Are there any drugs for hirsutism?

Hirsutism

Hirsutism: Typical male hair pattern in women on the (androgen-dependent) regions influenced by male hormones such as the upper lip, chin or inner thigh. Hirsutism can appear as the only complaint or it can also be the symptom of extensive masculinization (virilization).

Possible causes are congenital or acquired hormonal disorders, e.g. B. by ovarian tumors or anabolic steroids. In many cases, however, no trigger can be found and one speaks of idiopathic hirsutism.

Depending on the extent and cause, treatment is provided with medication and / or cosmetic removal of the troublesome hair by epilation, electrocoagulation or laser.

Leading complaints

  • Disturbing hair growth, especially on the chin and upper lip (women's beard) as well as on the cheeks, upper arms, stomach, thighs and back.

When to the doctor

In the next few days if

  • Strong hair grows in the areas described and the person concerned feels stressed as a result.

The illness

The so-called androgen-dependent hair follicles in regions such as the chin, upper lip, chest, inner thighs and back are affected by the increased growth of male hair. These spots are fine in women with hirsutism instead of with Vellus hair with dark, thick ones Terminal hair covered (as with men). The transitions from even more normal to increased to abnormally pronounced body hair are fluid. This is especially true for the women's beard - which sometimes doesn't bother blond women with fine hair at all.

If there are other, typically male changes in addition to hirsutism, such as a drop in the pitch of the voice, remodeling of muscles or baldness, it is masculinization. It always has pathological causes.

causes

Idiopathic hirsutism. In over 90% of the cases, no trigger for the hirsutism can be identified, the hormone levels are normal, and increased testosterone cannot be detected. That is why doctors attribute the undesirable male hair pattern to a particular sensitivity of the hair follicles to testosterone. This constellation often occurs in the course of hormonal changes, e.g. B. in puberty, pregnancy or menopause. The predisposition to this is increased in women with dark skin and hair types.

Hormonal hirsutism. Here, the impaired hair growth is due to the hormones, either due to an increased formation or to a relative preponderance of male sex hormones in the female body. These hormone-related disorders include, for example

Drug-induced hirsutism. Long-term use of androgens, anabolic steroids (for example in sports), cortisone, spironolactone and other drugs can also trigger hirsutism. As a rule, this disappears again after the active ingredients have been discontinued.

Other diseases with hirsutism. Rare causes of hirsutism are porphyrias, neurological diseases and anorexia.

Diagnostic assurance

First, the doctor checks the hair pattern and determines the severity of the hirsutism with the help of a specially created score (Ferriman-Gallwey score). This value is important for documentation and the objective examination of whether a therapy is working. In addition, during the physical examination, the doctor pays attention to other signs of masculinization, such as baldness or acne, and documents these as well.

He then asks the patient in detail about her family history, other hormone-related disorders (menstrual cycle disorders, childlessness, loss of libido) and medication she has taken.

The doctor uses a series of laboratory tests to look for hormonal irregularities. This includes, above all, the determination of

  • Sex hormones, e.g. B. Testosterone
  • Thyroid hormones
  • Insulin and blood sugar (often disturbed in polycystic ovary syndrome).

In addition, the doctor performs ultrasound and X-ray examinations in order to find a trigger such as adrenal gland tumors or polycystic ovaries and to be able to treat them in a targeted manner.

treatment

Despite all the examination methods, no treatable underlying disease is found in over 90% of those affected, here the doctors usually assume an increased testosterone sensitivity of the hair follicles. In these cases, the doctor recommends taking anti-androgens such as cyproterone acetate, either as an anti-androgen-containing pill (e.g. together with ethinylestradiol in Diane®) or, in postmenopausal women, pure cyproterone acetate (e.g. Androcur®). Another drug treatment option are creams with the active ingredient eflornithine (Vaniqua®), which reduce the number and thickness of hair on the upper lip and chin. Statutory health insurance does not cover the costs.

In addition, only cosmetic measures such as regular hair removal or permanent laser hair removal or sclerotherapy of the hair roots help. Laser epilation is more suitable for thicker and darker body hair, not for fine vellus hair. In addition, like the desolation of the face, it is not always successful.

forecast

The course of hirsutism depends on its cause. If medication or anabolic steroids have led to this, the unwanted hair usually disappears after discontinuing the preparation. If hormonal disorders are the cause, the hirsutism will improve with treatment of the underlying disease.

Where a treatable cause cannot be found, only regular hair removal or the use of lasers or flash lamps will help. With lasers, a permanent hair reduction of around 75% can be achieved after several sessions.

Your pharmacy recommends

You can pluck out unwanted hair, shave it off, pull it out with wax or sugar paste or epilate it. It should be noted that with all of these do-it-yourself methods, the hair root is retained, so the hair will grow back sooner or later.

  • The simplest methods are plucking and shaving. For women's beards, there are special razors with particularly small and round heads to catch every hair.
  • If you don't want to shave your hair regularly, you can choose between depilatory creams, wax and sugar pastes or epilators. There are special preparations and devices for the face, although it should be remembered that sensitive skin types run the risk of leaving small scars and hyperpigmentation. If only small areas are excessively hairy, it is often sufficient to bleach the hair. Bleaching creams or a 6–12% hydrogen peroxide solution are suitable for this.

Authors

Dr. med. Arne Schäffler, Dr. Bernadette Andre-Wallis in: Health Today, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 09:09


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.