• AANCHHAL Department of pharmacology, CT Group of Institutions, Jalandhar, India 144020
  • RAHUL MEHRA Department of pharmacology, CT Group of Institutions, Jalandhar, India 144020
  • AMIT BARWAL Department of pharmacology, CT Group of Institutions, Jalandhar, India 144020
  • SURYA PARKASH GAUTAM Department of pharmacology, CT Group of Institutions, Jalandhar, India 144020



Hirsutism, Hypertrichosis, Hair growth, Diagnosis, Treatment


The objective of the review is to explain the pathogenesis, causes and various treatment involved in hirsutism. This article discusses the disease’s pathogenesis, causes and diagnosis. This review looks at the main significant type of hairs and clinical studies on the role of several lifestyle therapies in hirsutism development. This review examines the numerous methods that causes hirsutism in order to discover new medicaments. In addition, it covers the various type of hirsutism therapy. Hirsutism, is reported to have the strongest impact on patients’ health-related quality of life, following in descending order by body mass index, irregular menses, and infertility. To assess the types of hairs and pathogenesis, sign and symptoms, as well as causes of hirsutism. Moreover, we studied the management of hirsutism and how to treat this. At least six to nine months of therapy are required to produce improvement in hirsutism. We suggest testing for elevated androgen levels in women with moderate or severe hirsutism or hirsutism of any degree when it is sudden in onset, rapidly progressive, or associated with other abnormalities such as menstrual dysfunction, obesity, or macroclitoris. For women with patient-important hirsutism despite cosmetic measures, we suggest either pharmacological therapy or direct hair removal methods. For pharmacological therapy, we suggest oral contraceptives for the majority of women, adding an Antiandrogens after 6 mo if the response is suboptimal. We recommend against androgen antagonist monotherapy unless adequate contraception is used. We suggest against using insulin-lowering drugs. For women who choose hair removal therapy, we suggest laser/photo epilation.


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Wendelin DS, Pope DN, Mallory SB. Hypertrichosis. J Am Acad Dermatol. 2003;48(2):161-79; quiz 180. doi: 10.1067/mjd.2003.100, PMID 12582385.

Bode D, Seehusen DA, Baird D. Hirsutism in women. Am Fam Physician. 2012;85(4):373-80. PMID 22335316.

Vulink AJ, Ten Bokkel Huinink D. Acquired hypertrichosis lanuginosa: a rare cutaneous paraneoplastic syndrome. J Clin Oncol. 2007;25(12):1625-6. doi: 10.1200/JCO.2007.10.6963, PMID 17443005.

Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440-7. doi: 10.1210/jcem-21-11-1440, PMID 13892577.

Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endocr Rev. 2000;21(4):347-62. doi: 10.1210/edrv.21.4.0401, PMID 10950156.

Yildiz BO. Diagnosis of hyperandrogenism: clinical criteria. Best Pract Res Clin Endocrinol Metab. 2006;20(2):167-76. doi: 10.1016/j.beem.2006.02.004, PMID 16772149.

Glintborg D, Andersen M. An update on the pathogenesis, inflammation, and metabolism in hirsutism and polycystic ovary syndrome. Gynecol Endocrinol. 2010;26(4):281-96. doi: 10.3109/09513590903247873. PMID 20141388.

PCOS and hyperandrogenism from the Textbook of Williams Gynecology. 1st ed. 2021. p. 383-99.

Pritts EA. Treatment of the infertile patient with polycystic ovarian syndrome. Obstet Gynecol Surv. Sep 2002;57(9):587-97. doi: 10.1097/00006254-200209000-00022, PMID 12218667.

Dunaif A. Hyperandrogenic anovulation PCOS: a unique disorder of insulin action associated with an increased risk of non-insulin-dependent diabetes mellitus. Am J Med. Jan 16 1995;98:(IA335-39).

Conway GS, Agrawal R, Betteridge DJ, Jacobs HS. Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol (Oxf). 1992;37(2):119-25. doi: 10.1111/j.1365-2265.1992.tb02295.x, PMID 1395062.

Hunter MH, Carek PJ. Evaluation and treatment of women with hirsutism. Am Fam Physician. 2003 Jun 15;67(12):2565-72. PMID 12825846.

Gheorghisan-Galateanu A, Fica S, Terzea DC, Caragheorgheopol A, Horhoianu V. Sertoli-Leydig cell tumor- a rare androgen secreting ovarian tumor in postmenopausal women. Case report and review of literature. J Cell Mol Med. Oct 2003;4:461-71. doi: 10.1111/j.1582-4934.2003.tb00249.x, PMID 14754515.

Brodell LA, Mercurio MG. Hirsutism: diagnosis and management. Gend Med. 2010;7(2):79-87. doi: 10.1016/j.genm.2010.04.002, PMID 20435271.

Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL, Shapiro J, Montori VM, Swiglo BA. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(4):1105-20. doi: 10.1210/jc.2007-2437, PMID 18252793.

Somani N, Harrison S, Bergfeld WF. The clinical evaluation of hirsutism. Dermatol Ther. 2008;21(5):376-91. doi: 10.1111/j.1529-8019.2008.00219.x, PMID 18844715.

Franks S, McCarthy M. Genetics of ovarian disorders: polycystic ovary syndrome. Rev Endocr Metab Disord. 2004;5(1):69-76. doi: 10.1023/B:REMD.0000016125.05878.96, PMID 14966390.

Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E. American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE), Androgen Excess and PCOS Society (AES). American Association of clinical endocrinologists, American College of endocrinology, and androgen excess and PCOS society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome- part 1. Endocr Pract. 2015;21(11):1291-300. doi: 10.4158/EP15748.DSC, PMID 26509855.

Blume Peytavi U. How to diagnose and treat medically women with excessive hair. Dermatol Clin. 2013;31(1):57-65. doi: 10.1016/j.det.2012.08.009, PMID 23159176.

Dokras A. Mood and anxiety disorders in women with PCOS. Steroids. 2012;77(4):338-41. doi: 10.1016/j.steroids.2011.12.008, PMID 22178257.

Krępuła K, Bidzinska Speichert B, Lenarcik A, Tworowska Bardzinska U. Psychiatric disorders related to polycystic ovary syndrome. Endokrynol Pol. 2012;63(6):488-91. PMID 23339008.

Goodman NF, Bledsoe MB, Cobin RH, Futterweit W, Goldzieher JW, Petak SM, Smith KD, Steinberger E. American association of clinical endocrinologists hyperandrogenic disorders task force. American Association of Clinical Endocrinologists medical guidelines for the clinical practice for the diagnosis and treatment of hyperandrogenic disorders. [American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of hyperandrogenic disorders]. Endocr Pract. 2001;7(2):120-34. doi: 10.4158/EP.7.2.120, PMID 12940239.

Polson DW, Adams J, Wadsworth J, Franks S. Polycystic ovaries- A common finding in normal women. Lancet. 1988;1(8590):870-72. doi: 10.1016/s0140-6736(88)91612-1, PMID 2895373.

Legro RS, Driscoll D, Strauss JF III, Fox J, Dunaif A. Evidence for a genetic basis for hyperandrogenemia in polycystic ovary syndrome. Proc Natl Acad Sci USA. 1998;95(25):14956-60. doi: 10.1073/pnas.95.25.14956, PMID 9843997.

Lin-Su K, Nimkarn S, New MI. Congenital adrenal hyperplasia in adolescents: diagnosis and management. Ann NY Acad Sci. 2008;1135:95-8. doi: 10.1196/annals.1429.021, PMID 18574213.

Reingold SB, Rosenfield RL. The relationship of mild hirsutism or acne in women to androgens. Arch Dermatol. 1987;123(2):209-12, PMID 2949707.

Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab. 2004;89(2):453-62. doi: 10.1210/jc.2003-031122, PMID 14764747.

Wild RA, Umstot ES, Andersen RN, Ranney GB, Givens JR. Androgen parameters and their correlation with body weight in one hundred thirty-eight women thought to have hyperandrogenism. Am J Obstet Gynecol. 1983;146(6):602-6. doi: 10.1016/0002-9378(83)90998-5, PMID 6223527.

Rosenfield RL. Hirsutism and the variable response of the pilosebaceous unit to androgen. J Investig Dermatol Symp Proc. 2005;10(3):205-8. doi: 10.1111/j.1087-0024.2005.10106.x, PMID 16382665.

Marynick SP, Chakmakjian ZH, McCaffree DL, Herndon JH Jr. Androgen excess in cystic acne. N Engl J Med. 1983;308(17):981-6. doi: 10.1056/NEJM198304283081701, PMID 6220224.

Azziz R, Dewailly D, Owerbach D. Clinical review 56: Nonclassic adrenal hyperplasia: current concepts. J Clin Endocrinol Metab. 1994;78(4):810-5. doi: 10.1210/jcem.78.4.8157702, PMID 8157702.

Chang RJ, Katz SE. Diagnosis of polycystic ovary syndrome. Endocrinol Metab Clin North Am. 1999;28(2):397-408, vii. doi: 10.1016/s0889-8529(05)70076-1, PMID 10352925.

Schmidt JB, Lindmaier A, Spona J. Hyperprolactinemia and hypophyseal hypothyroidism as cofactors in hirsutism and androgen-induced alopecia in women. Hautarzt. 1991;42(3):168-72. PMID 1905280.

Ibanez L, de Zegher F. Ethinylestradiol-drospirenone, flutamide-metformin, or both for adolescents and women with hyperinsulinemic hyperandrogenism: opposite effects on adipocytokines and body adiposity. J Clin Endocrinol Metab. 2004;89(4):1592-7. doi: 10.1210/jc.2003-031281, PMID 15070917.

Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220(4596):524-7. doi: 10.1126/science.6836297, PMID 6836297.

Sanchez LA, Perez M, Azziz R. Laser hair reduction in the hirsute patient: a critical assessment. Hum Reprod Update. 2002;8(2):169-81. doi: 10.1093/humupd/8.2.169, PMID 12099632.

Gan SD, Graber EM. Laser hair removal: a review. Dermatol Surg. 2013;39(6):823-38. doi: 10.1111/dsu.12116, PMID 23332016.

Hamzavi I, Tan E, Shapiro J, Lui H. 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. 2007;57(1):54-9. doi: 10.1016/j.jaad.2006.09.025, PMID 17270315.

Ibrahimi OA, Avram MM, William HCHanke CW, Suzanne L. Kilmer SL, Anderson RR, Rox Anderson R. Laser hair removal. Dermatol Ther. 2011;24(1):94-107. doi: 10.1111/j.1529-8019.2010.01382.x, PMID 21276162.

Nanni CA, Alster TS. Laser-assisted hair removal: side effects Q-switched Nd: YAG, long-pulsed ruby, and alexandrite lasers. J Am Acad Dermatol. 1999;41(2 Pt 1):165-71. doi: 10.1016/s0190-9622(99)70043-5, PMID 10426883.

Cusan L, Dupont A, Gomez JL, Tremblay RR, Labrie F. Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial. Fertil Steril. 1994;61(2):281-7. doi: 10.1016/s0015-0282(16)56518-2, PMID 8299783.

Van der Spuy ZM, Le Roux PA. Cyproterone acetate for hirsutism. Cochrane Database Syst Rev. 2003;(4):CD001125. doi: 10.1002/14651858.CD001125, PMID 14583927.

Wong IL, Morris RS, Chang L, Spahn MA, Stanczyk FZ, Lobo RA. A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women. J Clin Endocrinol Metab. 1995;80(1):233-8. doi: 10.1210/jcem.80.1.7829618, PMID 7829618.

Burkman RT Jr. The role of oral contraceptives in the treatment of hyperandrogenic disorders. Am J Med. 1995;98(1A):130S–6130S-6S. doi: 10.1016/s0002-9343(99)80071-0, PMID 7825633.

Mastorakos G, Koliopoulos C, Creatsas G. Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives. Fertil Steril. 2002;77(5):919-27. doi: 10.1016/s0015-0282(02)02993-x, PMID 12009344.

Olaah KS. The modern management of hirsutism. Rev Gynaecol Pract. 2004;4(4):211-20. doi: 10.1016/j.rigp.2004.05.001.

Yilmaz M, Biri A, Karakocç A, Syeyedahmad Seyedalinaghi Toruner F, Bingol B, Cakir N, Tiras B, Ayvaz G, Arslan M. The effects of rosiglitazone and metformin on insulin resistance and serum androgen levels in obese and lean patients with polycystic ovary syndrome. J Endocrinol Invest. 2005;28(11):1003-8. doi: 10.1007/BF03345339, PMID 16483179.

Cumming DC, Yang JC, Rebar RW, Yen SS. Treatment of hirsutism with spironolactone. JAMA. 1982;247(9):1295-8, PMID 7199587.

Sahin Y, Dilber S, Kelesştimur F. Comparison of diane 35 and diane 35 plus finasteride in the treatment of hirsutism. Fertil Steril. 2001;75(3):496-500. doi: 10.1016/s0015-0282(00)01764-7, PMID 11239530.

Nikolaou D, Gilling Smith C. Hirsutism. Curr Obstet Gynaecol. 2005;15(3):174-82. doi: 10.1016/j.curobgyn.2005.03.006.

Loriaux DL. An approach to the patient with hirsutism. J Clin Endocrinol Metab. 2012;97(9):2957-68. doi: 10.1210/jc.2011-2744, PMID 22962669.

Cosma M, Swiglo BA, Flynn DN, Kurtz DM, Labella ML, Mullan RJ, Elamin MB, Erwin PJ, Montori VM. Clinical review: Iinsulin sensitizers for the treatment of hirsutism: A systematic review and metaanalyses of randomized controlled trials. J Clin Endocrinol Metab. 2008;93(4):1135-42. doi: 10.1210/jc.2007-2429, PMID 18252787.

Helfer EL, Miller JL, Rose LI. Side-effects of spironolactone therapy in the hirsute woman. J Clin Endocrinol Metab. 1988;66(1):208-11. doi: 10.1210/jcem-66-1-208, PMID 3335604.

Winters SJ, Talbott E, Guzick DS, Zborowski J, McHugh KP. Serum testosterone levels decrease in middle age in women with the polycystic ovary syndrome. Fertil Steril. 2000;73(4):724-9. doi: 10.1016/s0015-0282(99)00641-x, PMID 10731532.



How to Cite

AANCHHAL, R. MEHRA, A. BARWAL, and S. P. GAUTAM. “IMPORTANCE OF HAIR GROWTH IN HISUTISM: DIAGNOSIS AND TREATMENT”. International Journal of Current Pharmaceutical Research, vol. 13, no. 6, Nov. 2021, pp. 43-49, doi:10.22159/ijcpr.2021v13i6.1914.



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