Hirsutism

Diagnosis

To diagnose hirsutism, a healthcare professional begins with a detailed medical history and physical examination. You’ll be asked about your symptoms, family history, and any medications you take that might affect hormone levels.

Blood tests are often recommended to measure hormone levels, including testosterone and other androgens, to determine if excess male hormones are the cause.

Your healthcare provider may also perform:

• Pelvic and abdominal exams to check for lumps or masses that could indicate a tumor.

• Imaging tests, such as ultrasound, MRI, or CT scans, to examine the ovaries and adrenal glands for signs of tumors or other abnormalities.

These tests help identify whether the hirsutism is caused by a hormonal imbalance, a medical condition such as polycystic ovary syndrome (PCOS), or another underlying issue.

Treatment

If no underlying hormonal disorder is found, treatment for hirsutism may not be necessary. However, if excess hair growth affects your confidence or is linked to a medical condition, several treatment options are available.

Medications
When self-care or cosmetic hair removal methods aren’t effective, medications may help reduce hair growth over time. It can take several months to notice visible improvement.

Common options include:

• Birth control pills: Oral contraceptives containing estrogen and progestin can reduce androgen production, helping slow hair growth. They are a common first-line treatment for those not planning pregnancy. Possible side effects include nausea and headaches.

• Anti-androgens: These drugs block androgens from acting on body cells. Spironolactone is the most widely used. Results appear gradually, and side effects can include irregular periods. Because anti-androgens may cause birth defects, effective contraception is essential during treatment.

• Topical cream: Eflornithine is a prescription cream used on facial areas to slow new hair growth. It can be combined with laser therapy or electrolysis for improved results.

Procedures
For longer-lasting results, professional hair removal treatments can be considered.

• Laser therapy: A focused beam of light damages hair follicles to inhibit future growth. It works best for people with darker hair and lighter skin. Multiple sessions are usually required. Your healthcare professional can help you choose the right laser for your skin type to reduce risks such as skin darkening, lightening, or blistering.

• Electrolysis: A fine needle is inserted into each hair follicle, delivering an electric current that destroys the follicle. This option is more effective for lighter hair colors, such as blonde or white, and may require several sessions. Numbing creams can help reduce discomfort.

Self care
Self-care methods can provide temporary relief from unwanted hair. Common options include:

• Plucking for removing small patches of hair.

• Shaving for quick and cost-effective results.

• Waxing for removing hair from larger areas, though it may irritate the skin.

• Depilatory creams that dissolve hair but can cause mild irritation.

• Bleaching to lighten hair color, making it less noticeable on lighter skin.

Always test new products on a small patch of skin to avoid reactions.

Preparing for your appointment
Before your appointment, check whether you should avoid removing hair beforehand, as this helps your healthcare professional evaluate the extent of hair growth.

You can prepare by listing:

• Key personal and medical information, including menstrual changes or hormonal symptoms.

• Medications, vitamins, and supplements you take, along with their doses.

• Questions you want to ask your healthcare professional.

Questions to ask include:

• What might be causing my symptoms?

• What tests do I need?

• What are my treatment options?

• How long will treatment take to show results?

• Should I see a specialist?

What to expect from your doctor
Your healthcare provider may ask questions about when the symptoms started, how quickly the hair has grown, and whether there are other changes such as acne, weight gain, or menstrual irregularities. These details help determine whether the hirsutism is linked to hormonal changes, medications, or genetic factors.