by Katherine Brind’Amour, PhD
Hirsutism is a condition that affects women, causing male-pattern hair growth. The hair grows in dark and coarse in places like the chest, face and back. It can range in severity and its impact on self-esteem and mental health. Some women may find the hair growth manageable and not bothersome, while others may find it difficult to handle and may experience insecurity issues with relationships and depression as a result.
There are many ways women can manage hirsutism symptoms naturally so that it’s easier to live with the condition — even without conventional medicine.
What Is Hirsutism?
Hirsutism is excessive hair growth where it shouldn’t be. The condition affects women and results in dark, thick or stiff hair. It grows in places where women don’t typically have noticeable hair, such as the upper lip, chin and jawline, chest, belly, arms, back and sideburns. It can also result in acne and hair loss on the top of the head. Hirsutism often causes women to feel uncomfortable, embarrassed, anxious about physical contact or skin exposure, self-conscious and insecure about their femininity.
Hirsutism is most often caused by an increase in male hormones called androgens, such as testosterone. Having extra androgens in the body can result in male-pattern hair growth and the condition’s other signs and symptoms. However, it can also be a trait common among women in a given family or caused by another health condition.
Thankfully, hirsutism has few health side effects other than its emotional impact. Mild hirsutism may even go unnoticed by some women. However, if it is caused by or linked to another condition, you may experience health problems and complications from those conditions. To best understand the cause and potential impact of your hair growth, you should see a health care professional for blood tests and a formal diagnosis. Some related conditions, such as polycystic ovary syndrome, or PCOS, can cause infertility and other lasting health problems.
Signs & Symptoms
- Dark, coarse hair growth on the face, chest, back, belly, arms, thighs or other areas where women don’t usually grow hair
- Acne on the face or body
- Balding or thinning hair on the head
- Voice getting deeper
- Breasts getting smaller
- Developing more muscle mass
- Growth of the clitoris
- Elevated levels of androgens (this affects about half of all women with hirsutism)
Causes & Risk Factors
At its core, hirsutism is caused by too much of certain male hormones in the body. These hormones, called androgens, are made in the hair follicles or are sent out from the ovaries or adrenal glands. The extra androgens can be caused by a number of conditions. This means broader hirsutism causes include: (1, 3, 4)
- Polycystic ovary syndrome (PCOS): This is one of the leading causes of hirsutism. It causes 3 in every 4 cases of hirsutism. PCOS causes irregular periods and hormone imbalances that result in hair growth where it normally shouldn’t be, and hair loss at the front of the head (a receding hairline). The condition may run in families and is long-lasting (chronic). In addition to irregular menstruation, PCOS is connected with other health problems, such as obesity, diabetes, trouble conceiving, high cholesterol and maybe even heart disease.
- Idiopathic hirsutism: This is hirsutism for which there is no known cause. It is the other leading cause of hirsutism. It is also usually chronic. Some believe it is a mild version of PCOS. Most people with idiopathic hirsutism have normal periods, and their only symptom is a slow increase in the growth of coarse, dark hair where it shouldn’t be.
- Cushing’s syndrome: This condition results from too much cortisol exposure. Cortisol is a hormone your body makes. High levels of cortisol can also come from medications, such as prednisone, when taken for long periods of time.
- Congenital adrenal hyperplasia: When the adrenal glands make abnormal amounts of steroid hormones, such as androgen and cortisol, this condition can result. It is inherited and can lead to hirsutism.
- Thyroid problems: When the thyroid is not working properly, leading to hypo- or hyperthyroidism, the imbalance of hormones can cause hirsutism. Women with symptoms of hirsutism may undergo thyroid tests to determine whether the hair growth may result from thyroid dysfunction.
- Medications: Many medications can cause new or different hair growth patterns. When you speak with a physician about your hair growth, he or she will need to know all drugs and supplements you use. This can help determine if the symptoms result from drugs rather than an underlying hormone imbalance.
- Tumors: Very rarely, a tumor in the adrenal glands or the ovaries can cause hirsutism. These tumors may make androgen, causing the hormone levels to rise and lead to hair growth.
Risk factors for hirsutism include: (1)
- Family history of the condition
- Mediterranean, South Asian or Middle Eastern ancestry
- Having a condition that can result in hirsutism, such as a thyroid problem or PCOS
Diagnosis & Conventional Treatment
Diagnosis of hirsutism involves a thorough medical history, physical exam and blood tests. Depending on your risk factors, you may be tested for thyroid function or a range of other conditions. If your hair growth and any other symptoms are sudden or dramatic, you can expect extra testing. However, if many women in your family have the trait and yours has come on slowly, it’s possible you may not even need blood tests for a diagnosis.
Regardless of your family health history, it is important to see a health care professional for diagnosis. Some of the conditions that can cause hirsutism can have serious side effects if they’re not properly treated.
Conventional hirsutism treatment options include: (3, 5)
- Topical hair removal by shaving, bleaching, chemical hair dissolving and waxing
- Electrolysis or laser hair removal, which both damage hair follicles to reduce the amount of hair that can grow. Electrolysis can be painful and expensive and good for treating small areas. Laser hair removal can also be expensive but is faster and less painful. Both treatments can be highly effective for a long time, but they require multiple treatments upfront. Electrolysis may have more permanent results despite the need for more upfront sessions.
- Prescription creams, such as eflornithine hydrochloride, which can slow or stop hair growth with ongoing use
- Weight loss, which can reduce symptoms and complications for some women — particularly those with PCOS
- Medications, including:
- Birth control pills to lower androgens and establish regular periods. These improve symptoms in the vast majority of women with hirsutism (60 percent to 100 percent)
- Antiandrogens, which work to directly lower androgen in the hair follicles
Women who suffer from emotional health issues related to hirsutism may also be offered therapy or medications, depending on how severe their psychological symptoms are.
People with other underlying conditions, such as PCOS, diabetes and thyroid problems may need additional treatments. Women taking medications that result in hirsutism as a side effect may need to change their dose or medications with the guidance of their physician.
As women enter their 30s and 40s, the level of androgens in the body naturally dip, and hirsutism treatment may no longer be needed. Hair removal and birth control are considered the best treatment options for hirsutism in conventional medical management.
5 Natural Tips for Managing Hirsutism
Women interested in natural therapies for the symptoms of hirsutism are in luck. Most hair removal options are natural, as are many other tips for managing hirsutism and its related symptoms. Consider trying these natural tips to manage hair growth and other symptoms of hirsutism:
- Get to a healthy weight
- Fight acne
- Improve your chances at fertility
- Take care of yourself emotionally
- Master a simple hair removal routine
Get to a healthy weight
Particularly for women with PCOS, losing weight can improve reproductive health. It can also lower the risk of heart disease and make it easier to manage diabetes. Although it may not directly impact hair growth, getting to a healthy weight is a cornerstone of natural PCOS therapy. In some cases, maintaining a healthy weight is the only therapy women with PCOS may need to control their symptoms. In others, women may need to combine efforts to achieve a healthy weight with conventional therapy to control symptoms and reduce their overall health risks. (6, 7, 8)
Natural tips to fight obesity include:
- Eat a diet to shed weight and set you up for long-term health. A general diet plan should include high-fiber foods, lean proteins (skinless chicken and fish), healthy fats (think coconut, olive and fish oils) and small, frequent meals.
- Just as important as what you eat is what you should avoid: foods high in sugar, fat and sodium. In general, processed foods, baked goods and “junk” foods are empty calories.
- Exercise. Increasing the amount of calories you burn while reducing the number of calories you eat creates a calorie deficit. This helps you lose weight. Find an activity you enjoy and get active even for just a short time every day. Make it easy by building extra activity into your routine.
- Park farther away from the grocery store or your work building
- Take steps instead of elevators
- Do yard work, house cleaning and other errands or just dance around the house
- Find a friend at a similar fitness level to be active with you
- Take a walk after dinner with your spouse, kids or dog
- Reduce stress levels. Too much stress can result in weight gain and difficulty losing weight. Take time out every day to do something you enjoy. Consider chatting with friends, doing a hobby, trying yoga, listening to music, journaling or whatever else eases your stress levels.
- Consider the DASH (Dietary Approaches to Stop Hypertension). A study found that women with PCOS who followed the DASH diet for eight weeks lost a significant amount of weight and improved in other health indicators as well. The diet involves restricting calories and consists of about half complex carbohydrates, 18 percent protein and 30 percent fat. It is high in vegetables, fruits, whole grains and low-fat dairy and low in refined grains, saturated fat and cholesterol. (9)
The hormone imbalance involved in hirsutism makes it easy for acne to take hold. Fight and prevent it as much as possible by making your skin an inhospitable place for acne. To prevent acne in the first place, try these simple steps: (10)
- Keep your face clean (but not too clean). Wash your face twice a day, but not more. Use a clean, soft washcloth (a fresh one each time) or your hands to gently scrub dirt and oil away from your face. Wash with a gentle cleanser and take it easy on areas already irritated with acne so that you’re not breaking the skin and introducing the risk of infection.
- Use moisturizer. Apply a noncomedogenic face lotion to your skin after washing. This will keep the moisturizer from clogging your pores. Keeping your skin moisturized will prevent over-drying from topical acne remedies. It can also help balance and soothe dry, oily, peeling, irritated or combination skin.
- Avoid face makeup. Don’t wear face foundation, cover-up, blush or face powders. If you use sunscreen on your face every day, search for one that is also noncomedogenic.
- Simplify your hair care. Styling products for your hair, such as hairspray and pomades, can end up on your face. Cover your face if you use them, and wash your hands afterward. Keep your hair clean as well, since natural hair oils and chemicals from shampoo and conditioner can touch your face and clog pores. Keep hair pulled back from your face if possible.
- Don’t touch your face. If you must, wash your hands first. Don’t pick at or pop pimples. This can make acne worse and also cause permanent skin damage and infections.
- Follow other common acne-related tips. This means you should avoid greasy foods (mostly because if you touch your face after, you can clog pores). You can also stay out of the sun, exercise more often and relieve stress.
Treat pimples that are already there using natural remedies for acne:
- Kill bacteria using pure apple cider vinegar as a toner.
- Cleanse or spot treat acne with tea tree oil. Add a few drops of the oil to a natural facewash, face mask or your regular moisturizer. You can purchase ready-made tea tree acne spot treatments at many drugstores and natural grocery stores. Do not apply full-strength tea tree oil directly to skin.
- Exfoliate gently. Avoid irritating and scrubbing but remove dead skin from your pores using homemade exfoliants. Simple options include brown sugar or sea salt combined with coconut oil or honey. Mix equal amounts of the gritty ingredient with the smooth ingredient, rub gently into the skin and rinse well.
Improve your chances at fertility
Women with PCOS and hirsutism may struggle with fertility. Obesity can also make it harder to get pregnant. If you have PCOS or obesity, you can naturally improve your chances of getting pregnant by following some of these tips:
- Get to a healthy weight (see step 1!) but don’t overdo it. Excessive exercise and very low bodyweight can also make it hard to get or stay pregnant.
- Eat for fertility. Restricting calories and eating a balanced diet can help you lose weight and prepare your body to better regulate itself. If you are obese, following a healthy diet and losing weight can improve your chances of becoming pregnant. (11)
- According to the author of the book “The Fertility Diet,” a diet to enhance ovulation includes eating complex carbohydrates (rather than refined sugars), fiber from plenty of fresh fruits and veggies, full-fat dairy products, plant protein from beans and nuts and tofu, and avoiding trans fats. Taking 400 micrograms of folic acid daily is also recommended. (12)
- Try some of Dr. Axe’s natural infertility remedies, including 1,500 milligrams of evening primrose oil the first two weeks of each menstrual cycle. Other supplement options that may promote fertility include chasteberry, B vitamins and progesterone cream.
- Speak with a health care provider before adding supplements for fertility, particularly if you are taking medications to control your PCOS or hirsutism symptoms.
- Work with a physician or fertility expert. By knowing the cause of your hirsutism and any related conditions that may impact fertility, you can build a customized game plan to improve fertility. If you have endometriosis, PCOS or a thyroid condition, your best fertility plan will differ from someone with simple idiopathic hirsutism.
- Consider trying natural procreative technology (NaPro or NPT). Studies have found this approach (usually combining natural fertility tracking with thorough checks for physical causes of fertility problems) can help women become pregnant, even after years of difficulty. (13)
Take care of yourself emotionally
The hair growth associated with hirsutism can be distressing for some women. If you are bothered by the extra hair growth or feel self-conscious, unfeminine, anxious about interacting with others, depressed or obsessed with the extra hair, it’s important to see a health care professional. Not only can professionals help find a treatment that will work well for your hair growth and lifestyle, they can also make sure that you address any mental health concerns that may have arisen as a result of your diagnosis.
You may be able to address your stress and emotions by following some of these tips:
- Exercise. Not only will it help balance hormones, get you to a healthy weight (or keep you there), and improve your chances at fertility, exercise can relieve stress and symptoms of anxiety or depression. Seeing your body’s fitness improve may also improve your feelings about your appearance.
- Talk to someone. If you have hirsutism, chances are good that other women in your family do too. Ask them how they cope and about any tricks they may have for managing hair growth or the stress that comes with it.
- If you don’t have a family member to talk to, reach out to friends, a counselor or a psychiatrist.
- You can also talk to your partner about your concerns. If hair growth has caused you to avoid physical contact with your loved ones, let them know the reason for the distance.
- Create a soothing home environment. Making your home a place of refuge can provide you with one place you don’t have to worry as much about hirsutism. Try aromatherapy, belly massage with lavender and bergamot, keeping a regular bedtime, avoiding screen time an hour before bed, keeping your room dark for sleep and building in time for soothing routines. These can include warm baths, reading, trying new recipes, watching comedies, listening to music and chatting with friends. Ensure that some of your time spent at home is free for you to de-stress, rather than packing every spare moment with chores and to-dos. (14, 15)
- Try Dr. Axe’s tips for managing depression naturally. These include spending time outdoors, using lavender and Roman chamomile essential oils to promote calm and sleep, and considering the following supplements:
- St. John’s wort
- B-complex vitamins
- Vitamin D-3
- Fish oil
Master a simple hair removal routine
Even if you have found other natural or conventional treatments that manage your other symptoms well, you may wish to remove excess hair. Many treatments can take weeks or months to start working. Furthermore, some treatments are not perfectly or permanently effective, meaning you may have some hair growth even with treatment. If the extra hair bothers you, experiment with routines to make hair removal or dyeing as manageable as possible.
Facial hair removal for women can be particularly anxiety-ridden, but the more comfortable you are with your method, the easier you may find your routine to maintain. Consider these tips for non-laser or electrolysis hair removal for hirsutism if you wish to avoid visible hair:
- Shave your face daily or every other day, if needed. Shave your facial hair most often and prioritize body hair depending on how exposed it will be or how important it is to you to be hair-free.
- Shaving is low-cost and drug-free. Try electric razors for touch-ups in between full sessions.
- When you do shave, use a gentle shaving cream and watch out for acne.
- On most body surfaces you should shave in the direction the hair grows rather than against it, which can irritate your skin.
- Waxing is more painful but may last longer than shaving. Try at-home kits or find a salon or dermatologist to help with hair removal.
- Consider asking for a discount or membership if you visit a salon regularly.
- Some salons can offer combination services, including bleaching or depilatories.
- Follow a set schedule. Once you know how quickly your hair grows, you can plan. Having a specific time set aside takes some of the stress out of squeezing in the next hair removal session.
- For example, take care of facial hair daily or every other day, and set aside some time on Saturday morning for other body hair. Making it part of your routine may reduce your anxiety.
- Invest in products that work. Since you will use a razor, shaving cream, depilatory or waxing kit on a large amount of skin, including your face, it’s important to have products that do not irritate your skin, dry it out, worsen acne, cause razor burn or ingrown hairs or smell unpleasant to you.
- Try buying a few separate products from stores that allow returns.
- Use a razor that minimizes razor burn and a shaving cream that does the same.
- If you cannot find a women’s shaving cream that is noncomedogenic, try looking for unscented men’s shaving creams made for sensitive skin. You can make your own natural shaving cream as well.
- Don’t make more work for yourself. Unless you feel very uncomfortable with your body hair during the winter, scale back the frequency of your hair removal when your skin is covered by warm sweaters and scarves.
- Hirsutism can be caused by underlying conditions with serious health repercussions. Do not attempt to self-diagnose or self-treat hirsutism. A medical professional can help uncover and guide treatment for the condition and any related health problems.
- Some hair removal creams, bleaches, chemicals and removal therapies (such as electrolysis and laser hair removal) can cause pain and skin irritation. Use them according to their instructions and stop if irritation occurs.
- Speak with a health care professional if your symptoms change quickly or become severe. This can signal a serious health problem.
Hirsutism Key Points
- Hirsutism is a health problem affecting only women. It causes male-pattern hair growth on areas such as the face, chest, belly and back. It can also cause balding, an increase in muscle tone, acne, a decrease in breast size and other symptoms.
- Most women with hirsutism also have polycystic ovary syndrome (PCOS). This condition causes an imbalance in hormones that often leads to hirsutism. Treating PCOS can often relieve hirsutism symptoms.
- Conventional treatments for hirsutism include hair removal and birth control pills. Other options include medication adjustments and drugs to fight the production of androgens — hormones that cause the increased hair growth.
- Even without treatment, hirsutism itself does not cause significant physical health problems. However, the appearance of hair where it’s not expected can distress some women. It may result in low self-esteem or emotional health issues.
- Seek a formal diagnosis and testing for hirsutism if you have symptoms. With treatment, this long-term condition can be well-managed. Its symptoms also typically fade as the body’s production of androgens naturally decreases with age.
5 Natural Tips to Help You Manage Hirsutism and Its Related Symptoms
- Get to a healthy weight
- Fight acne
- Improve your chances at fertility
- Take care of yourself emotionally
- Master a simple hair removal routine
Read Next: 7 Steps to Balance Hormones Naturally
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