What is the Difference Between Hypertrichosis and Hirsutism?

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Hypertrichosis and hirsutism are both conditions characterized by excessive hair growth, but they differ in the locations of the hair growth and the underlying causes. Here are the main differences between the two:

  1. Definition: Hypertrichosis refers to excessive hair growth beyond normal variation for a patient's age, sex, or race or for a particular body area. Hirsutism, on the other hand, refers to an abnormal excess of hair growth solely in androgen-dependent areas of the body in females.
  2. Location: Hypertrichosis can occur in both males and females and is not limited to specific body areas. Hirsutism is a term used to describe male-pattern terminal hair growth in women, within androgen-dependent sites.
  3. Causes: Both hypertrichosis and hirsutism can be caused by extreme production of androgen hormones, such as testosterone. However, hypertrichosis can also be caused by drugs, systemic illnesses, or paraneoplastic syndromes. Hirsutism is often associated with other signs of androgen excess and is commonly caused by endocrine conditions, most commonly polycystic ovary syndrome (PCOS).
  4. Assessment: The standard for hirsutism assessment is the modified Ferriman-Gallwey (mFG) score. Hypertrichosis is not assessed using a specific scoring system but can be diagnosed through a thorough evaluation of the patient's medical history and symptoms.

In summary, hypertrichosis is excessive hair growth that can occur in both males and females and is not limited to specific body areas, while hirsutism is the excessive growth of terminal hair in androgen-dependent areas of the body in females. The causes of these conditions may be different, and they are assessed using different methods.

Comparative Table: Hypertrichosis vs Hirsutism

Hypertrichosis and hirsutism are both conditions characterized by excessive hair growth, but they differ in terms of the location and type of hair growth, as well as their underlying causes. Here is a table summarizing the differences between the two:

Characteristic Hypertrichosis Hirsutism
Definition Excessive hair growth beyond normal variation for a patient's age, sex, or race or for a particular body area. Excessive hair growth solely in androgen-dependent areas of the body in females.
Location Can be generalized or localized, affecting any part of the body. Affects androgen-dependent areas such as the face, chest, abdomen, chin, and back.
Hair Type Can involve both vellus (thinner, lighter) hair and terminal (darker, coarser) hair. Involves terminal hair.
Causes Can be congenital, acquired, drug-induced, or due to systemic illness or paraneoplastic syndromes. Commonly associated with hormonal factors, particularly increased circulating androgen levels or enhanced sensitivity of hair follicles to androgens.
Diagnosis Diagnosed based on the patient's history, physical examination, and sometimes laboratory tests to identify underlying causes. Diagnosed using the modified Ferriman-Gallwey visual scale, which assesses the extent and severity of hair growth in specific areas.
Treatment Depending on the cause, treatment options may include discontinuing incriminated drugs, bleaching, physical and chemical depilatories, epilation, electrolysis, intense pulsed light therapy, and laser hair removal. Treatment options include topical medications such as eflornithine, oral contraceptives, antiandrogens, and glucocorticoids.

It is essential to evaluate and diagnose both conditions to determine the appropriate treatment and manage any underlying conditions that may be contributing to the excessive hair growth.