Hirsutism: understanding unwanted hair growth
Reviewed by the My London Pharmacy clinical team, Zeenah Araim, Pharmacist Independent Prescriber
·29 July 2026
·7 min read
Quick answer
Hirsutism is excess hair growth in women in a male pattern (on the face, chest, or back), usually caused by higher levels or increased sensitivity to androgen hormones. It is often linked to conditions such as polycystic ovary syndrome. A range of treatments and hair-removal options can help manage it.
What is hirsutism?
Hirsutism is the growth of thick, dark, coarse hair in areas where women typically have little or only fine, pale hair, following a pattern more usually seen in men, such as the upper lip, chin, jawline, chest, upper abdomen, lower back and thighs. It is common, affecting a notable proportion of women to some degree, and while it is not dangerous in itself, it can be genuinely distressing and affect self-confidence and wellbeing.
It helps to distinguish hirsutism from simply having more body hair than average, which often runs in families and is not related to hormones. Hirsutism specifically refers to a male-pattern distribution of coarse hair, which is usually driven by androgens, hormones such as testosterone that all women produce in small amounts. The amount of hair that counts as excessive is partly subjective and shaped by personal, cultural and family norms, which is why what matters most is how the hair growth affects you rather than a fixed measurement.
Common causes
The most common underlying cause of hirsutism is polycystic ovary syndrome (PCOS), a hormonal condition that can also cause irregular or absent periods, acne, and difficulty managing weight. In many women the excess hair is due to the hair follicles being more sensitive to normal levels of androgens, rather than to a genuine excess of these hormones in the blood, which is why some women have marked hair growth despite normal blood test results.
Less commonly, hirsutism can be linked to other hormonal conditions, some medicines, or, rarely, disorders of the adrenal glands or ovaries. Occasionally no specific cause is found, which is sometimes called idiopathic hirsutism. Hair growth that appears suddenly, worsens quickly, or comes with other marked changes such as a deepening voice, increasing muscle bulk or male-pattern balding warrants prompt assessment, as these can point to a less common cause that needs investigating.
How it is assessed
A clinician will usually begin by asking about when the hair growth started, how quickly it has progressed, the pattern of your periods, any other symptoms such as acne, and your family history, since a gradual onset with a family tendency is generally reassuring. They may look at the pattern and distribution of the hair and check for other signs that help point towards an underlying cause.
Blood tests to measure hormone levels are sometimes arranged, particularly if the onset was rapid, the hair growth is marked, or there are other symptoms alongside it. These tests can help confirm a likely cause such as PCOS and, importantly, help exclude the rarer conditions that occasionally lie behind unwanted hair growth, which is reassuring in itself. It is worth knowing that normal hormone results are common in hirsutism and do not mean nothing is happening, since increased skin sensitivity to androgens can drive hair growth even when blood levels are unremarkable.
Identifying any underlying cause, such as PCOS, is valuable not just for the hair itself but because it allows related aspects of health, including periods, fertility, and longer-term wellbeing, to be considered and managed together rather than in isolation. A clinician will usually explain what any test is looking for beforehand, so the process feels clear rather than daunting.
Treatment and management
Treatment aims to slow new hair growth and address any underlying cause, and it is important to know from the start that it usually takes several months to see a difference. This is because treatments act on hairs that are only just beginning to grow, while existing hairs still need to complete their natural cycle, so patience and consistency really matter.
Combined hormonal contraceptives are a common first step, as they can lower androgen activity and also help regulate periods; examples a clinician might consider include Eloine and Zoely. In some cases, medicines that block the effect of androgens may be added under appropriate guidance, and a prescription cream can be used to slow the growth of facial hair specifically. Where PCOS is involved, managing other aspects (including weight where relevant) can also support overall improvement. Treatment is highly individual, and a clinician can talk through the options that fit your circumstances, preferences and any plans for pregnancy.
Hair removal and self-care
Alongside or instead of medicines, many people use hair-removal methods to manage the appearance of unwanted hair, and these can be used at the same time as any treatment. Options range from everyday approaches such as plucking, shaving, waxing, threading and depilatory creams, to longer-lasting methods such as laser hair removal and electrolysis, which can reduce hair over a course of sessions. Bleaching can also make fine hair less noticeable without removing it.
These methods do not treat any underlying cause, but they can be very effective for day-to-day management and confidence, and are often used together with medical treatment for the best overall result. It is worth remembering that shaving does not make hair grow back thicker or faster, despite the common myth: regrowth simply feels blunter for a short time. Which method suits you often comes down to the area involved, your skin type and sensitivity, cost, and personal preference, and it is fine to try more than one.
Hirsutism and PCOS: the wider picture
Because PCOS is the most frequent cause of hirsutism, it is worth understanding the wider picture when the two go together. PCOS is a common condition affecting the ovaries and hormones, and unwanted hair is often just one of several features, which can also include irregular periods, acne, and challenges with weight. Treating it therefore means looking beyond the hair alone.
Managing PCOS well can help the hair growth and also supports longer-term health, since the condition is linked to other considerations such as blood sugar over time. This might include support with weight where it is relevant, help with periods and, for those who wish to conceive, advice about fertility. Bringing these threads together under one plan, guided by a clinician, is usually more effective and reassuring than tackling each symptom separately.
The emotional impact and finding support
It is important to acknowledge that unwanted hair growth can have a real emotional impact. Many women find it affects their confidence, mood and how comfortable they feel in social situations, and some spend considerable time and effort managing it day to day. None of this is vain or trivial: it is a completely understandable response, and it is one reason hirsutism is recognised as a genuine medical concern rather than a purely cosmetic one.
Support is available, and you do not have to simply put up with it. Being able to discuss it openly, understand the cause, and see a clear plan often lifts much of the associated worry, even before treatment has had time to work. If low mood or anxiety is significant, that is worth raising too, as it can be supported alongside the physical management.
When to see a clinician
It is worth seeking advice if unwanted hair growth is bothering you, if it has come on suddenly or is worsening quickly, or if it comes alongside irregular periods, acne, weight changes or other symptoms. These combinations can point to an underlying condition that benefits from proper assessment and management, rather than being managed by hair removal alone.
Hirsutism is a recognised medical concern, not just a cosmetic one, and effective help is available. Our clinical team can discuss your symptoms discreetly and without judgement, help identify any underlying cause, and advise on suitable treatment and management options that fit your circumstances and preferences.
Frequently asked questions
What causes hirsutism?
It is usually driven by androgen hormones or increased skin sensitivity to them. The most common underlying cause is polycystic ovary syndrome (PCOS).
Is hirsutism the same as having lots of body hair?
No. Hirsutism specifically means male-pattern hair growth in women, such as on the face and chest, rather than generally fine or familial body hair.
How long does treatment take to work?
Because of the hair growth cycle, hormonal treatments often take several months to show a noticeable difference, so patience is needed.
Can the combined pill help with hirsutism?
Yes. Some combined hormonal contraceptives can reduce androgen activity and are often used as a first step, alongside other measures a clinician may suggest.
Does shaving make the hair grow back thicker?
No. This is a common myth. Shaving cuts the hair rather than changing it, so regrowth may feel blunter for a short time but is not actually thicker.
When should I see a clinician about excess hair growth?
Seek advice if it is distressing, comes on suddenly, worsens quickly, or is accompanied by irregular periods or other changes, as these may signal an underlying cause.