An update on the assessment and management of hirsutism

Hirsutism is the abnormal excessive growth of coarse terminal hair over androgen-sensitive body areas. It is a very common endocrine pathology, affecting up to 10% of young females and has been linked with multiple conditions. Polycystic ovary syndrome (PCOS) and Idiopathic hirsutism encompass 90% of the cases. Patients presenting with hirsutism may require additional investigations and a plan with options for treatment. Mechanical hair removal is first-line management, along with lifestyle changes. Laser and phototherapy have been gaining popularity. The combined contraceptive pill is the preferred initial medical treatment offered, if not contraindicated, followed by anti-androgen therapy. Other emerging therapeutic options are inositol and vitamin D, especially in patients with PCOS. Treatment options should be discussed with patients, irrespective of the clinical severity, as they could be addressing underlying psychosocial concerns.