Hirsutism: What Causes Excess Hair and What You Can Do

Hirsutism means unwanted, male-pattern hair in women — think thick dark hair on the face, chest, or back. It’s not just a cosmetic issue. Often it points to hormones, meds, or conditions like polycystic ovary syndrome (PCOS). Knowing the cause helps pick the right fix.

If new or sudden hair growth appears, especially with acne, deepening voice, or irregular periods, see a doctor. Those signs suggest higher androgen levels and need a quick check. If hair started slowly after puberty and runs in the family, it’s often genetic and less urgent but still treatable.

How doctors check for the cause

Your clinician will take a short history, check menstrual patterns, and do a physical exam. Blood tests usually measure testosterone, DHEA-S, and sometimes thyroid and prolactin. If levels are very high or symptoms are sudden, imaging like an ultrasound or CT scan may be ordered to look for ovarian or adrenal issues.

Most cases link back to PCOS or milder hormonal shifts. Certain medicines — like some steroids and anti-seizure drugs — can cause excess hair. Rarely, tumours produce androgens; that’s why sudden fast growth needs prompt investigation.

Practical treatments that work

Pick a plan based on cause, how fast the hair grows, and how much it bothers you. First-line medical options include combined oral contraceptives to lower androgens and spironolactone, which blocks androgen effects on hair. Spironolactone takes a few months to work and needs contraception for those who can get pregnant.

Eflornithine cream slows facial hair growth and helps when hair is light or in small areas. Finasteride is another option but is used less in women of childbearing age. For antibiotic or doctor-prescribed approaches, talk dosing and risks with your clinician.

Hair removal methods give faster cosmetic results. Shaving, waxing, and depilatory creams are cheap but temporary. Electrolysis and laser hair removal provide longer-lasting reduction; lasers need several sessions and work best on dark hair. Electrolysis can permanently remove single hairs but takes time.

Lifestyle helps too. Losing 5–10% of body weight can cut androgen levels in people with PCOS and reduce hair growth. Avoid self-blame — diet, exercise, and targeted treatments often bring noticeable improvement.

Finally, consider mental health. Excess hair can hit confidence. Support groups, therapy, or talking with others who’ve managed hirsutism can make a big difference while you sort medical choices.

If you’re unsure where to start, book a visit with a GP or an endocrinologist. Small steps—tests, a treatment trial, and a hair removal plan—usually lead to big improvements.