Τόμος 9 (1991) – Τεύχος 2 – Άρθρο 3 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 9 (1991) – Issue 2 – Article 3 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

9: 85-100 (1991)

PHARMAKON-Press: Epitheorese Klin. Farmakol. Farmakokinet.

9: 85-100 (1991)

hirsutism, hypertrichosis, androgens secretion, pathogenesis, therapy

Hirsutism and hypertrichosis are disorders involving increased growth of body hair. Hypertrichosis is a disorder in which there is a generalized increase in body hair, including in areas that are not androgen-sensitive, such as the arms and the legs, the forehead, and the eyebrows; the disorder occurs in both men and women. On the other hand, in hirsutism, excess androgen causes vellus hair follicles, which produce fine, short, non pigmented hairs, to become terminal hair follicles, which produce coarse, long, pigmen­ted hairs. This occurs only in areas of the body sensitive to the effects of androgens (mainly testosterone), e.g. the face, upper lip, breasts and lower abdomen. In normal women, the majority of testosterone is derived from peri­pheral conversion of androstenedione; this hormone and smaller quantities of testosterone are secreted by both the ovaries and adre­nals. The skin disposes (a) the enzyme 5α­reductase implicating in the conversion of testosterone to dihydrotestosterone and (b) androgen receptor, binding sites. Androgens are transported in the blood on carrier proteins, principally sex hormone binding globulin (SHBG); the majority of testosterone is bound to SHBG and only about 1% of testosterone is free. A reduction in the amount of SHBG will not be reflected by the total serum testoste­rone, but will result in a raised free testo­sterone (2%) level, and this is the hormonal picture seen in most hirsute women. Adrenal function may be controlled by ACTH production and ovarian function by FSH and LH. The release of prolactin appears to be an intrinsic property of anterior pituitary. The hypothala­mus forms of the prolactin inhibiting factor that prevents prolactin secretion; hirsutism is a feature of the hyperprοlactinemia-geiactοrrhea­amenorrhea syndrome. Hirsutism may be due to the polycyclic ovarian syndrome, ovarian tumors, congenital adrenal hyperplasia, Cu­shing’s syndrome, adrenal tumours. On the other hand, hirsutism may be characterised as idiopathic, racial or iatrogenic. The therapeutic strategies of hirsuties include the medical therapies, such as suppressive therapy (oral contraceptives, and/or corticosteroids), and anti-androgen therapy (cyproterone acetate, spi­ronolactone and cimetidine) and the cosmetic treatments, such as chemical hair removal, depilatories, electrolysis, thermolysis and de­pilation with enzymes.

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