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Hypertrichosis: Causes, Symptoms and Treatment

Hypertrichosis is a condition characterized by excessive hair growth anywhere on the body, affecting both men and women. Causes range from genetic factors to medications and underlying medical conditions.

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Things worth knowing about "Hypertrichosis"

Hypertrichosis is a condition characterized by excessive hair growth anywhere on the body, affecting both men and women. Causes range from genetic factors to medications and underlying medical conditions.

What is Hypertrichosis?

Hypertrichosis is a medical term describing excessive hair growth that can occur on any part of the body, regardless of sex or location. It is distinct from hirsutism, which refers specifically to androgen-dependent hair growth in women following a male pattern. Hypertrichosis can be congenital (present from birth) or acquired during a person's lifetime, and it affects both males and females equally.

Causes

The causes of hypertrichosis are diverse and include:

Genetic factors: Rare inherited forms, such as congenital generalized hypertrichosis (e.g., Ambras syndrome), result in extensive hair growth across the entire body.
Medications: Certain drugs can trigger excessive hair growth as a side effect, including cyclosporine, minoxidil, phenytoin, diazoxide, and corticosteroids.
Nutritional deficiencies: Malnutrition, particularly in conditions such as anorexia nervosa, may contribute to the development of hypertrichosis.
Metabolic disorders: Thyroid diseases, porphyrias, and other metabolic disturbances can promote increased hair growth.
Paraneoplastic syndromes: In rare cases, acquired hypertrichosis may be a sign of an internal malignancy.
Local irritation: Prolonged mechanical pressure, friction, or skin inflammation may cause localized increases in hair growth.

Types of Hypertrichosis

Congenital Hypertrichosis

The congenital form is usually hereditary and is present at birth or shortly thereafter. An extreme variant is Ambras syndrome (also known as werewolf syndrome), in which the entire body, including the face, is covered with dense hair. This form is exceptionally rare.

Acquired Hypertrichosis

This form develops during a person's lifetime and may be linked to medications, systemic disease, or external factors. It can be generalized (affecting the whole body) or localized (restricted to a specific area).

Symptoms

The primary symptom of hypertrichosis is visibly excessive hair growth in unusual or disproportionately affected areas of the body. The hair involved may be:

Lanugo hair (fine, soft, downy hair)
Vellus hair (thin, short, unpigmented hair)
Terminal hair (coarse, pigmented hair)

Depending on the severity and extent of the condition, hypertrichosis can cause significant psychological distress and affect a person's self-image and quality of life.

Diagnosis

Diagnosis of hypertrichosis is primarily clinical, based on physical examination. To identify the underlying cause, the following investigations may be required:

Medical history: Review of medication use, family history, and associated medical conditions.
Laboratory tests: Hormone levels, complete blood count, thyroid function, and urinary porphyrins.
Imaging: Ultrasound or CT scans may be used if an underlying malignancy is suspected.
Genetic testing: May be helpful in cases of suspected congenital hypertrichosis.

Treatment

Treatment of hypertrichosis depends on the underlying cause:

Treating the cause: If a medication is responsible, discontinuing or switching the drug may normalize hair growth. For metabolic or systemic diseases, treating the underlying condition is the primary goal.
Cosmetic measures: Epilation, shaving, waxing, bleaching, or chemical depilatory creams can improve appearance.
Permanent hair removal: Laser therapy and electrolysis (needle epilation) offer long-lasting or permanent results.
Psychological support: As the condition is often associated with emotional distress, psychological counseling may be beneficial.

References

Wendelin DS, Pope DN, Mallory SB. Hypertrichosis. Journal of the American Academy of Dermatology. 2003;48(2):161-181.
Paus R, Cotsarelis G. The Biology of Hair Follicles. New England Journal of Medicine. 1999;341(7):491-497.
Tosti A, Piraccini BM. Anomalies of Hair Shaft and Hair Follicle. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. McGraw-Hill Education; 2012.

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