Hair and Nails

Hirsutism is defined as excessive hair growth in both a normal and an abnormal distribution [13]. Most pregnant women develop some degree of hirsutism, which is usually most pronounced on the face (upper lip, chin, and cheeks). The arms, legs, and back can also be involved (Figs. 3.1, 3.2) [22, 23]. In addition, suprapubic midline hair growth with a male-pattern distribution may also be increased during pregnancy [5, 23]. Acne may be an accompanying feature of hirsutism [23].

Hirsutism generally starts early in pregnancy, and is usually more pronounced in women with preexisting abundant body hair or very dark hair or in women with a preexisting tendency toward a male pattern of hair distribution [4, 23]. Within 6 months postpartum and even before delivery, most of the excess fine lanugo hairs disappear, but coarse and bristly hair usually remains. Recurrence with subsequent pregnancies is common [23].