A practical approach to hirsutism

Women often express concern about what they consider to be excess body or facial hair. This surplus of hair may be normal or it may signal hypertrichosis or hirsutism. Hirsutism may be idiopathic, secondary to increased responsiveness of hair follicles to normal circulating levels of androgens, or it may result from an excess of androgens, which may be exogenous, or of ovarian or adrenal origin. The evaluation of hirsutism must include the identification, or exclusion, of androgen-producing tumors, but other extensive evaluation is controversial. Treatment includes local measures, antiandrogenic therapy and treatment focused on the underlying source of excess androgen.