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Excessive or unwanted hair in women

Most of the time, women have fine hair above their lips and on their chins, chests, abdomens, or backs. The growth of coarse dark hair in these areas (more typical of male-pattern hair growth) is called hirsutism.

Causes

Women normally produce low levels of male hormones (androgens). If your body makes too much of this hormone, you may have unwanted hair growth.

In most cases, the exact cause is never known. The condition often runs in families.

A common cause of hirsutism is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormone conditions that cause unwanted hair growth may also have:

  • Acne
  • Problems with menstrual periods
  • Trouble losing weight
  • Diabetes

If these symptoms start suddenly, you may have a tumor that releases male hormones.

Other, rare causes of unwanted hair growth may include:

Use of certain medicines may also be the cause of unwanted hair growth, including:

  • Testosterone
  • Danazol
  • Anabolic steroids
  • DHEA
  • Glucocorticoids
  • Cyclosporine
  • Minoxidil
  • Phenytoin

In rare cases, women with hirsutism have normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified.

Symptoms

The main symptom of this condition is the presence of coarse dark hair in areas that are sensitive to male hormones. These areas include:

  • Chin and upper lip
  • Chest and upper abdomen
  • Back and buttocks
  • Inner thigh

Exams and Tests

Your health care provider will examine you and ask about your symptoms.

Tests that may be done may include any of the following:

Treatment

Hirsutism is generally a long-term problem. There are many ways to remove or treat unwanted hair. Some treatment effects last longer than others.

  • Medicines. Drugs such as birth control pills and anti-androgen medicines are an option for some women.
  • Electrolysis. Electrical current is used to permanently damage individual hair follicles so they do not grow back. This method is expensive, and multiple treatments are needed. Swelling, scarring, and redness of the skin may occur.
  • Laser energy directed at the dark color (melanin) in the hairs. This method is best for a large area of very dark hair. It does not work on blond or red hair.

Temporary options include:

  • Shaving. Although this does not cause more hair to grow, it may make hair look thicker.
  • Chemicals, plucking, and waxing. These options are safe and inexpensive. However, chemical products may irritate the skin.

For women who are overweight, weight loss may be able to help reduce hair growth.

Outlook (Prognosis)

Hair follicles grow for about 6 months before falling out. Therefore, it takes many months of taking medicine before you will notice a decrease in hair growth.

Many women get good results with temporary steps to remove hair or lighten it.

Possible Complications

Most of the time, hirsutism does not cause health problems. But many women find it bothersome or embarrassing.

When to Contact a Medical Professional

Call your health care provider if:

  • The hair grows rapidly.
  • You also have male features such as acne, deepening voice, increased muscle mass, male pattern thinning of your hair, and decreased breast size.
  • You are concerned that medicine you are taking may be increasing the growth of unwanted hair.

Alternative Names

Hypertrichosis; Hirsutism; Hair - excessive (women); Excessive hair in women; Hair - women - excessive or unwanted

References

Bolognia JL, Schaffer JV, Duncan KO, Ko CJ. Hypertrichosis and hirsutism. In: Bolognia JL, Schaffer JV, Duncan KO, Ko CJ, eds. Dermatology Essentials. Philadelphia, PA: Elsevier Saunders; 2014:chap 57.

Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 17.

Habif TP. Hair diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier Mosby; 2016:chap 24.

Review Date 11/1/2015

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.