Excessive hair growth

What is hypertrichosis?

Hypertrichosis is the term used for the growth of hair on any part of the body in excess of the amount usually present in persons of the same age, race, and sex, excluding androgen-induced hair growth.

In its generalized and circumscribed forms, hypertrichosis may either be an isolated finding, or be associated with other abnormalities. Therefore, accurate classification of hypertrichosis is mandatory.

Hirsutism is a condition of unwanted, male-pattern hair growth in women. Hirsutism results in excessive amounts of dark, course hair on body areas where men typically grow hair — face, chest and back.

Hypertrichosis Vs. Hirsutism

Hypertrichosis and hirsutism both exhibit excessive hair growth. However, in hypertrichosis, excessive hair growth is not confined on androgenic areas or bodily surfaces that rely on androgen for hair to grow. Basically, hirsutism involves overproduction of androgen. The term hirsutism therefore is only applicable to women who have hair distribution like that of the men. Hypertrichosis, on the other hand, involves a whole lot of factors. Hypertrichosis could be congenital or acquired.

What causes hirsutism?

At puberty, a girl’s ovaries begin to produce a mix of female and male sex hormones, causing hair to grow in the armpits and pubic area. Hirsutism can occur if the mix becomes unbalanced with too high a proportion of male sex hormones (androgens).

Hirsutism can be caused by:

  • Polycystic ovary syndrome. This most common cause of hirsutism is caused by an imbalance of sex hormones that can result in irregular periods, obesity, infertility and sometimes multiple cysts on your ovaries.

  • Cushing’s syndrome. This occurs when your body is exposed to high levels of the hormone cortisol. It can develop from your adrenal glands making too much cortisol or from taking medications such as prednisone over a long period.

  • Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands.

  • Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands can cause hirsutism.

  • Medications. Some medications can cause hirsutism. These include danazol, which is used to treat women with endometriosis; systemic corticosteroids and fluoxetine (Prozac) for depression.

Sometimes, hirsutism can occur with no identifiable cause. This happens more frequently in certain populations, such as in women of Mediterranean, Middle Eastern and South Asian ancestry.

Risk factors for hirsutism

Several factors can influence your likelihood of developing hirsutism, including:

  • Family history. Several conditions that cause hirsutism, including congenital adrenal hyperplasia and polycystic ovary syndrome, run in families.

  • Ancestry. Women of Mediterranean, Middle Eastern and South Asian ancestry are more likely to develop hirsutism with no identifiable cause than are other women.

  • Obesity. Being obese causes increased androgen production, which can worsen hirsutism.

What causes hypertrichosis?

There are many theories about the cause of hypertrichosis.

Congenital hypertrichosis may run in the family. It seems to be caused by genes that stimulate hair growth becoming abnormally active. In most people, the genes that caused extensive hair growth in humankind’s very early ancestors are now inactive because people do not need to be covered in hair to stay warm.

In people with congenital hypertrichosis, these genes get reactivated in the womb. There is still no known cause for this.

However, acquired hypertrichosis, which develops later in a person’s life, has a range of possible causes. Causes include:

  • malnutrition

  • poor diet or certain eating disorders, such as anorexia nervosa

  • certain drugs and medications, such as hair growth drugs, certain immunosuppressants, and androgenic steroids

  • cancer and cell mutation

  • autoimmune and infectious diseases affecting the skin

  • condition called porphyria cutanea tarda, can cause the skin to be extremely sensitive to UV light, may trigger hypertrichosis.

Hypertrichosis treatment

Excessive hair may cause cosmetic embarrassment, resulting in a significant emotional burden, particularly if extensive. Treatment options are limited, and the results of therapy not always satisfactory. Patients should, therefore, be adequately advised of the available treatment modalities for temporary or permanent hair removal. No single method of hair removal is appropriate for all body locations or patients, and the one adopted will depend on the character, area, and amount of hair growth, as well as on the age of the patient, and their personal preference. The currently available treatment methods include cosmetic procedures (bleaching, trimming, shaving, plucking, waxing, chemical depilatories, and electrosurgical epilation), and hair removal using light sources and lasers. Laser-assisted hair removal is the most efficient method of long-term hair removal currently available.

Some people may opt for long-term treatments, such as laser epilation or electrolysis at the clinics or medical spas.

Electrolysis destroys the individual hair follicles using electrical charges.

Laser epilation does the same using laser light and is typically less painful than electrolysis. For some people, the treatment will result in permanent hair loss, though it may take multiple sessions to achieve the desired result.

Depending on the type, hypertrichosis is often accompanied by other symptoms and may be linked to an underlying condition. Therefore, patients who experiences excessive hair growth should go to a dermatology clinic or speak with their dermatologists to rule out any possible underlying condition and discuss treatment options.