If other females in your family have excess body hair, your niece
probably has familial hirsutism, common in some cultures, rather than
a hormonal imbalance. To be sure, she should be examined by a doctor,
to rule out any underlying causes. Familial hirsutism is not a
disease, and does not cause any health or medical problems.
Classical Congenital Adrenal Hyperplasia
The classic form of congenital adrenal hyperplasia occurs when
cortisol synthesis is extremely low. The disorder usually manifests in
childhood. Hypersecretion of adrenal androgens causes masculinization
of the external genitalia of the female fetus. Affected infants can
have ambiguous genitalia or even erroneous gender assignment. Because
testicles are not present to produce müllerian inhibiting factor, the
internal female organs are intact.1,2,4
Children with classic congenital adrenal hyperplasia may lack
sufficient amounts of cortisol to mount a stress response, and they
frequently succumb to minor illnesses. Those who survive to adulthood
experience premature puberty. Premature closure of the epiphyses
results in short stature even though these children grow at an
accelerated rate when young. Severe acne is also a frequent problem.
Adult women with classic congenital adrenal hyperplasia may have
pronounced hirsutism and amenorrhea.?
?A person's body hair is noticeable more in some areas than in others.
TeenHealthFX does not suggest that you shave or wax the hair in this
area, as it is very sensitive and the hair will grow back. If you have
small individual hairs growing on your nipple you can either pluck or
cut them so they are less noticeable, often times they may not grow
Certain ethnic background tend to have thicker, darker body hair.
Check out your mom, sisters, and aunts to see what their hair pattern
It is possible that you have excessive body hair if you have thick
dark hairs growing on the middle of your chest, and/or chin, mustache
areas and lower abdomen. This can be a medical condition and you may
want to consider seeing a doctor who can evaluate whether the hair
pattern is abnormal.?
?Hirsutism can range from a few dark chin hairs to a miniature
mustache and sideburns to a full beard and hairy chest.
In most cases, hirsutism is a symptom of elevated blood levels of male
hormones (androgens) being produced by the adrenal glands or ovaries,
says Maria New, chairwoman of pediatrics and chief of endocrinology at
Cornell Medical Center in New York City. Sometimes, the hormone levels
are normal but certain hair follicles are thought to be hypersensitive
to the androgens testosterone and androstenedione. In rare instances,
an androgen-secreting tumor or polycystic ovarian disease is to blame.
Occasionally, no cause can be found. According to Dr. McMichael,
hirsutism can begin at any age, but most patients develop symptoms
during their childbearing years.
"In young girls who have not yet reached puberty, hirsutism is serious
and could be a sign of a hormone-secreting tumor," Dr. McMichael told
physicians at a recent meeting of the American Academy of Dermatology.
In postmenopausal women, sudden or severe hirsutism could also be
caused by an androgen-secreting tumor.
Many women who have become hirsute assume the hairiness is hereditary
and never ask a physician about it. Fortunately, hirsutism is rarely a
sign of a serious health problem. If, however, excessive or rapidly
growing hair appears suddenly in areas where women do not typically
grow hair, and if this growth comes with irregular periods, lack of
menstruation, acne, or other symptoms, the patient should consult a
dermatologist, gynecologist, endocrinologist, or internist as soon as
possible, Dr. McMichael advises.
Hirsutism can range from a few dark chin hairs to a miniature mustache
and sideburns to a full beard, hairy chest, and even male-pattern
baldness. The emotional impact of hirsutism can be extreme.?
Regarding laser hair removal, this site says : ?Before investing
hundreds or thousands of dollars in sophisticated hair-removal
treatments, girls and women with hirsutism should try to discover the
source of their excessive hair growth, New and Petricca advise. In
most cases, the best approach is attacking hirsutism from the inside
and the outside simultaneously.
"We often have to start by finding the cause, administering the
medication indicated, giving them laser treatment to get rid of what
now exists, and hope that our treatment of the hormonal difficulty
prevents recurrence," Dr. New says.
Karen says that getting rid of her unwanted hair was time consuming
but well worth the wait. "I was definitely more hesitant meeting new
people" before getting treated, says Karen, who recently got engaged.
"I didn't want people to get too close ... I was definitely
self-conscious about it."
Her message to other women with hirsutism: "There's something you can
do. You don't have to get a job at the local zoo."
?Familial hirsutism is found most commonly in southern European
and South Asian countries in which it is considered to be a normal
trait. Hirsutism indicative of underlying endocrinopathy varies from
culture to culture, depending on the incidence of the various
endocrinopathies in a particular society.?
? ?Hirsutism resulting from congenital adrenal hyperplasia (CAH)
begins early in childhood,?
? Familial hirsutism is not associated with androgen excess.
o Familial hirsutism is both typical and natural in certain
populations, such as some women of Mediterranean or Middle Eastern
o Drugs that can induce hirsutism by their inherent androgenic effects
include dehydroepiandrosterone sulfate (DHEA-S), testosterone,
danazol, and anabolic steroids.
o Currently used low-dose oral contraceptives are less likely to cause
hirsutism than were previous formulations.
o Drugs such as phenytoin, minoxidil, diazoxide, cyclosporine,
streptomycin, psoralen, penicillamine, high-dose corticosteroids,
metyrapone, phenothiazines, acetazolamide, and hexachlorobenzene
presumably exert their effects independently of androgens. The exact
mode of action of these drugs on hair follicles is not known, but the
same mechanisms do not appear to be involved in all patients.
o Drug-induced hirsutism can be distinguished from drug-induced
hypertrichosis, in which a uniform growth of fine hair appears over
extensive areas of the trunk, hands, and face and is unrelated to
androgen-dependent hair growth.?
?In some cases, excess hair growth, called hirsutism (pronounced:
hur-suh-tih-zum), may be the result of certain medical conditions. In
girls, polycystic ovary syndrome and other hormonal disorders can
cause dark, coarse hair to grow on the face, especially the upper lip,
and on the arms, chest, and legs. Some medications, like anabolic
steroids, can also cause hirsutism.?
Congenital anomalies such as congenital hypertrichosis and Cornelia
de Lange syndrome. Hirsutism may appear early in children and young
Congenital hirsutism. This type is inherited and transmitted as an
autosomal dominant, where vellus hair may cover the entire skin
surface except the palms and soles, which are free of hair follicles.
Congenital hypertrichosis is associated in some areas besides
hirsutism with dental anomalies and gingival fibromatoses.
Emotional factors : Stress has been blamed to cause hirsutism .
Psychic trauma and emotional stress in spite that it may cause falling
of hair, it may cause hirsutism in susceptible individuals. This may
be related to the increased 17 ketosteroids in emotionally disturbed
Familial :Some types of idiopathic hirsutism are familial running in
families and certain races especially dark skinned individuals.
Starvation: may cause hirsutism
Metabolic disorders: such, as error of metabolism of porphyrins may be
associated with hirsutism.?
?Hypertrichosis is non?androgen-related pattern of excessive hair
growth that may involve vellus, terminal, or lanugo type hair.
Hypertrichosis can accompany certain genetic syndromes, or it can be
induced secondarily by exogenous medications, most notably phenytoin,
minoxidil, cyclosporine, diazoxide, corticosteroids, phenytoin
(Dilantin), streptomycin, hexachlorobenzene, penicillamine, heavy
metals, sodium tetradecyl sulfate, acetazolamide, and interferon.
Hirsutism commonly occurs in women and presents as androgen-induced
male-pattern hair growth of the terminal type. Hirsutism may have a
congenital or exogenous origin. More common causes of hirsutism
include polycystic ovary syndrome (PCOS), idiopathic hirsutism,
hyperprolactinemia, hyperthecosis, and medications (eg, danazol,
androgenic oral contraceptives). Less common causes of hirsutism
include congenital adrenal hyperplasia, ovarian tumors, Sertoli-Leydig
cell tumors, granulosa?thecal cell tumors, other tumors that stimulate
the ovarian stroma, adrenal tumors, Cushing disease, tumors of the
adrenal cortex, and severe insulin-resistance syndromes.?
Hirsutism - you are not alone
This means you share this problem in common with a lot of women and
you are normal. Only very rarely is hirsutism a sign of a serious
hormone abnormality that requires further investigation. In these rare
cases the patient may also have been experiencing changes in the
genitals, enlargement of the clitoris, loss of hair from the temples
and reduced size of the breasts.
In the United Kingdom 18 percent of women have hirsutism on the chest,
28 percent on the face, 35 percent on the tummy and 70 percent on the
Where do male hormones come from in women?
Male hormones causing hair growth in females come from three sources:
The adrenal glands
From fat which converts other hormones to male ones. In a baby in the
womb, the adrenal glands secrete male hormones but this stops shortly
after birth and secretion is switched off until puberty. As puberty
approaches in the early teens, the adrenal glands "wake up" and start
to secrete male hormones again. The adrenal glands probably cause the
growth of pubic hair and hair under the armpits.
?Hirsutism can range from very mild to severe. Some women who are
hirsute have normal levels of male hormones. This is called idiopathic
hirsutism (no exact cause known).?
?There is no evidence to suggest that shaving increases the rate of
hair growth. However plucking the hair should be avoided as this
stimulates a new cycle of hair growth.
If you have tried some of these measures and you are still
uncomfortable with your level of unwanted hair you might like to try
drug treatment. However, as with all drugs any risks of treatment
should be weighed against any likely benefit.
It is important for you to know that drug treatment is unlikely to
have any visible effect on your unwanted hair before three months (the
average time of the growth phase of body hair). When you stoptaking
the drug your hirsutism will come back, so you will need to continue
the treatment indefinitely.
There are two main drug treatments. Both of these drugs block the
effects of testosterone.
Cyproterone acetate blocks the activity of testosterone. It is given
in doses of 100mg daily from day 5-15 of the cycle along with a high
dose of the female hormone, oestrogen. This treatment is given every
month. This is effective in about 70% of patients.?
?In children given cyproterone acetate there is evidence that the drug
may switch off the adrenal glands but this does not happen in adults.
However, the drug has side effects and there are also risks associated
with the prolonged use of oral oestrogen.?
This site explains how hormones affect hair growth in girls and women:
As far as removing the hair, please check with the child?s doctor
before attempting to shave, bleach, or use depilatories or laser
treatments. If your niece herself is not bothered by the hair,
perhaps the best thing to do is leave the hair as is, for now. It?s
best not to make it an issue now, if it is not one to her.
This site discusses several hair removal methods:
I hope this has helped you understand what could be the cause for your
nieces? excess body hair. If any part of this answer is unclear,
please request an Answer Clarification, and allow me to respond,
before you rate. I wish your niece the best!
congenital adrenal hyperplasia