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Hirsutism

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Update in Cosmetic Dermatology

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Abstract

Hirsutism is an excessive terminal hair that appears with a male pattern in women, and it can be the only manifestation or can be part of hyperandrogenism. Hirsutism results from an interaction between the plasma androgens and the apparent sensitivity of the hair follicle to androgen, and it is classified as being produced by an excess of androgens from ovaries and/or adrenals by an increased sensitivity of the pilosebaceous unit by androgens or by the use of medications or changes in sex hormone-binding globulin secretion.

The aims of treatment are to normalize the androgen overproduction, to suppress the androgen action, to recognize patients with higher risk of metabolic disorders, and to identify patients with reproductive tract or adrenal neoplasm. Treatment of hirsutism should be individualized and will be according with its etiology.

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References

  1. Azziz R, Carmina E, Sawaya ME (2000) Idiopathic hirsutism. Endocr Rev 21:347–362

    Article  PubMed  CAS  Google Scholar 

  2. Azziz R, Zacur A (1989) 21-hydroxylase deficiency in female hyperandrogenism; screening and diagnosis. J Clin Endocrinol Metab 69:569–577

    Article  Google Scholar 

  3. Bhattacharya SM, Jha A (2012) Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with polycystic ovary syndrome. Fertil Steril 98:1053–1059, Epub 2012 Jul 13

    Article  PubMed  CAS  Google Scholar 

  4. Cosma M, Swiglo BA, Flynn DN, Kurtz DM, LaBella ML, Mullan RJ, Elamin MB, Erwin PJ, Montori VM (2008) Insulin sensitizers for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials. J Clin Endocrinol Metab 93:1135–1142

    Article  PubMed  CAS  Google Scholar 

  5. Couzinet B, Le Strat N, Brilly S, Schaison G (1986) Comparative effects of cyproterone acetate or a long-acting gonadotropin-releasing hormone agonist in polycystic ovarian disease. J Clin Endocrinol Metab 63:1031–1035

    Article  PubMed  CAS  Google Scholar 

  6. Cusan L, Dupont A, Gomez J-L (1994) Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial. Fertil Steril 61:281–287

    PubMed  CAS  Google Scholar 

  7. Ehrmann DA (2005) Polycystic ovary syndrome. N Engl J Med 352:1223–1236

    Article  PubMed  CAS  Google Scholar 

  8. Erenus M, Gurbuz O, Durmusoglu F, Demircay Z (1994) Comparison of the efficacy of spironolactone versus flutamide in the treatment of hirsutism. Fertil Steril 61:613–616

    PubMed  CAS  Google Scholar 

  9. Ferriman D, Gallwey JD (1961) Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 21:1140–1148

    Article  Google Scholar 

  10. Fitzgerald C, Elstein M, Spona J (1999) Effect of age on the response of the hypothalamo-pituitary-ovarian axis to a combined oral contraceptive. Fertil Steril 71:1079–1084

    Article  PubMed  CAS  Google Scholar 

  11. Fruzzetti F, De Lorenzo D, Parrini D, Ricci C (1994) Effects of finasteride, a 5α-reductase inhibitor, on circulating androgens and gonadotropin secretion in hirsute women. J Clin Endocrinol Metab 79:831–835

    Article  PubMed  CAS  Google Scholar 

  12. Gorgu M, Aslan G, Akoz T, Endogan B (2000) Comparison of alexandrite laser and electrolysis for hair removal. Dermatol Surg 26:37–41

    Article  PubMed  CAS  Google Scholar 

  13. Hamzavi I, Tan E, Shapiro J, Luis H (2007) A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women. J Am Acad Dermatol 57:54–59

    Article  PubMed  Google Scholar 

  14. Kuttenn F, Couillin P, Girard F, Billaud L, Vincens M, Boucekkine C, Thalabard JC, Maudelonde T, Spritzer P, Mowszowicz I, Mauvais-Jarvis P (1985) Late-onset adrenal hyperplasia in hirsutism. N Eng J Med 313:224–231

    Article  CAS  Google Scholar 

  15. Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL, Shapiro J, Montori VM, Swiglo BA (2008) Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 93:1105–1120

    Article  PubMed  CAS  Google Scholar 

  16. Mercurio MG (2001) Hirsutism: diagnosis and management. J Gend Specif Med 4:29–34

    PubMed  CAS  Google Scholar 

  17. Mowszowicz I, Melanitou E, Doukani A, Wright F, Kuttenn F, Mauvais-Jarvis P (1983) Androgen binding capacity and 5 alpha-reductase activity in pubic skin fibroblasts from hirsute patients. J Clin Endocrinol Metab 56:1209–1213

    Article  PubMed  CAS  Google Scholar 

  18. New MI (2006) Nonclassical 21-hydroxylase deficiency. J Clin Endocrinol Metab 91:4205–4214

    Article  PubMed  CAS  Google Scholar 

  19. New MI, Lorenzen F, Pang S, Gunczler P, Dupont B, Levine LS (1979) Acquired adrenal hyperplasia with 21-hydroxylase deficiency is not the same genetic disorders as congenital adrenal hyperplasia. J Clin Endocrinol Metab 48:356–359

    Article  PubMed  CAS  Google Scholar 

  20. Norman RJ, Dewailly D, Legro RS, Hickey TE (2007) Polycystic ovary syndrome. Lancet 370:685–697

    Article  PubMed  CAS  Google Scholar 

  21. Petitti DB (2003) Combination estrogen-progestin oral contraceptives. N Engl J Med 349:1443–1450

    Article  PubMed  CAS  Google Scholar 

  22. Richards RN, Mcharg GE (1995) Electrolysis: observations from 13 years and 140.000 hours of experience. J Am Acad Dermatol 33:662–666

    Article  PubMed  CAS  Google Scholar 

  23. Rosenfield RL (2005) Clinical practice. Hirsutism. N Engl J Med 353:2578–2588

    Article  PubMed  CAS  Google Scholar 

  24. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnosis criteria and long-term health risks related to polycystic ovary syndrome. Fertile Steril 81:19–125

    Google Scholar 

  25. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnosis criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19:41–47

    Article  Google Scholar 

  26. Scully RE (1989) Ovarian tumors with endocrine manifestations. In: DeGroot LJ, Besser GM, Cahill GF (eds) Endocrinology, 2nd edn. WB Saunders, Philadelphia, pp 1994–2008

    Google Scholar 

  27. Smith SR, Piacquado DJ, Beger B, Littler C (2006) Eflornithine cream combined with laser therapy in the management of unwanted facial hair is growth in women: a randomized trial. Dermatol Surg 32:1237–1243

    Article  PubMed  CAS  Google Scholar 

  28. Spritzer PM (2002) Hirsutism revisited. Arq Bras Endocrinol Metab 46:127–136

    Article  Google Scholar 

  29. Spritzer PM, Billaud L, Thalabard JC, Birman P, Mowszowicz I, Raux-Demay MC, Clair F, Kuttenn F, Mauvais-Jarvis P (1990) Cyproterone acetate versus hydrocortisone treatment in late-onset adrenal hyperplasia. J Clin Endocrinol Metab 70:642–646

    Article  PubMed  CAS  Google Scholar 

  30. Spritzer PM, Oppermann-Lisboa K, Mattiello S, Lhulier F (2000) Spironolactone as a single agent for long-term therapy of hirsute patients. Clin Endocrinol 52:587–594

    Article  CAS  Google Scholar 

  31. Swiglo BA, Cosma M, Flynn DN, Kurtz DN, LaBella ML, Mullan RJ, Erwin PJ, Montori VM (2008) Antiandrogens for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials. J Clin Endocrinol Metab 93:1153–1160

    Article  PubMed  Google Scholar 

  32. Tolino A, Petrone A, Sarnacchiaro F, Cirillo D, Ronsini S, Lombardi G, Nappi C (1996) Finasteride in the treatment of hirsutism: new therapeutic perspectives. Fertil Steril 66:61–65

    PubMed  CAS  Google Scholar 

  33. Urushibata O, Kase K (1995) A comparative study of axillar hair removal in women: plucking versus the blend method. J Dermatol 22:738–742

    PubMed  CAS  Google Scholar 

  34. Venturoli S, Marescalchi O, Colombo FM, Macrelli S, Ravaioli B, Bagnoli A, Paradisi R, Flamigni C (1999) A prospective randomized trial comparing low dose flutamide, finasteride, ketoconazole and cyproterone acetate-estrogen regimens in the treatment of hirsutism. J Clin Endocrinol Metab 84:1304–1310

    Article  PubMed  CAS  Google Scholar 

  35. Wong IL, Morris RS, Chang L, Spahn MA, Stanczyk FZ, Lobo RA (1995) A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women. J Clin Endocrinol Metab 80:233–238

    Article  PubMed  CAS  Google Scholar 

  36. Yildiz BO (2004) Recent advances in the treatment of polycystic ovary syndrome. Expert Opin Investig Drugs 13:1295–1305

    Article  PubMed  CAS  Google Scholar 

  37. Yildiz BO (2008) Assessment, diagnosis and treatment of a patient with hirsutism. Nat Clin Pract Endocrinol Metab 4:294–300

    Article  PubMed  Google Scholar 

  38. Zawadski JK, Dunaif A (1990) Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Evans JR, Hersaltine S, Marriam GR (eds) Polycystic ovary syndrome. Blackwell, Boston, pp 377–384

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Ticiana C. Rodrigues M.D.

  2. Endocrine Division, Hospital de Clínicas de Porto Alegre, 2350, Ramiro Barcelos Street – Building 12, 4th Floor, 90035-003, Porto Alegre, RS, Brazil

    Ticiana C. Rodrigues M.D. & Poli Mara Spritzer

  3. Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Poli Mara Spritzer

Authors
  1. Ticiana C. Rodrigues M.D.
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  2. Poli Mara Spritzer
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Correspondence to Ticiana C. Rodrigues M.D. .

Editor information

Editors and Affiliations

  1. Leonard M. Miller School of Medicine, Department of Dermatology, University of Miami, Belle Meade Island Drive 881, Miami, 33138, Florida, USA

    Antonella Tosti

  2. , Clinica Hexsel de Dermatologia, Pontifícia Universidade Católica do Rio, Dr Timoteo Street 782, Porto Alegre, 90570-040, Rio Grande do Sul, Brazil

    Doris Hexsel

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Rodrigues, T.C., Spritzer, P.M. (2013). Hirsutism. In: Tosti, A., Hexsel, D. (eds) Update in Cosmetic Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34029-1_5

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  • DOI: https://doi.org/10.1007/978-3-642-34029-1_5

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34028-4

  • Online ISBN: 978-3-642-34029-1

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