Estimated reading time: 6 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
How familiar are you with the condition hirsutism? Hirsutism is excessive hair growth in areas where hair is usually minimal or absent in women. These can be places like the face, chest, back, and abdomen. This type of hair growth follows a "male" pattern and is typically because of an increase in male hormones, called androgens, in the body. For people with congenital adrenal hyperplasia (CAH), hirsutism is a fairly common symptom! This is because CAH disrupts the normal hormone balance, and can lead to excess androgens in the body. So what can you as a patient or parent do to manage this symptom? Here is a guide from PatientsLikeMe.
How CAH Leads to Hirsutism
CAH is a genetic condition that affects the adrenal glands. These are responsible for making a few different hormones, including cortisol and androgens. People with CAH often have a deficiency in an enzyme called 21-hydroxylase, which is needed for the body to produce cortisol. When cortisol levels are low, the adrenal glands compensate by making more androgens. Androgens, like testosterone, are responsible for developing male traits. This includes body hair. For females with CAH, higher androgen levels can cause fine, light body hair (called vellus hair) to change into thicker, darker hair (known as terminal hair). This usually happens in areas sensitive to androgens, like the face and chest. This change in hair texture and location leads to hirsutism.
Hirsutism and Daily Life
Living with hirsutism can be emotionally and socially challenging1. Many women and girls with this condition feel self-conscious about their appearance, which can affect their confidence and mental well-being. In some cases, hirsutism may lead to anxiety or depression, especially if the person feels uncomfortable in social situations or experiences bullying or negative comments about their appearance. In the study linked above, they found:
- 30% of women had levels of depression above clinical cut off point
- 75% reported clinical levels of anxiety
- 29% reported both
Support from mental health professionals and CAH communities can help individuals cope with hirsutism’s emotional challenges and improve confidence. For parents of children with CAH, managing hirsutism can be a sensitive topic. It is important to give your child support and help them understand that they are not alone. Encourage open communication and talk about treatment options with them. It can improve self-esteem and help the person feel more in control.
Knowing what’s going on inside the body can help explain congenital adrenal hyperplasia (CAH) symptoms.
Watch now: Why don’t I feel good?
There’s a range of CAH signs and symptoms.
People with CAH make too little cortisol and aldosterone, while producing too many androgens. These hormone imbalances affect the body’s ability to function properly. Learn more about the range of CAH signs and symptoms and how steroids help treat both cortisol deficiency and androgen overproduction.
Learn more about these key hormones at: whatthecah.com.
Managing Hirsutism with CAH
There are a few ways to manage hirsutism as a result of CAH. The options range from medical treatments to hair removal. Here’s a breakdown of the most common approaches
Medications for Hirsutism
The standard treatment for CAH patients with hirsutism typically involves the use of combined oral contraceptives (OCPs2) and antiandrogens in more severe cases. Glucocorticoids (such as hydrocortisone or dexamethasone) may also be considered, especially in classic CAH but with caution due to potential adverse effects of hormone replacement therapy. Additional treatments might be necessary to address the existing excess hair if medications are not completely successful.
Hair Removal
Many people with hirsutism choose to get rid of excess hair to feel more comfortable and confident. There are several options3 out there.
- Shaving: Although it is temporary, shaving is quick and easy. Contrary to popular belief, shaving does not4 make hair grow back thicker or darker.
- Waxing and Plucking: These methods remove hair from the root. This provides a longer-lasting result compared to shaving. However, they can be painful and may cause skin irritation or ingrown hairs.
- Depilatory Creams: These creams dissolve hair at the skin's surface but may cause irritation in sensitive areas.
- Laser Hair Removal and Electrolysis: These are longer-term5 solutions for reducing hair growth. Laser hair removal targets dark hair follicles and can provide several months of relief. Electrolysis, on the other hand, is a permanent hair removal option that uses electrical currents to destroy hair follicles. Both methods require multiple treatments to be effective.
- Vaniqa: This prescription cream6 slows hair growth and is particularly helpful for treating unwanted facial hair in women. Results are gradual, but many people find it a valuable addition to their routine.
Joining support groups or connecting with others who have CAH can help people feel less isolated and more empowered to manage their condition. Keeping a healthy lifestyle, including regular exercise and a balanced diet, can also help regulate hormone levels and improve overall well-being. Weight management is especially important for people with CAH. Excess weight can exacerbate hormonal imbalances and increase7 androgen production.
Hirsutism is a common and challenging symptom for people with CAH. Fortunately, there are many ways to manage it effectively. By working closely with an endocrinologist and exploring treatment options, you can reduce the impact of excess hair growth. For parents of children with CAH, getting them education and emotional support is key to helping them navigate the challenges of this condition. While hirsutism can be distressing, it is important to remember that everyone’s experience with CAH is unique. Finding the right combination of treatments can make a big difference in managing this condition.
PatientsLikeMe is your gateway to taking control of your health, offering a supportive community and powerful tools to manage your wellness journey. By joining PatientsLikeMe, you can connect with others who understand your experiences and provide invaluable advice and encouragement. Track your symptoms, treatments, and outcomes with ease, allowing for better informed health decisions and improved communication with your healthcare team.
- https://pubmed.ncbi.nlm.nih.gov/16880018/
- https://www.ncbi.nlm.nih.gov/books/NBK430882/
- https://pubmed.ncbi.nlm.nih.gov/20587996/
- https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/hair-removal/faq-20058427#:~:text=No%20%E2%80%94%20shaving%20hair%20doesn't,perhaps%20appear%20darker%20or%20thicker.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7190465/
- https://www.doctorfox.co.uk/female-facial-hair/faqs.html
- https://pubmed.ncbi.nlm.nih.gov/31499497/