Hirsutism: Causes and Symptoms

What is hirsutism?

Hirsutism is a condition in which unwanted, excessive facial and body hair growth occurs in females. Usually, the excess hair is thick and coarse. It tends to be most noticeable in areas where hair growth typically occurs in males. This includes areas such as the upper lip, chin, sideburns area, and chest. This condition often begins around the time of puberty but can affect women of all ages.

What causes hirsutism?

Causes of hirsutism include:

• Hyperandrogenism: a condition in which females make more androgens (male hormones) than usual. While the main role of androgens is to help develop male features, all females have small amounts of androgens in addition to female hormones. When male hormone levels are higher than typical, this can lead to an increase in facial and body hair, acne, hair loss in a male pattern and irregular or absent periods. Very young girls may develop early signs of puberty such as pubic and armpit hair, acne and a growth spurt before 8 years of age. With further increases in male hormone levels, females may experience voice changes, muscle development, and an increase in the size of the clitoris.
• Polycystic ovarian syndrome (PCOS): a condition in which tiny cysts are seen on ultrasound in the periphery of the ovaries and the patient has higher than normal levels of male hormones. Periods may be irregular or absent. The patient may develop severe acne.
• Obesity or overweight: because the chances of having PCOS are higher
• Congenital adrenal hyperplasia: a genetic condition in which low levels of certain enzymes lead to high male hormone levels. The condition can range from very severe and life threatening with male-like genitals and abnormal sodium and potassium levels diagnosed in the first few weeks of life, to mild with normal looking genitals and normal sodium and potassium levels, diagnosed around the time of puberty or later.
• Other genetic conditions with deficiencies in certain enzymes that cause high male hormone levels in females
• Tumors in the ovaries or adrenal glands that make large amounts of male hormones
• Familial: Increased facial or body hair may occur in certain families, particularly within certain ethnic groups, without an obvious cause
• Certain medications
• Idiopathic hirsutism, in which there is no clear cause for the condition

What are the symptoms of hirsutism?

Common symptoms of hirsutism include:

• Excessive hair on the face, especially the upper lip, chin, along the sideburns area and jawline, in the upper and lower back, chest, and over the abdomen below and above the belly button When this is caused by high levels of male hormones, one may also see:
• Acne and/or unusually oily skin
• Irregular or absent periods
• Hair loss on the head in a male pattern
• Deepening of the voice
• More noticeable muscle development
• An increase in size of the clitoris

Rev. 3/2020. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.