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Most cases are due to idiopathic hirsutism along racial or familial lines.

  • Exclude adrenal or ovarian pathology (e.g. PCOS)

  • Use bleaching, waxing or depilatory creams, or shave

  • Do not pluck hairs, esp. around the lips and chin; plucking stimulates hair growth but shaving appears to have no effect

  • Women of reproductive age may use the combined oral contraceptive pill (COCP): ethinyloestradiol + cyproterone or drosperinone

  • Drug treatment: spironolactone 100–200 mg daily; takes 6–12 mths to respond; preferred to cyproterone acetate

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