Hirsutism
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This document discusses hirsutism scoring and treatment. It describes the Ferriman-Gallwey scoring method which evaluates hair growth in 9 body areas and assigns a score from 0-36. It also lists important principles for treating hirsutism such as its chronic nature and need for expert monitoring. Treatment modalities discussed include lifestyle changes, hair removal methods, and medications like oral contraceptives and anti-androgens which can decrease androgen levels and block their effects.
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This document discusses hyperandrogenism and hirsutism in women. It provides information on:
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This document provides an overview of hirsutism. It begins with definitions of terms like hirsutism, virilization, and hypertrichosis. It then discusses the causes of hirsutism, which can include polycystic ovary syndrome (PCOS), ovarian tumors, adrenal tumors, and other conditions. The document reviews approaches to clinical evaluation and investigations for hirsutism, including the Ferriman-Gallwey scoring system. It provides guidelines on tests to measure androgens and rule out conditions like congenital adrenal hyperplasia. Overall, the document provides a comprehensive review of hirsutism, including its definition, causes, evaluation, and treatment guidelines.
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Hirsutism
- 2. HIRSUTISM SCORING CHART Ferriman–Gallwey score is a method of evaluating and quantifying hirsutism in women. The original method used 11 body areas to assess hair growth, but was decreased to 9 body areas in the modified method.
- 3. 1. Upper lip 2. Chin Hair growth is rated from 0 (no 3. Chest growth of terminal hair) to 4 4. Upper back (extensive hair growth) in each of the nine locations. 5. Lower back 6. Upper abdomen Score ranges from a minimum 7. Lower abdomen score of 0 to a maximum score of 36. 8. Upper arms 9. Thighs 10. Forearms (deleted in the modified method) 11. Legs (deleted in the modified method)
- 5. HIRSUTISM TREATMENT 1. 2. 3. 4. Important principles for the management of hirsutism are listed as follows : Treatment will never be curative and therefore, chronic treatment will likely be necessary. The effects of drugs are not evident before several months of administration. Treatment should take into account the characteristics and expectations of the individual patient. Treatment must be monitored by an expert.
- 6. TREATMENT MODALITIES A) Life-style modification and Weight loss : Physical exercise & Weight loss in overweight women can decrease levels of androgens and lessen hirsutism..
- 7. TREATMENT MODALITIES B) Hair removal and lightening ●Shaving : safe and effective method. ●Chemical hair removal, waxing, and bleaching (may cause skin sensitivity ). ●Electrolysis : inserting a very fine needle into the hair follicle and applying an electrical current. Best for small areas. ●Laser : effective, faster, and less painful than electrolysis. It can often permanently reduce hair growth. ●Creams (Eflornithine hydrochloride)
- 8. TREATMENT MODALITIES C) Medications 1) Oral contraceptive pills (OCPs) :The mainstay for hirsutism therapy for decades. OCPs suppress ovarian androgen synthesis via inhibition of gonadotrophin secretion & increases SHBG concentrations markedly, thereby suppressing free testosterone levels.
- 9. TREATMENT MODALITIES 2) Anti-androgens : Directly decrease androgen production or block the action of androgens on the hair follicle. (Teratogenic) •The most commonly used anti-androgen is spironolactone. •Other alternatives :Finasteride & Cyproterone acetate