At a Glance - Hirsutism versus hypertrichosis

HIRSUTISM
DISCRIMINATORY SIGNS

- Excess hair growth in women following a male distribution pattern.
- Coarse terminal hair in the moustache, beard area, chest or lower
abdomen.
- Genetically determined.
- Common, but cultural acceptability varies.
- If periods are abnormal, consider serum testosterone level as is
associated with polycystic ovarian syndrome (PCOS).

MANAGEMENT
- If the patient is overweight, advise weight loss.
- Bleach the hairs or use depilatory creams.
- Waxing, sugaring, plucking or shaving.
- Electrolysis, laser treatment.
- Androgen suppression - the oral contraceptive pill, metformin; or
peripheral androgen blockade - spironolactone, cyproterone.
- Eflornithine cream.

HYPERTRICHOSIS
DISCRIMINATORY SIGNS
- Excess hair growth over and above the normal for the age, sex and race
of an individual.
- It can be localised or generalised.
- If confined to lumbosacral area it may be a marker for spina bifida.
- May be congenital or acquired.
- If acquired, the hair is usually unpigmented or may involve pigmented
terminal hair.
- Can occur in people who go on to develop malignancy, hence, known as
malignant down.
- It can be caused by ciclosporin, diazoxide and minoxidil.

MANAGEMENT
- No specific treatment.
- Consider stopping drugs that can cause hair growth.
- Advise on hair removal as in hirsutism.

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