Hirsutism is a condition noticed in females wherein there is an abnormal presence of androgenic hair/terminal hair throughout the body. This condition generally involves presence of predominant facial hair, along with terminal hair in hands and feet. On the other hand excessive hair in pubic and scalp region without any other noticeable terminal hair is not categorized as hirsutism, but as localized hypertrichosis. Both conditions are often confused with one another; hirsutism can therefore be distinguished as hypertrichosis exclusive to females and female children.
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Hypertrichosis in men is also known as Ambras syndrome or werewolf syndrome in extreme cases. Hypertrichosis has many causative factors; some are genetic whereas others may be acquired i.e. by some medication or external factors. Genetic factors show extreme cases and complete body hair presence; on the other hand external factors may present localized terminal hair. Hirsutism is often a major concern among women as social norms perceive women with excessive body hair as unacceptable to the society, or unfavorable in the gene pool. The root cause for hirsutism hasn’t been universally defined, a cluster of reasons are given for the persistence of facial and body hair, one of them being the increased sensitivity of hair follicle towards androgens present in the body.
Typically, both human males and females have androgens in the body, the count in females being significantly lower than men are, in some hirsutism cases even existing low levels of androgens may trigger hypertrichosis in women. Higher insulin levels and obesity are also observed to be a factor contributing to hirsutism, in such cases, lowering insulin levels has been shown to gradually reduce the effects of hirsutism. In majority of the cases however, polycystic ovaries have been found to be the major factor in causing hirsutism, it has been defined as a contributing factor for the recent increase in hirsutism cases.
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Polycystic ovary syndrome (PCOS) can lead to ovarian cancer or ovarian tumors in later stages. Androgen secreting tumor of the ovaries are also a possible reason for hirsutism, such cases also display virilization of the female, displaying male pattern secondary sexual characteristics, uncommon with a typical hirsutism case.
The treatment for hirsutism has not been exclusively defined or approved by the FDA. Many practitioner use symptomatic relief or systemic control of body hormones as a common approach. In significant number of cases, especially older women, laser treatment is seen as an effective way to reduce the distress caused by hirsutism. In cases where doctors suspect a serious underlying cause, such as abnormal androgen levels, or insulin levels, or PCOS, doctors prescribe a variety of hormone regulators like oral contraceptives (which are inexpensive) or insulin regulators, along with anti-androgenic compounds like sibutramine/flutamide or androgen receptor blocker like spironolactone, etc.
Since there is no currently existing defined or exclusive drug treatment for hirsutism, no specific companies can be mentioned, to be promoting such drugs. Off label use and prescription are often seen. Laser hair removal and other cosmetic procedures are currently the most widely used treatment for hirsutism.
The prevalence of these cases is majorly reported in the North American and European region. The reason being that, in these regions the typical average females do not have excessive facial or body hair; hence the presence of underlying physiological disorder is always considered. On the other hand, Mediterranean and certain South American populations along with a majority of Middle Eastern, and South Asian populations are found to have natural hirsutism. In these regions the average females are known to have some facial hair and dominant terminal hair in the hand and legs.
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In such cases a medical practitioner must investigate racial origin of a hirsutism patient as females in these regions do not posses any underlying cause for their natural hirsutism. East Asian populations have rarely reported cases of hirsutism. The market for hirsutism treatment therefore majorly lies in North America and Europe. Asia-Pacific has shown recent spurt of growth in cosmetic procedures used to remove excess body hair, along with South America and rest of the world. Westernization and globalization is seen to be a factor promoting the change in acceptance towards female body hair.