Hirsutism

doi:10.1136/bmj.b3090

Published 28 August 2009, doi:10.1136/bmj.b3090
Cite this as: BMJ 2009;339:b3090

Practice

10-Minute Consultation

Hirsutism

Raekha Kumar, clinical research associate¹, Joan St John, general practitioner with special interest in diabetes², Devasenan Devendra, community consultant endocrinologist and senior lecturer in medicine³

¹ Imperial College School of Medicine, Jeffrey Kelson Diabetes Centre, Central Middlesex Hospital, London NW10 7NS, ² The Law Medical Practice Group, Wembley, Middlesex HA9 6QQ , ³ Imperial College School of Medicine, Jeffrey Kelson Diabetes Centre, Central Middlesex Hospital

Correspondence to: D Devendra d.devendra@imperial.ac.uk

The first 150 words of the full text of this article appear below.

A 20 year old woman of Indian origin attends your surgery withan excess growth of dark hair on her face, arms, and thighs,which has been getting worse over the past two years. She hasa body mass index of 27.

Hirsutism is the presence of terminal hair (long, coarse, andpigmented) in women and girls, in a male androgen sensitivepattern. This must be differentiated from hypertrichosis, whichis generalised hair growth not exclusive to androgen sensitiveareas (caused by—for example, the use of Minoxidil). Hirsutismaffects 5-15% of women of reproductive age. Androgens, principallytestosterone (from the adrenal glands and ovaries), increasehair growth by converting fine, unpigmented vellus hair to terminalhair in androgen sensitive areas such as the face, chest, andabdomen.

Ask about:

Why the patient has come to see you now—cosmetic appearanceor psychological distress may be factors
History of hirsutism—gradualor abrupt . . . [Full text of this article]