Hirsute: Definition, Related Terms, and Clinical Significance

Hirsute (adjective) means excessively hairy. Derived from Latin hirsutus (rough, shaggy).

Key Medical Terms

• Hirsutism: Excessive terminal hair growth in women in androgen-dependent areas (face, chest, back) following a male pattern. Affects 5–10% of women.
• Hirsuties: General term for excessive hair growth (less common).
• Hypertrichosis: Excessive hair growth not limited to androgen-dependent areas; can be generalized or localized, congenital or acquired.

Causes of Hirsutism

• PCOS (most common: 70–80%)
• Idiopathic (normal androgens, increased follicular sensitivity)
• Non-classic congenital adrenal hyperplasia
• Androgen-secreting tumors (ovarian/adrenal)
• Medications (minoxidil, cyclosporine, anabolic steroids, valproate)
• Cushing’s syndrome, acromegaly, thyroid dysfunction

Evaluation

• Ferriman-Gallwey score (visual assessment of 9 body areas)
• Serum total/free testosterone, DHEAS, 17-OHP, prolactin, TSH
• Pelvic ultrasound (ovarian morphology)

Management

• Combined OCs (first-line)
• Anti-androgens (spironolactone, finasteride, flutamide)
• Topical eflornithine cream
• Mechanical removal (laser, electrolysis) for cosmetic reduction
• Treat underlying cause

Distinguishing hirsutism from hypertrichosis guides appropriate workup.