HIRSUTISM SCORING CHART

Ferriman–Gallwey score is a method of evaluating and quantifying hirsutism in women.

The original method used 11 body areas to assess hair growth, but was decreased to 9 body areas in the modified method.

1. Upper lip2. Chin3. Chest4. Upper back5. Lower back6. Upper abdomen7. Lower abdomen8. Upper arms9. Thighs10. Forearms (deleted in the modified method)11. Legs (deleted in the modified method)

Hair growth is rated from 0 (no growth of terminal hair) to 4 (extensive hair growth) in each of the nine locations.

Score ranges from a minimum score of 0 to a maximum score of 36.

HIRSUTISM TREATMENT

Important principles for the management of hirsutism are listed as follows :

1. Treatment will never be curative and therefore, chronic treatment will likely be necessary.

2. The effects of drugs are not evident before several months of administration.

3. Treatment should take into account the characteristics and expectations of the individual patient.

4. Treatment must be monitored by an expert.

TREATMENT MODALITIES

A) Life-style modification and Weight loss : Physical exercise & Weight loss in overweight women can decrease levels of androgens and lessen hirsutism..

TREATMENT MODALITIES

B) Hair removal and lightening ●Shaving : safe and effective method.●Chemical hair removal, waxing, and bleaching (may cause skin sensitivity ).●Electrolysis : inserting a very fine needle into the hair follicle and applying an electrical current. Best for small areas. ●Laser : effective, faster, and less painful than electrolysis. It can often permanently reduce hair growth.●Creams (Eflornithine hydrochloride)

TREATMENT MODALITIES

C) Medications 1) Oral contraceptive pills (OCPs) :The mainstay for hirsutism therapy for decades. OCPs suppress ovarian androgen synthesis via inhibition of gonadotrophin secretion & increases SHBG concentrations markedly, thereby suppressing free testosterone levels.

TREATMENT MODALITIES

2) Anti-androgens : Directly decrease androgen production or block the action of androgens on the hair follicle. (Teratogenic)•The most commonly used anti-androgen is spironolactone. •Other alternatives :Finasteride & Cyproterone acetate