Unwanted Hair Growth (Hirsutism)

Chin and upper lip hair is the most common presentation of hirsutism, and polycystic ovary syndrome accounts for the large majority of cases. PCOS is usually gradual and often comes with irregular or absent periods, acne, or thinning at the crown. Growth that appears over weeks rather than drifting over years is assessed differently and needs prompt review. Log where the hair is, how coarse it feels, how often you remove it, your cycle dates and any new medications, since removal frequency is often the clearest measure of change over time.

Hair follicles run in cycles, and a follicle already in its growth phase will finish that phase regardless of what you take. That is why combined oral contraceptives, anti-androgens such as spironolactone, or metformin where it is appropriate are usually judged at around six months rather than six weeks. Mechanical removal continues during that period. Track removal frequency month by month, because moving from shaving daily to twice a week is a real result even when the mirror looks unchanged. Bring that record to your review appointment.

Hirsutism means coarse, dark, terminal hair in a male pattern: upper lip, chin, chest, upper abdomen, lower back and inner thighs. It is driven by androgens. Hypertrichosis is a general increase in hair, fine or coarse, anywhere on the body, not following a male pattern, and is more often linked to medications such as minoxidil, ciclosporin or phenytoin. Some hair density is simply familial and varies widely between families and ancestries, so lifelong stable hair is a different question from new change. Note when you first noticed a difference.

Rapid change over weeks to a few months, particularly with a deepening voice, enlargement of the clitoris, increased muscle bulk, a receding hairline or periods stopping, needs prompt medical assessment, because that pattern can point to an androgen-secreting ovarian or adrenal tumor. Purple stretch marks, easy bruising, a rounded face, weakness climbing stairs, or new high blood pressure or diabetes alongside hair growth also warrant early review. Gradual growth with irregular periods or acne can be discussed at a routine appointment.

Bring dates: when you first noticed the change, how quickly it progressed, your cycle pattern over the past year, your weight trend, every medication and supplement including any testosterone or steroid use, and family history of similar hair growth or diabetes. Monthly photos taken in the same light and at the same distance are more useful than any description. Trace Health charts severity, removal frequency and lifestyle factors on one timeline and exports a doctor-ready PDF, so a short appointment starts with evidence rather than recall.