Excess hair (hirsutism)

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     Treatment of hirsutism
     Proper therapy for hirsutism

Excess hair growth in women androgen-dependent areas is a manifestation of the disease, called hirsutism. In this case, excess hair may appear on the upper lip, chin, cheeks, ears, back and chest, in the nipples, lower abdomen, on the front and inner thighs.

In other words, hirsutism is excessive hairiness in male pattern.

It is not about vellus but of terminal hair - long, thick and pigmented. Where terminal hair in women are not unusual (given the national characteristics and age) - for example, in the legs, arms, lower back (that is, in androgen-independent region) - a question of hirsutism is not, and can talk about hypertrichosis, that is, excessive hair growth in those places, where both men and women, the presence of hair is the norm.

Therefore, hirsutism is manifested only in women, but hypertrichosis - both women and men. Depending on the nationality, the prevalence of hirsutism reaches 5-10%.

This norm is, of course, a relative thing, and physicians themselves are not entirely clear oriented in it. For example, some sources believe that the "mustache" for women are also not a sign of hirsutism, as well as hair on the nipples. Well, this, of course, depends on the nationality and degree of manifestation of this same effect. And a subjective attitude, too. That is why there is such a term as "hirsutism, significant for the patient".

This is together with Ferriman-Gallwey scale that objectively diagnoses the presence of hirsutism according to the degree of pilosis in separate zones. But if the hirsutism is considered as abnormal body hair reaches 14 points on this scale, then for some women, the tragedy is already 7. And educated endocrinologist, of course, will come to this issue, taking the patient's personal assessment.

Why is an endocrinologist but not a dermatologist, for example? That is because, although hirsutism is primarily cosmetic (and also psychological) problem, by itself it may be a sign of latent endocrine dysfunctions. And this is a serious matter; this is not by chance that it is often associated with pathologies such as irregular menses and acne, nervous system disorders, disorders of the structure and growth of teeth, obesity and diabetes. There is even a disease like "diabetes of bearded women", or Ahard-Thiers syndrome.

The appearance of excess hair can also be a harbinger of virilism, which causes coarsening of the voice, increased muscle development, reducing the size of breasts, baldness at the temples and the increase in the size of the clitoris.

Excess body hair can occur during or after puberty, often after childbirth. The appearance of excess hair can be one of the signs of more serious violations in the female body. This happens most often when hirsutism occurs against a background of one or more of these symptoms:

    - excess hair appear suddenly, and their number is growing rapidly;
    - there are menstrual irregularities;
    - there is obesity;
    - there is a clitoris enlargement (clitoromegaly).

The appearance of excess hair on the body, in any case you should consult your doctor. Even if you are used to solve all your problems in a beauty parlor, in this case you should wait. The fact that mechanical methods of removing excess hair - shaving, waxing, electrolysis - do not help with hirsutism, on the contrary, they might cause increased growth of excess hair.

It is believed that laser hair removal effectively removes excess hair, as it destroys the hair follicles, but in this case, success is not guaranteed by 100%, too. Too many visitors of forums on the problem of excess hair, write that laser hair removal has not helped them.

Again, how would you not assured in a beauty salon that after one laser session, all will pass, you will need several sessions (to eight), and each session is worth good money. In addition, there is a risk of burns and skin tumors.

Doctors figured out yet finally with the induction of hirsutism. It is known that the appearance of excess hair due to excessive production of male hormones (androgens) in the female body, usually in the ovaries or adrenal cortex. But not all forms of hirsutism associated with endocrine disorders, for example, such as:

- constitutional (family, genetic) hirsutism, associated with heredity. Genetic form of hirsutism includes, partically, excessive hair growth in women in some ethnic groups (in the East and the Mediterranean). Some increase in the growth of facial hair in women during menopause related hormonal changes, too, is considered as a variant of the norm;

- exogenous hirsutism - excess hair appearance, caused by taking drugs (steroid hormones, glucocorticoids, contraceptives, some heart medications and antibiotics). For example, is not safe in this respect, prolonged use of minoxidil, cyclosporine, cortisone, hydrocortisone, diazoxide, streptomycin, interferon, acetazolamide;

- idiopathic hirsutism. This is a case when endocrine pathology is not found and no possibility of exogenous and constitutional forms. In short, the cause of the disease has not been established. Possible causes of excess hair growth, there may be increased sensitivity of hair follicles to androgens, increased amount of male hormone receptors in the skin, increased activity of the enzyme responsible for the transfer of testosterone to dihydrotestosterone (active fraction).

However, all these forms are somehow related to the endocrine field, although not always of a pathological character. Not for nothing that statistics brings together polycystic ovary and idiopathic hirsutism - in statistics, they accounting for about 90 percent of all diseases of hirsutism.

This also should include stress factors as well as the appearance of excess hair on a woman's body can also be triggered by chronic stress and debilitating hunger strike. Still, these factors act indirectly, through the endocrine imbalance. And in general, hirsutism is a marker for increased production of androgens in women (hyperandrogenism).

That is why, before prescribe treatment, it will be offered you to be tested for testosterone, DHEA-s and other hormones in blood serum, including androstenedione, which, they say, in women moves of testosterone. And rightly so. But it would be wrong to restrict only the analysis of hormonal levels.

This is because hirsutism is often caused by disease of the ovaries, which increases the secretion of androgens (polycystic, tumors and their metastases to the ovaries). The most frequent cause of excessive androgen production is polycystic ovaries.

And now look: According to scientists, polycystic ovaries detected in 92% of women with hirsutism. But elevated levels of androgens in the blood - only 50%. So often with hyperandrogenism in women, androgen levels in the blood are normal. Paradox?

No any paradox! Hyperandrogenism - this is not only the excess production of testosterone and other androgens by ovaries and adrenal glands, but also increased the conversion of androgens to more active forms directly into the tissues (e.g., the skin turns testosterone into dihydrotestosterone (DHT). If you have an idea about chemical kinetics, then you realize that even with increased androgen production, their rapid exhaustion into skin receptors (the same hair follicles) may lead to the fact that the levels of hormones in the blood remain within normal limits.

Uniquely elevated levels of androgens in the blood is observated mainly in the case of androgen-producing ovarian tumors (as luteome, tecome).

Cause of excess hair growth may also be adrenal disease (enhancement of the functions of the cortex, benign and malignant tumors) and other endocrine disorders, mainly in the thyroid gland. Here, too, restriction of only one laboratory test for the maintenance of hormones may play a doctor (and hence the patient), a cruel joke.

Such confusion with the tests due to the fact that many doctors mistakenly equate the term "hyperandrogenism" with hyperandrogenemia - rising levels of androgens in the blood. For this reason, patients in the presence of hyperandrogenism, which is not accompanied by increased levels of androgens in the blood, are often not granted the necessary treatment in time, resulting the manifestations of hyperandrogenism are progressing and getting worse.

And I'll add that, if we take the figures quoted by scientists, it turns out that this is, probably, in every second patient (92% and 50%!) Although professional should read not only the high school textbooks.

I used to wonder why on sites devoted to treatment of hirsutism authors often writte that with proper therapy, prognosis is always favorable, but at the same time on the forums, women screaming shouting that the treatment they did not work? And now I understand: so that with proper ...

And it becomes clear statistics cited by scientists, the frequency of diagnoses among women with hirsutism: polycystic ovaries - 40%, idiopathic hirsutism - 50%! In fact, the diagnosis of "idiopathic hirsutism" means that the doctor you wrote: "I why you have excess hair!" But if he does not knows he going to treat, then the treatment will be not know what.

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