Skip to content

Hirsutism

Hirsutism refers to excess hair growing in a male pattern on a woman’s face, chest, or abdomen. The hair is typically dark and coarse rather than fine vellus hair, and the root cause is almost always hormonal, with androgens stimulating follicles in hormone-sensitive areas.

Diane 35

Cyproterone, Ethinylestradiol

2/0.035mg

Cyproterone with ethinylestradiol as a film-coated tablet, used in the management of acne and hirsutism. An anti-androgen paired with an oestrogen.

From$1.03/ tabletView

Vaniqa

Eflornithine

13.9%

Eflornithine 13.9% cream, applied to the skin for hirsutism. It blocks ornithine decarboxylase in the follicle, which hair cells need to grow.

From$49.30/ tubeView

Key points

  • Polycystic ovary syndrome accounts for most cases, though adrenal disorders, thyroid problems and some medicines can also raise androgen levels enough to cause it.
  • Cyproterone combined with ethinylestradiol works by blocking androgen receptors while lowering the ovaries’ own androgen output, taken as an oral contraceptive.
  • A topical cream containing eflornithine offers a targeted option for facial hair, slowing regrowth by acting on an enzyme within the follicle.

What drives the excess hair

Polycystic ovary syndrome (PCOS) accounts for the majority of cases and is widely prevalent. Beyond PCOS, adrenal disorders, thyroid dysfunction, and certain medicines can raise androgen levels enough to trigger hirsutism. A smaller proportion of cases have no identifiable hormonal cause.

Hormonal and topical approaches

Because androgens are usually the driving force, treatment is aimed at lowering their effect on follicles. Combined oral contraceptives containing cyproterone and ethinylestradiol are a well-established option: cyproterone is an anti-androgen that blocks the receptor, while ethinylestradiol suppresses ovarian androgen output. For unwanted facial hair specifically, a cream containing eflornithine can slow regrowth by inhibiting an enzyme the follicle needs. These treatments sit within the broader areas of women’s health and skin care. Results take several months to become visible, and hair that is already present requires physical removal alongside any medical treatment.

If hirsutism appears suddenly or worsens quickly, an underlying cause such as an adrenal or ovarian tumour should be ruled out promptly.

Further reading