabolics and steroids change the immunal level of the system.

TREATMENT.
There are different modes of treatment of Hirsutism. They can be broadly classified thus:
i. Cosmetic modes
ii. Medical modes

COSMETIC MEAURES.

Shaving: This is the removal of unwanted hair with the aid of a razor or electric shaver to avoid stubble growth
Waxing: The application of warm wax to the skin harbouring the unwanted hair is one of the modes of treatment of hirsutism. On hardening, the hair is pulled from the skin.
These methods, though simple and inexpensive have their side effects. Some of these side effects include,
- Folliculitis,
- Physical discomfort,
- Scarring,
- Irritant dermatitis or discoloration.

MEDICAL MEASURES.

ORAL MEDICATION.
- Anti-androgens: This is the use of drugs that block androgens from attaching to their receptors on the body. The most commonly used anti-androgen is spironolactone (aldactone). But because these drugs can cause birth defect, it is important to use contraception while taking them.
- Oral contraceptives: This reduces gonadotropin secretion, hence ovarian androgen production, and inhibits adrenal androgen production. In doing this, it also increases levels of SHBG resulting in lower levels of free testosterone.
OTHER MEANS.
Hair can also be removed with electrolysis or laser therapy
- Laser therapy: This can permanently stop the growth of hair on a body part by damaging the hair follicles with a highly concentrated light. This is more effective when it is used overtime.
- Electrolysis: This involves inserting a needle into each hair follicle. This needle emits a pulse of electric current to damage and destroy the hair follicle. Consistency in this form of treatment seals the permanence of the results.

CONCLUSION.

This condition is known to create psychological distress on patients. It is always best to visit a physician for proper evaluation and recommendation of treatment method after determination of cause.
It is worthy to note that side effects, as afore mentioned, do abound for those who take the self-prescribed path of Cosmetic Measures.