Acne and Hirsutism

Women with acne and hirsutism are two of the more common problems that i see in my office. Acne may or may not be a hormonal problem. However, hirsutism always is.

The term “idiopathic” means that we do not understand the cause. Many women have come across the term “idiopathic hirsutism”. There is no such thing. If a woman has hirsutism, she either has or has had a hormonal problem. At least at one time in her life, she had to be producing too much androgen.

Acne is an infection principally of the sebaceous glands that are present in the hair follicles. One of the principal causes of acne is an increase in the oils produced by the sebaceous glands that occurs at the time of puberty due to an increased production of testosterone that occurs in both teenage girls and boys.

Acne can also occur in older people as well. We always look for a hormonal cause and sometimes we find it but oftentimes we don’t.

Hirsutism is defined as the presence in a woman of coarse dark hair growing on the body where it does not belong. Generally speaking, the closer to the midline of the body, the more significant the hair is.

In order for a woman to develop hirsutism, she must have had an overproduction of androgens (male hormones). Sometimes, all the hormone levels are normal leading me to conclude that the overproduction of androgens occurred in the past but is no longer present.

Studies have also shown that women with hirsutism often are producing too much androgen but because the way he your body works, they are also getting rid of the androgens and an accelerated rate. Therefore, the blood levels may be normal. This has been a source of confusion in the past.

Studies have also shown that women with hirsutism, even if they have normal menstrual cycles, are probably a variant of polycystic ovary syndrome and therefore should be evaluated.

Besides being a significant cosmetic issue, acne and hirsutism are often “red flags” for more serious underlying problems and should be evaluated.  Please contact me if you have any questions or to schedule an appointment.

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