Hirsutism (ICD-10-GM L68.0: Hirsutism) is the increased terminal hair (long hair) in women, according to the male distribution pattern (androgen-dependent).
Differentiated from hirsutism is hypertrichosis, which is an androgen-independent increased body and facial hair (without a male distribution pattern), and virilization. The latter refers to the masculinization of the female. In addition to the male hair type, other secondary male sexual characteristics appear here such as: Clitoral hypertrophy (enlargement of the clitoris), alopecia androgenetica (androgenic hair loss), increase in libido, masculinization of body proportions, deep voice.
The following forms of hirsutism are distinguished:
- Idiopathic hirsutism (with no apparent cause; 90% of cases) – often occurs in families, in sexually mature women without androgenization signs, and is defined as follows:
- Normal or only very slightly increased testosterone levels.
- A functional disorder of the skin in the sense of increased sensitivity of the androgen receptors to testosterone
- An increased conversion of androgen precursors into androgens
- A reduced production of transport proteins (SHGB = sex hormone binding globulin), so that the effective free testosterone is present in higher concentrations
- Symptomatic (secondary) hirsutism – a cause is identifiable.
Frequency peak: the disease usually manifests itself for the first time in puberty. Some of the affected women suffer from idiopathic hirsutism, especially after menopause (menopause in women).
The prevalence (disease frequency) is 5-10% of women of sexual age (in Germany). The lady’s beard occurs more frequently in women from the Mediterranean region and the Orient.
Course and prognosis: Many of the affected women suffer from their masculine hairiness. Symptomatic hirsutism can be treated causally. However, therapy is protracted. In idiopathic hirsutism, symptomatic therapy (e.g., epilation/hair removal by laser therapy) is used.
