At 19th-century circus sideshows, bearded ladies were often labeled freaks. But these women simply suffered from extreme cases of hirsutism, an excessive growth of coarse, colored hair in areas where such hair is typically associated with males, such as the upper lip and chin. Up to 10 percent of women have this condition to some degree.

Named for the Latin word hirsutus, or “hairy,” the condition is often caused by high levels of androgens. Androgens are the main male sex hormones, but all women naturally have small amounts of them. Certain medications, such as steroids and some progestins, can lead to a spike in androgens. Some prescription drugs that treat endometriosis, schizophrenia, and migraine headaches may do the same.

In some cases, the excess androgens stem from an abnormality of the ovaries, adrenal glands, or pituitary glands. The most common culprit is polycystic ovarian syndrome (PCOS), a hormonal disorder that affects some 10 percent of girls and women of childbearing age. The next most common is congenital adrenal hyperplasia, in which the adrenal glands pump out excessive amounts of male hormones. Cushing’s syndrome, involving excess cortisol and androgens, is another culprit. And in a significant number of instances, there’s no discernible cause of the hair growth; these cases are called idiopathic hirsutism.

Although the excessive hair doesn’t have any side effects, the condition that causes it—such as PCOS—may have complications if left untreated. Hirsutism itself may be treated with oral contraceptives, which inhibit androgen production in adolescent girls; antiandrogen medications; and topical creams. Laser therapy and electrolysis can also permanently remove unwanted hair. Cortisol treats girls and boys with congenital adrenal hyperplasia, but boys seldom require treatment for the excess hair.

ADDITIONAL FACTS

  1. Women of Mediterranean, Middle Eastern, and South Asian descent are more likely to develop idiopathic hirsutism.
  2. Excessive hair growth that doesn’t occur in specifically male hair-growth areas is called hypertrichosis. This disorder may be caused by anorexia or thyroid problems.