Excessive hair

Two types of overgrowth of hair occur: Hirsuties

This is the growth of coarse terminal hair in a male distribution occurring in a woman. This is not always easy to assess since what is unacceptable and emotionally disturbing to one woman may be quite acceptable to another. The amount of hair growth may appear to be within normal limits in a patient complaining of excessive hair but it should never be dismissed as of no consequence if it is important to the woman concerned. Nevertheless, it is important to limit the number of investigations once it is clear that there is no underlying abnormality. Strong reassurance may then be the most helpful management. It is of course most apparent on the face but is often present on the thighs, abdomen and back as well.

Hirsuties occurs most commonly after the menopause and may be present to some degree in normal women as a result of familial or racial traits. It may arise without any underlying hormonal disorder or as a result of virilising hormones. These causes are listed in the box on the right. In addition to androgens, a number of drugs can cause hirsuties. It is important to remember that hirsuties may be part of a virilising syndrome or polycystic ovaries. It is useful to measure the serum testosterone and oestrogen level, as well as urinary 17 oxosteroid concentrations.

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