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By Lahle Wolfe


Wikipedia: Hirsuitism

Boulder Medical Center: Causes of hirsuitism

Cares Foundation: Coping with hirsuitism

The Diabetes Center at Mercy Med:  Hirsuitism

Fast Click to Comprehensive
Diabetes Problems & Complaints

Acanthosis Nigricans (AN)
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Newly Diagnosed

Diabetes Problems & Complaints
(less detail, easier reading)

Acanthosis Nigricans
Alopecia Areata (AA)
Gum Disease
Skin Tags
Yeast Infections

Information Links about PCOS

What is PCOS?
Genetically Transmitted
PCOS Signs & Symptoms
-- Gyn Disorders
-- Metabolic Problems
-- Disorders Associated
       with PCOS
-- Cosmetic Problems
-- Health Problems
Diagnosing PCOS
Treatment for PCOS
Complications & Risk Associated with PCOS

Electrolysis Links

Myths & Facts about Electrolysis

American Electrolysis Association Website

Laser Hair Removal Links

Consumer Guide to Laser Hair Removal

Institute of Laser Medicine (UCLA Medical Plaza)

American Society for Dermatology

Hirsutism Links

Hirsutism (eMedicine Article)

eMedicine links to disorders that can cause hirsutism

Adrenal Adenoma
Adrenal Carcinoma
C-11 Hydroxylase Deficiency
C-17 Hydroxylase Deficiency
Cushing Syndrome
Malignant Lesions of the Ovaries
Ovarian Cancer

Hirsutism (Article by The Endocrine Society and the Hormone Foundation

new glucose revolution for living well with pcos
New Glucose Revolution: Living Well With PCOS:   Dr. Brand-Miller --author of the NY Times bestseller The New Glucose Revolution, the authoritative guide to the glycemic index--along with Dr. Nadir Farid and Kate Marsh, address the root cause of PCOS--insulin resistance.

womans guide to living with pcos  
Collette Harris

A Woman's  Guide to
 Living with PCOS
Author Collette Harris recounts her own battles won with PCOS.

 living with pcos  
Boss, Sterling, Legro
Living With PCOS:  
Named after the cysts that may form in the ovaries, PCOS is a hormone disorder that causes irregular menstrual cycles, obesity, and infertility, among other symptoms. If untreated, it can lead to heart disease, diabetes, and uterine cancer. This is a book about and by PCOS women (coauthors Boss and Sterling both have it; physician Legro is an expert on the syndrome), which is evident in their easy-to-understand descriptions of the disorder, its symptoms, medical diagnosis, and treatments (including. alternative methods) as well as the emotional impact.

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Islets of Hope offers general information about medical issues.  Our information is not intended to be used as a substitute for professional medical care or advice.  

Links on our site are not intended as recommendation or endorsement of products, opinions, information, other persons or organizations but are presented for general information purpose only.

Diabetes Medical Library                        back to main "Problems" page
Problems and Complaints Associated with Diabetes

Hirsutism - Excess Hair
Symptoms, Causes & Treatment


Mini Site Index
What is Alopecia Hirsutism?
Hair Removal Treatment
Alopecia Areata May Occurs Simultaneously

Disorders that can be associated with hirsutism
Type 2 Diabetes
Hashimoto's Thyroiditis
Cushing Syndomre
Insulin Resistance
Metabolic Syndrome (X)
Polycystic Ovarian Syndrome (PCOS)  

diabetes insulin resistance pcos and hirsutism
Example of mild facial hirsutism in a women with PCOS


What is Alopecia Hirsutism?

Hirsutism is the excessive growth of hair (thicker, darker and in greater quantity).  Women normally have facial hair which is usually fine ("peach fuzz") and often not noticeable.  When these hairs masculinize, or, turn into male terminal hairs, they become thicker, darker, and grow longer and faster.  This gives the impression that there is more hair, when it fact, it is just existing hair follicles responding to disease or some hormonal imbalance.

Once a hair turns terminal it will remain terminal.  In women, hirsutism is most common on the forearms, face, chest, and legs but can occur anywhere.  In men, to be diagnosed with hirsutism, the amount of hair has to be exceptionally large because men have higher testosterone levels, a male hormone that causes hair to turn into terminal hairs sometime during adolescence.  Women too, can be hirsute due to hereditary factors, but typically when a woman suddenly begins to develop signs of hirsutism that was not present in childhood, there is some underlying medical cause that should be addressed.  


Hirsutism is generally caused by increased androgens, especially the male hormone testosterone.  It is a common sign of polycystic ovary syndrome (PCOS) in women because elevated androgens are often associated with this condition.  In addition to abnormal levels of testosterone, women with PCOS may also have unopposed estrogen (high levels of estrogen and low levels of progesterone).

Hirsutism can be caused, or made worse by:

One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman. But most women probably don't care where they score, excess body hair to any extent can cause emotional distress for both women and men.


Many people with unwanted hair seek methods of hair removal to control the appearance of hirsutism, they may try:

  • depilatories
  • plucking
  • shaving
  • electrolysis
  • laser hair removal

Electrolysis can accomplish miracles and at a fraction of the cost of laser treatment but takes a lot longer to cover large areas.

A needle is inserted into the hair follicle and stimulated with a mild electrical current. Be very careful who you choose because improperly done, electrolysis can cause scarring and infections.  Personal referrals are often the best way to locate a qualified electrolysis.  Make sure your technician either reserves needles only used on your, or, uses disposal needles.  Done properly, pain should be minimal except in sensitive areas.  Numbing creams or ice may be used.

The FDA currently has only approved electrolysis as a permanent hair removal treatment.  However, it should be said in favor of laser hair removal that it can be less painful, faster, and just as permanent as electrolysis and without the same risk of infection.  The reason the FDA has not approved the term "permanent" for lasers and limits laser ads to "hair reduction" is because some hair cannot be treated with a laser. With electrolysis, if you can see the hair you can zap it.  Lasers, however, are picky.  They do not work on white, gray, light red or blonde hair.  But they do work well on darker hair; the darker and thicker, the better your results.

Also, only certain lasers are even partially effective on dark-skinned women, and few work in light-skinned women simply because they tend to have hair too light for the laser to pick up.  Olive skinned women with thick, dark hair, are ideal candidates for laser hair removal.

Shop around, prices vary and are usually ridiculously overpriced.  After being quoted more than $5,000 for laser treatment (3 treatments, on the entire face and chin) I found a wonderful plastic surgeon who only charged $150 per hour (you can cover a lot of territory in an hour).  If you live in Northern VA and want the name of this plastic surgeon, e-mail me at

Since anyone can be trained to use a laser, be sure to ask about the credentials of your laser technician.  Certain lasers are more effective than others, so ask which laser will be used.

Both electrolysis and laser treatments have some things in common:

  • You need to stop plucking and waxing hair one month in advance of your first treatment (shaving and clipping are fine).
  • You need to space out treatment (more important when using lasers) and cannot pluck or wax hairs in between treatment.
  • You need to repeat the procedure on the same spot, often as much as 5-8 times
  • Both are permanent means of hair removal but new hair can grow, or become terminal if underlying medical problems are not also addressed
  • Both should be done only by qualified, specially trained personnel (not beauty salons gals who learned on a weekend class)
  • Both can cause some discomfort and scarring, and each procedure carries their own risk factors

To read more about laser procedures, cautions, and expectations, visit the


Treating the underlying cause of hirsutism is critical because left untreated new hairs will become terminal hairs.  Waxing, plucking, and tweezing do not make hair grow in thicker or faster (but it can cause ingrown hairs).  

Anti-androgens may be effective in stopping the progression of hirsutism in women, even slowing down the rate of growth and thickness of the hair, making it appear less visible.  A commonly prescribed drug for androgen-driven hirsutism in women is aldactone (spironolactone).  This drug is a potassium-sparing diuretic (never take potassium supplement while on this drug) that is used sometimes to treat heart patients.  Aldactone has the side-effect in women of blocking androgen product, that is certain androgens do not convert into the type that worsens hirsutism.

Some therapies that may be considered to treatment in hirsute patients include:

  • Aldactone is a category X drug.  Because of its anti-androgen properties it is harmful to fetuses, especially males.  It can causes sever birth defects and miscarriage.  You should not take this drug while pregnant, or while trying to become pregnant.  To benefit from the androgen blocking side effects, women need to take 100 mg per day.  This is a high dose that can cause dizziness.  It also must be taken 3-6 months before you see signs of improvement.
  • Birth control pills may also be prescribed.  Some are effective in reducing the rate of growth and thickness of hair, and may also address acne problems.
  • Vaniqa (pronounced van-i-ka), is a prescription topical cream approved for treating mild hirsutism.  It is not usually covered by insurance and is expensive.  You apply the cream daily, and over time, the appearance and growth rate of hair is reduced.  For those that Vaniqa works for, it works well and if you have time to invest it is cheaper than other means of hair removal.  Vaniqa's effects are not permanent, and can take up to 6 months before you see results.

    Note:  I was extremely hirsute and after 1 year on Vaniqa had nothing to show for it, but I do know of other women with milder hirsutism that it did help.
  • Natural remedies include saw palmetto for women (which some claim has anti-androgen properties, but only in women) and wild yam cream (some say that this natural progesterone helps to oppose the estrogen levels and restore hormonal imbalances in PCOS).  

Alopecia Areata Sometimes Occurs Simultaneously with Hirsutism

Some of the same factors that cause excess hair, may also come into play with alopecia areata (AA) (disease and hormonal disorder).

In AA, scalp, or body hair loss occurs.  It is not uncommon for women with hormonally-driven hirsutism to also suffer from AA simultaneously; they may grow facial hair, while losing scalp hair.  The conditions, however, are entirely separate and need to be addressed as such.

For hirsute problems you should seek the advice of an endocrinologist to determine the underlying cause.  For AA, seek out the advice of a dermatologist.


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Page Updated 03/26/2006