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Hirsutism is the medical term for excess hair on a woman in the places only adult men "should" grow hair. At least 25% and as much as 85% of normal middle-aged women remove unwanted facial and body hair, although few of these women are termed hirsute. For most women, the tendency towards hirsutism is inherited. Excess hair growth may be present in both the female and male family members. Hirsutism usually begins around puberty, but mild hirsutism can start at any age. Most women gradually develop more facial or body hair with age.

Hypertrichosis is an excessive quantity of hair in a normal location. When a woman has a lot of hair on the calf of the leg, it would be called hypertrichosis and not hirsutism. Some women with will also have facial hair from hypertrichosis.

Hirsutism is usually caused by an increased sensitivity of the skin to a group of hormones called androgens (testosterone and androstenedione) or increased production of these hormones. Androgen disorders (hyperandrogenism) affects between 5% to 10% of all women. Hyperandrogenism is increased levels of male hormone production in women. The most commonly seen symptom is irregular menstrual cycles.

A doctor can do some tests to see if this is caused by a treatable condition. Testing usually includes testosterone (T) levels and dehydroepiandrosterone sulfate (DHEAS). Others tests such as 17-hydroxyprogesterone, prolactin, T4, TSH, breast exam, and an endometrial biopsy may be indicated.

Treatments for hyperandrogenism include oral contraceptives, spironolactone and flutamide. A prescription cream that stops facial hair growth, Vaniqa (pronounced Van-ih-KA) is also available. Studies show it helps most women and has no major side effects. Laser hair removal is also an option as an adjunct therapy to aid in removal of unwanted hair.

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