Materiały źródłowe

• #1 Hirsutism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470417/

  Hirsutism is the growth of excessive male-pattern hair in women after puberty. It affects facial and body areas dependent on androgens, namely mustache and beard, pubic hair, buttocks, and thighs. It is a frequent reason for dermatological consultation. This activity reviews the evaluation and management of hirsutism and highlights the role of the healthcare team in the recognition and management of this condition. […] The management of hirsutism is interprofessional, including the dermatologist, the endocrinologist, and the gynecologist. The treatments used serve to reduce the severity of hirsutism, as well as to improve overall health and self-esteem. […] Hirsutism is a common disorder encountered in clinical practice. While not life-threatening, it has significant morbidity because of cosmetic issues. In some women, it may a sign of an underlying malignancy. Thus, the disorder is best managed by an interprofessional team.

• #2 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) […] Hirsutism refers to the growth of coarse, dark hair in areas where females typically grow fine hair or no hair at all: above the lip and on the chin, chest, abdomen, and back. This excess hair growth is caused by an increased level of male hormones (androgens). Although all females produce androgens from the ovaries and the adrenal glands, increased levels of androgens can lead to acne and hirsutism. This article focuses on hirsutism. […] Females with excess hair growth need to be evaluated by a health care provider, especially if the hair develops or worsens rapidly, or if relatives have comparatively less hair growth. In the vast majority of cases, hirsutism is not caused by a serious medical condition; however, the cause of hirsutism should be determined, and underlying conditions may need to be treated.

• #3 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Hirsutism is caused by an excess production or action of hormones called androgens. Androgens are secreted by the ovaries and adrenal glands into the circulation. Hair follicles respond to androgens by growing thick hair and producing sebum. Once activated, hair follicles can also convert circulating weak androgens into stronger androgens. Several different conditions can lead to hirsutism. The two most common causes of hirsutism are polycystic ovary syndrome (PCOS) and idiopathic hirsutism. Both are diagnosed by physical examination, medical and family history, and sometimes blood tests. […] Females with PCOS often have hirsutism in combination with irregular menstrual cycles. Instead of the normal 24- to 38-day menstrual cycle length, females with PCOS often have cycle lengths that are >38 days. Females with PCOS typically have fewer than six cycles per year. When cycles are this irregular, it usually means that a female is not ovulating on a regular basis. Females with PCOS may also have acne and balding or increased hair loss near the front of the head. PCOS is a chronic condition, but several treatments can reduce hair growth.

• #4 Hirsutism (Remedy BNSSG ICB)

  https://remedy.bnssg.icb.nhs.uk/adults/endocrinology/hirsutism/

  Hirsutism is defined as excessive terminal hair that appears in a male pattern (e.g. is androgen dependent) in women. […] The majority of hirsutism is due to androgen excess (80%), and the majority of women who have hirsutism have PCOS (70-80%). […] Up to 20% of women may have idiopathic hirsutism (hirsutism without hyperandrogenism) this rarely needs further investigation if the patient has normal periods and a normal serum testosterone. […] Routine referral to Endocrinology for women with a raised testosterone level of 4 nmol/L. […] If patient-important hirsutism persists despite 6 months of treatment with a contraceptive pill OR a patient does not want/is too high risk for a contraceptive pill, make a routine referral to Endocrinology to discuss alternative treatments e.g. anti-androgen therapy (non-formulary, specialist only).

• #5 Hirsutism – OBGYN | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/conditions-treated/hirsutism

  Hirsutism in women is defined as excessive coarse hair appearing in a male-type pattern. It represents exposure of hair follicles to high levels of the male hormone androgen in the blood and/or the hair follicle itself. Consequently, one-half of women with mild hirsutism have elevated levels of circulating androgens, as do most women with more severe hirsutism, although the severity of hirsutism is not necessarily proportion to the circulating androgen level. […] It is important to recognize that hirsutism can be an emotional burden that can harm ones self-esteem and body image. Many women with hirsutism report feeling unfeminine and embarrassed due to unwanted hair. Many of these women also hide their hair growth and avoid physical closeness with others to conceal it. Because hair removal can be time-consuming, expensive, and frustrating, many hirsute women feel unable to manage their hair removal effectively, and some experience depression. Nevertheless, significant variability exists in how women view their hirsutism, ranging from not bothersome to humiliating.

• #6 Understanding the causes and management of hirsutism | Nursing Times

  https://www.nursingtimes.net/mental-health/understanding-the-causes-and-management-of-hirsutism-21-02-2006/

  Female hirsutism can make women extremely self-conscious, threatening both their sense of femininity and self-esteem. […] These patients often require additional emotional support from the nurse. […] It is important to adopt a caring and sensitive approach to these patients. […] Those who do seek help need to be treated in an understanding way and the underlying cause should be diagnosed as quickly as possible to eliminate any potentially life-threatening causes. […] Women with PCOS may need additional counselling, particularly those whose infertility is affecting their hopes of starting a family. […] Treatment of hirsutism necessarily depends on the underlying condition. […] Patients who take CPA on its own should be made aware that it can take up to a year of treatment before the full benefits are seen.

• #7 Hirsutism – OBGYN | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/conditions-treated/hirsutism

  The first step in assessing hirsutism is to have a complete history and physical examination performed by a trained health care provider. A careful history and physical examination can assess the degree of hirsutism, acne or hair loss, and other problems that are important in directing diagnostic testing and management. An equally important step is assessing the emotional impact of hirsutism on the individual so that a personalized management plan can be developed to target the physical, medical and psychological burdens of unwanted hair. Understanding how a woman feels about her body image and improving this perception are essential components of any management plan. […] Hirsutism is often treated with a combination of approaches, including oral contraceptives with or without an antiandrogen, such as spironolactone, to lower levels or block actions of androgen on hair follicles. Oral contraceptives are often combined with antiandrogens to improve their clinical effect and to prevent pregnancy, since accidental exposure of the male fetus to antiantrogens can harm fetal development. A topical cream (eflornithine hydrochloride) also can be applied to treat facial hirsutism.

• #8 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. […] Hirsutism may be treated with pharmacologic agents and/or hair removal. Recommended pharmacologic therapies include combined oral contraceptives, finasteride, spironolactone, and topical eflornithine. […] Women with an abnormal hirsutism score based on the Ferriman-Gallwey scoring system should be evaluated for elevated androgen levels. […] Combined oral contraceptives are first-line therapy for women with hirsutism who are not trying to conceive and in whom cosmetic measures are ineffective. […] If patient-important hirsutism persists after six months of therapy with combined oral contraceptives, the addition of an antiandrogen should be considered.

• #9 Hirsutism Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hirsutism

  Suggests testing for elevated androgen levels in all women with an abnormal hirsutism score. […] Recommends against antiandrogen monotherapy unless adequate contraception is used. […] For hirsute women with obesity, including those with polycystic ovary syndrome, we also recommend lifestyle changes. […] For the majority of women with hirsutism who are not seeking fertility, we suggest oral contraceptives as initial therapy for treating patient-important hirsutism. […] For most women with hirsutism, we suggest against antiandrogen monotherapy as initial therapy (because of the teratogenic potential of these medications) unless these women use adequate contraception. […] For women with hirsutism at higher risk for venous thromboembolism (e.g., those who are obese or over age 39 years), we suggest initial therapy with an oral contraceptive containing the lowest effective dose of ethinyl estradiol (usually 20 mcg) and a low-risk progestin.

• #10 hirsutism Archives – The ObG Project

  https://www.obgproject.com/tag/hirsutism/

  9 body areas. […] Scored from 0 to 4 based on extent of hair growth and location. […] Hirsutism: Score >8. […] […] […] Diagnosis of Hyperandrogenism […] Role of Lab Testing […] Regular Menses […] Free/Total testosterone […] >200 ng/dL: Consider ovarian tumor. […] DHEAS […] >700 micrograms/dL: Consider adrenal tumor. […] 17OHP (first thing in the morning) […] >200 ng/dL: Consider nonclassical congenital adrenal hyperplasia (CAH). […] Note: If labwork is normal, consider idiopathic hirsutism and/or acne. […] […] […] Irregular Menses […] Testosterone, DHEAS and 17OHP (as above) plus […] LH/FSH. […] Prolactin. […] TSH. […] Note: If patient meets diagnostic criteria for PCOS (see ‘Related ObG Topics’ below), screen for diabetes and elevated lipids.

• #11 Hirsutism (Remedy BNSSG ICB)

  https://remedy.bnssg.icb.nhs.uk/adults/endocrinology/hirsutism/

  In any patient in whom there is a clinical suggestion of rapid onset of symptoms including virilisation, refer urgently to Endocrinology. […] This includes a significantly elevated testosterone (6nmol/L in pre-menopausal and 3nmol/L in post-menopausal women). […] For hirsute women with obesity including PCOS, advise lifestyle measures. […] We recommend first line treatment with a contraceptive pill for women not seeking fertility. […] NICE suggest the use of Dianette (cyproterone acetate and ethinylestradiol) for the treatment of moderate to severe hirsutism in women of reproductive age. […] Anti-androgen therapy is considered a 2nd line treatment in view of its teratogenicity. […] Metformin is not routinely recommended for the treatment of hirsutism in PCOS.

• #12 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Although it is normal for females to have some amount of facial and body hair, females with any degree of hirsutism are typically distressed. Hirsutism is associated with depression and anxiety (independent of obesity and a PCOS diagnosis) that improve with the treatment of their hirsutism. Any female bothered by any degree of hirsutism (terminal hairs) is a candidate for treatment. […] The treatment of hirsutism requires patience because hair follicles have a life cycle of approximately six months. Most medications must be taken for six months before a noticeable improvement occurs. In the meantime, the existing hair can be mechanically removed or bleached, and some females continue to use these methods in combination with medication. […] Your provider will monitor the progress of treatment and may repeat tests if he or she is concerned about an underlying condition. If a medication is ineffective initially, the dose or type of medication may be changed.

• #13 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  Systemic therapies directed at hirsutism can be divided into those that decrease ovarian or adrenal androgen production and those that inhibit androgen action in the skin. The systemic therapies include glucocorticoids, oral contraceptives (OCs), spironolactone, flutamide, finasteride, cyproterone acetate (not available in the United States), and insulin sensitizers (metformin and rosiglitazone). […] With current systemic therapies for hirsutism, 6 months to a year of therapy is usually required before results are noticeable. Even then, only approximately one half to three quarters of patients show improvement. The problem may lie partially in the nature of the hair follicle, which persists for 6 months to a year even after androgen levels have been normalized. Ineffectiveness may also be due to the inability of treatment to completely normalize elevated tissue dihydrotestosterone levels. Newer therapies directed at inhibition of 5-alpha-reductase or blockade of the androgen receptor may improve the ability to treat patients.

• #14 Hirsutism: What It Is, In Women, Causes, PCOS & Treatment

  https://my.clevelandclinic.org/health/diseases/14523-hirsutism

  Hirsutism is a common condition that causes excessive hair growth. It primarily affects females. […] Hirsutism can cause distress, but its treatable. […] Hirsutism is treatable. Treatments include: […] Weight loss is often the first step in treating hirsutism. Losing even 5% of your body weight can lower your androgen levels and stop excessive hair growth. […] Birth control pills are the most common medication used to treat hirsutism. They lower androgen levels, regulate your menstrual cycle and prevent pregnancy. […] Androgen-suppressing medications can effectively treat mild cases of hirsutism by lowering the amount of androgens your body produces. […] Eflornithine skin cream is a topical product that you rub on your affected areas. It doesn’t remove hair, but it slows down how fast your hair grows.

• #15 Hirsutism: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hirsutism

  Hirsutism treatment is unnecessary if no abnormal aetiology can be diagnosed and if the patient is not concerned about the cosmetic appearance. Management is mainly directed at any underlying cause if present. Treatment of hirsutism is not usually curative, unless a treatable underlying cause has been found. Because of the cyclical nature of hair growth, any systemic treatment may take up to six months to be effective. […] Encourage weight loss if overweight: Weight loss increases steroid hormone-binding globulin levels and decreases insulin resistance and the levels of serum androgens and luteinising hormones. Obesity has an adverse effect on the outcome of all systemic treatments. Women who are overweight, hyperandrogenic or hyperinsulinaemic are at increased risk of diabetes mellitus and cardiovascular disease.

• #16 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Photoepilation is the preferred treatment for most patients who desire permanent hair removal. […] If bothersome hirsutism persists despite cosmetic measures (e.g., shaving, plucking, waxing), pharmacologic treatment should be initiated, followed by direct hair removal methods if pharmacologic treatment does not yield satisfactory results. […] Combined oral contraceptives should be used as initial therapy for hirsutism in women who are not trying to conceive. […] If combined oral contraceptives are contraindicated or ineffective, the antiandrogens spironolactone, finasteride (Propecia), or dutasteride (Avodart) may be considered. […] The ornithine decarboxylase inhibitor eflornithine (Vaniqa) can be used as topical therapy for excessive facial hair. […] Numerous hair removal methods may be used to treat hirsutism. […] Photoepilation destroys pigmented terminal hair follicles through thermal damage from one of four types of lasers, based on the patient’s hair color and skin pigmentation.

• #17 Hirsutism Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hirsutism

  Suggests testing for elevated androgen levels in all women with an abnormal hirsutism score. […] Recommends against antiandrogen monotherapy unless adequate contraception is used. […] For hirsute women with obesity, including those with polycystic ovary syndrome, we also recommend lifestyle changes. […] For the majority of women with hirsutism who are not seeking fertility, we suggest oral contraceptives as initial therapy for treating patient-important hirsutism. […] For most women with hirsutism, we suggest against antiandrogen monotherapy as initial therapy (because of the teratogenic potential of these medications) unless these women use adequate contraception. […] For women with hirsutism at higher risk for venous thromboembolism (e.g., those who are obese or over age 39 years), we suggest initial therapy with an oral contraceptive containing the lowest effective dose of ethinyl estradiol (usually 20 mcg) and a low-risk progestin.

• #18 Hirsutism Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hirsutism

  If patient-important hirsutism remains despite 6 months of monotherapy with an oral contraceptive, we suggest adding an antiandrogen. […] We suggest against using insulin-lowering drugs for the sole indication of treating hirsutism. […] We suggest against the use of topical antiandrogen therapy for hirsutism. […] For women who choose hair removal therapy, we suggest photoepilation for those whose unwanted hair is auburn, brown, or black, and we suggest electrolysis for those with white or blonde hair. […] For women of color who choose photoepilation treatment, we suggest using a long-wavelength, long pulse-duration light source such as Nd:YAG or diode laser delivered with appropriate skin cooling.

• #19 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Tests that measure the amount of certain hormones in your blood, including testosterone or testosterone-like hormones, might help determine whether elevated androgen levels are causing your hirsutism. […] Treatment of hirsutism with no sign of endocrine disorder is not necessary. For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications. […] If cosmetic or self-care methods of hair removal haven’t worked for you, talk with your doctor about drugs that treat hirsutism. […] The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). […] Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women.

• #20 Evaluation and Treatment of Women with Hirsutism | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0615/p2565.html

  For women with idiopathic hirsutism, PCOS, or late-onset CAH, appropriate treatment decisions depend on each patient’s desires and childbearing plans. […] Antiandrogens may be combined with OCs for the treatment of hirsutism. […] The most commonly used antiandrogens are spironolactone (Aldactone) and flutamide (Eulexin). […] For patients whose terminal hair growth does not decrease significantly, treatment with insulin-sensitizing agents may be useful. […] Increased androgen production from nonspecific hyper-secretion or adult-onset adrenal hyperplasia responds to glucocorticoid suppression with dexamethasone.

• #21 Hirsutism

  https://www.pcds.org.uk/clinical-guidance/hirsutism

  Hirsutism is the presence of excess terminal hair growth in women as a result of increased androgen production or increased skin sensitivity to androgens, or both. Hirsutism usually requires further investigation – refer to the related chapter Hyperandrogenism. Management often involves multiple of the methods/treatments listed below. Provide a patient information leaflet. Bleaching – makes the excessive hair less obvious. Depilatory creams – are mainly based on thioglycolate. A thick layer is applied to the hairy area of skin for 15-30 minutes and then wiped off, the hair comes away with the cream. Side effects include a contact irritant eczema. Due to the risk of skin irritation it is recommended that the cream is tested on a small area of skin before using it more widely. Vaniqa (Eflornithine) – applied twice daily, a cream that works to slow the growth of facial hair. Improvements can take two to four months. If improvement is noted the cream must be continued with to maintain effectiveness. Vaniqa is often used in combination with physical methods of hair removal / laser. If no improvement is seen within four months of using Vaniqa the treatment should be stopped. While physical approaches can help, they can cause irritation, in growing hairs and a folliculitis, which may take several weeks to settle – hair removal has to be stopped, at least temporarily. If physical methods are used inappropriately or with too much force they can scar. Patients require 6-12 months of treatment before assessing outcomes; if effective then patients need to remain on treatment for continued efficacy.

• #22 hirsutism Archives – The ObG Project

  https://www.obgproject.com/tag/hirsutism/

  Hirsutism Treatment – Multimodal Approach […] Lifestyle modifications […] Weight loss for obese patients is effective with multiple other long term benefits aside from addressing hyperandrogenism. […] Medication […] Combined hormonal contraceptives (not currently FDA approved for this indication) […] Effective regardless of route. […] Third-generation progestins (desogestrel, gestodene, and norgestimate): Less androgenic activity vs levonorgestrel. […] Drospirenone (spironolactone derivative): Antiandrogen activity. […] Antiandrogens […] Spironolactone (approved indication): 50 to 200 mg/day […] May be used to enhance hormonal contraceptive. […] Less data available on other antiandrogens. […] Other medications […] Metformin: Used in adolescents with PCOS and insulin resistance.

• #23 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  The treatment of hirsutism begins with a careful explanation about the cause of the problem and reassurance that the patient is not losing her femininity. Then, direct intervention, if possible, is instituted for the underlying disorder. If hirsutism persists (or the patient has idiopathic hirsutism), other cosmetic or systemic treatment may be necessary. In some cases, cosmetic measures may be sufficient. In others, the slow progress of systemic therapy may necessitate more immediate cosmetic treatment. The most effective strategy is to combine systemic therapy, which has a slow onset of effectiveness, with mechanical depilation (shaving, plucking, waxing, depilatory creams) or light-based (laser or pulsed-light) hair removal. […] Hirsutism requires a careful and systematic clinical evaluation coupled with a rational approach to treatment. Throughout this process, the patient must understand that, although diagnostic testing can be time consuming (and even inconclusive), it is sometimes essential for determining an effective intervention. In other cases, counseling and education may be all that is needed. For the patient who desires treatment, a wide variety of pharmacologic strategies are available. Informing the patient that current systemic therapy is imperfect is important. Furthermore, none of the drugs used to treat hirsutism have US Food and Drug Administration (FDA) approval for such use. Initiate therapy only in patients who give informed consent after a complete explanation of the potential benefits and risks of a particular treatment and alternative approaches.

• #24 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  Cosmetic measures for hirsutism and their disadvantages are as follows: Hydrogen peroxide bleaching is not suitable for severe hirsutism. Plucking can cause skin irritation, folliculitis, and scarring. Waxing can cause skin irritation, folliculitis, and scarring. The wax used has a low melting point. Shaving may be psychologically unacceptable. Chemical depilatories can cause skin irritation. Electrolysis can be painful, and short-wave diathermy can cause scarring. Laser therapy has been shown not only to reduce unwanted hair but also to improve depression and anxiety in women with hirsutism. In many patients, hirsutism can be controlled just with laser, without using any drugs.

• #25 Evaluation and Treatment of Women with Hirsutism | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0615/p2565.html

  For patients with mild hirsutism, local measures such as shaving, bleaching, depilatories, and electrolysis may suffice. […] Electrolysis is one of the most effective and permanent methods of hair removal, and may be an adjunct to hormonal treatment. […] The need for rapid methods of hair removal has led to the development of laser therapy for hirsutism. […] Weight loss should be encouraged for obese patients, because this increases SHBG levels and decreases insulin resistance and the levels of serum androgens and luteinizing hormones. […] Pharmacologic treatment for hirsutism should be aimed at blocking androgen action at hair follicles or suppression of androgen production. […] Eflornithine (Vaniqa) topical cream has been shown to slow rates of terminal hair growth significantly in up to 32 percent of patients and can be used adjunctively with usual methods of hair removal.

• #26 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Shaving is a safe and effective method for hair removal but may require daily sessions. […] Chemical hair removal, waxing, and bleaching – Hair removal agents and wax can be used to remove hair, and bleaches can be used to lighten hair. […] Electrolysis damages individual hair follicles by inserting a very fine needle into the hair follicle and applying an electrical current. Electrolysis is best suited for treatment of small areas, although larger areas may be treated with multiple sessions over time. […] Laser hair removal is effective, faster, and less painful than electrolysis. It can often permanently reduce hair growth, particularly in those who are fair-skinned with dark hair. […] Eflornithine hydrochloride (brand name: Vaniqa) is a skin cream that can be used to slow the growth of unwanted facial hair in females. It does not remove hair permanently.

• #27 Hirsutism in Women (Excess Body Hair Growth) | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/hirsutism-in-women-excess-body-hair-growth

  Hirsutism is excess hair growth on the body or face. For women, the hair may grow in areas where men often have a lot of hair but women often don’t. This includes the upper lip, chin, chest, and back. It’s caused by an excess of male hormones called androgens. All women naturally produce small amounts of androgens. But high levels of these hormones can lead to hirsutism. […] Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person. […] Methods to remove or reduce unwanted hair include: Shaving. Hair will start growing back right away, so shaving needs to be repeated often. Depilatory lotion. This is a type of hair removal done with chemicals put on the skin. It softens hair above the skin so it can be wiped away. Waxing. Hot or cold wax can be used to pull out hair from the root. This treatment needs to be done every 2 to 3 weeks. Bleaching. Chemicals can lighten the color of the hair and make it harder to see. Electrolysis. A very thin needle is put into a hair follicle. Electricity is sent through the needle. This damages the hair follicle. This method is done over several sessions. This can reduce and remove hair for months or longer. Laser hair removal. A special laser is pointed at the skin. The light from the laser is absorbed by color (pigment) in the hair and destroys the hair. This works best on people with dark hair and light skin. This method is done over several sessions. This can reduce and remove hair for months or longer. Medicated cream. Skin cream with eflornithine can slow hair growth. Results show up in 6 to 8 weeks. The hair will regrow in about 8 weeks if you stop using the cream. […] Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments. […] Hirsutism is often a long-term (chronic) condition. But you can manage it by working with your healthcare provider to create a treatment plan.

• #28 Hirsutism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470417/

  The approach to hirsutism requires a systemic approach coupled with a focussed treatment plan. The primary care providers, including the nurse practitioner, must educate the patient about compliance with treatment and the time consuming diagnostic procedures. Mental health consultation may be appropriate. Dermatology nurses can provide patient education and monitor treatment. The pharmacist should educate the patient on pharmacological treatment and their limitations, as well as checking for drugs that may contribute to the condition. Finally, the clinician should provide options for other treatments and only initiate therapy after obtaining informed consent. […] The outcomes for many patients with hirsutism are not satisfactory. Recurrence of hair growth is common, and repeated treatments to remove hair are also costly, creating a financial burden on the patients.

• #29 Hirsutism: causes and management

  https://www.independentnurse.co.uk/content/clinical/hirsutism-causes-and-management/

  Hirsutism is a common and frequently distressing condition for women. […] Hirsutism is associated with increased anxiety, depression, self-consciousness and embarrassment, diminished self-confidence and body dissatisfaction. […] The presence of unwanted facial hair is a particularly distressing symptom because this is visible to others. Clinical experience shows that women with hirsutism generally only seek medical help if they experience facial hirsutism.

• #30 Hirsutism | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22904

  The management of hirsutism is interprofessional, including the dermatologist, the endocrinologist, and the gynecologist. The treatments used serve to reduce the severity of hirsutism, as well as to improve overall health and self-esteem. […] Hirsutism is a common disorder encountered in clinical practice. While not life-threatening, it has significant morbidity because of cosmetic issues. In some women, it may a sign of an underlying malignancy. Thus, the disorder is best managed by an interprofessional team. […] The approach to hirsutism requires a systemic approach coupled with a focussed treatment plan. The primary care providers, including the nurse practitioner, must educate the patient about compliance with treatment and the time consuming diagnostic procedures. Mental health consultation may be appropriate. Dermatology nurses can provide patient education and monitor treatment. The pharmacist should educate the patient on pharmacological treatment and their limitations, as well as checking for drugs that may contribute to the condition. Finally, the clinician should provide options for other treatments and only initiate therapy after obtaining informed consent.

• #31 Learning About Hirsutism | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-hirsutism.tw12235

  Hirsutism may also occur in some women who have diabetes or who are obese. […] Your doctor may want to do some tests to find out if a medical problem is causing your excess hair growth. If the cause is not a medical problem, treating it is often a matter of choice. Treatments include: […] Women who have PCOS and who are overweight may be able to reduce excess hair growth by reaching a healthy weight. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #32

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12235

  Hirsutism may also occur in some women who have diabetes or who are obese. […] Your doctor may want to do some tests to find out if a medical problem is causing your excess hair growth. If the cause is not a medical problem, treating it is often a matter of choice. Treatments include: […] Women who have PCOS and who are overweight may be able to reduce excess hair growth by reaching a healthy weight. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #33 Hirsutism: Causes, Treatments for Excessive Hairiness in Women

  https://www.webmd.com/women/hirsutism-hair-women

  You may be able to lessen your chances of getting hirsutism, depending on the cause. If you have PCOS, here are some ways to lower your risk: Eat a healthy, low-calorie diet. Lose weight. Exercise regularly. […] Talk to your doctor if you take medicines that can cause hirsutism. You may be able to adjust some of these drugs. […] Hirsutism causes excessive hair growth, mainly in women and people AFAB. Though the symptoms of this condition can feel embarrassing, there are treatments available if you want to lessen the amount of facial and body hair. Talk to your doctor if you think you might have hirsutism.

• #34 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Over time, many females find that a multipronged approach that includes direct hair removal (such as laser), suppression of androgen production with estrogen-progestin contraceptives and androgen blockade with an antiandrogen (spironolactone) may produce the maximal reduction in bothersome hair growth. […] Your health care provider is the best source of information for questions and concerns related to your medical problem. […] This article will be updated as needed on our website (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for health care professionals, are also available.

• #35 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  The treatment of PCOS may also involve lifestyle changes including weight loss, treatment of infertility, diabetes, and risk factors for cardiovascular disease. […] Several methods can be used to physically remove or lighten excess hair so that it less noticeable. These methods can be used in conjunction with medication. However, females with hirsutism who are trying to become pregnant or are already pregnant cannot take medications for hirsutism. Pregnant females should ask their health care provider about the safety of the various mechanical and chemical treatment methods during pregnancy. Electrolysis and laser are both called „permanent hair reduction” techniques. However, for females with PCOS, hair will grow back after either treatment, unless medication to suppress hair growth is also taken (a birth control pill or antiandrogen).

• #36 Hirsutism – OBGYN | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/conditions-treated/hirsutism

  A successful management plan for unwanted hair addresses a womans own concerns and allows for an individualized strategy that balances time spent on mechanical hair removal with prevention of further hair growth through medical therapy. Follow-up visits are often necessary to review progress, assess side effects, and advise further management as necessary, thereby increasing long-term satisfaction. The best management of unwanted hair growth often requires a multidisciplinary approach provided by qualified physicians, aestheticians, laser therapists, and electrologists and that 3 to 6 months of treatment is commonly required before improvement of hirsutism is observed.

• #37 Hirsutism | Altru Health System

  https://www.altru.org/health-library/conditions/hirsutism

  Hirsutism (HUR-soot-iz-um) is a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern face, chest and back. […] Self-care methods and effective treatment options are available for women who wish to treat hirsutism. […] If you think you have too much coarse hair on your face or body, talk with your doctor about treatment options. […] Treatment of hirsutism with no sign of endocrine disorder is not necessary. For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications. […] If cosmetic or self-care methods of hair removal haven’t worked for you, talk with your doctor about drugs that treat hirsutism. […] Self-care methods such as the following temporarily remove or reduce the visibility of unwanted facial and body hair. There is no evidence that self-removal of hair leads to heavier hair growth. […] When you make your appointment, ask if you should avoid removing your unwanted hair so the doctor can better evaluate your condition.

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