What is Hair Growth (Hirsutism)?
Due to excess androgen hormones, thin colorless hairs (vellus type hairs) on the face, abdomen and chest become thicker and longer (terminal hair). The disease caused by hair growth is called hirsutism.
Hair growth is not a hair disease. As a result of the increased androgen hormones in the body turning into Di-hydro testosterone, which is the more active form of the testosterone hormone, with the increase of 5-Alpha reductase enzyme activity in the skin, there is an increase in hair growth, sebaceous glands and acne (pimples).
Hair. How is its development?
Hair does not develop continuously. It has active and inactive periods.
1-Anagen Phase: growth period
2-Catagen Phase: regression period
3-Telogen Phase: rest period
p>
Excessive testosterone activity in women accelerates the anagen phase (growth phase) of hair development. In girls, hair growth (hirsutism) occurs as a result of the transformation of vellus type thin and colorless hairs in puberty (13-14 years old) into thick (terminal) hairs under the influence of testosterone and its active form in the skin, DHT (di-hydro testosterone).
REASONS FOR HAIR GROWTH AND INCREASE OF ANDROGEN HORMONES
1-95% of the reasons for hair growth in women is the increase in androgens. The main reason for this is due to the increase in the production of hormones called androstendione in the ovarian theca cells due to laziness in ovulation.
2-Androstendione hormone then turns into testosterone hormone. While the ovaries normally produce 25% of testosterone in women, when there is an increase in androstendione due to laziness in ovulation, testosterone increases 2-fold.
3-Testosterone hormone is DHT (di hydro testosterone), which is more active in the skin and increases hair growth, acne and oiliness. It turns into hormone.
How much testosterone is in the blood?
80% of testosterone is bound to SHBG (sex hormone binding globulin) and 19% is bound to albumin. . 1% is active in free circulation. In women with hair growth, the amount of free testosterone increases from 1% to 2%. For this; In hair growth studies, both total and free testosterone hormone levels should be checked. It is the amount of free testosterone that causes hair growth.
What causes hair growth in women What are the diseases?
1-Poly Cystic Ovary Syndrome (PCOS): 95% of the hair growth in women occurs due to this disease. The reason for the hair growth caused by the increase in androgens due to the absence of ovulation was explained in the above paragraphs.
2-Hyperinsulinemia: What is insulin resistance? Why does hyper insulinemia occur? Decreased glucose response to a given insulin is called insulin resistance. In other words, although glucose should enter the cell under the influence of insulin, it does not and glucose increases in the blood.
Insulin Resistance = Syndurum X = What is Metabolic Syndurum?
a ) Triglycerides being over 150mg/dl
b) HDL Cholesterol being below 50mg/dl
c) Waist circumference in women being over 85cm
d) FBG (fasting blood sugar) 110 mg/dl and above
e) Blood pressure being over 130/80
Excessive hair growth also occurs in this type of women.
How does an increase in insulin in the blood cause hair growth?
Insulin increases IGF-1 activity and increases the production of andrsotendione hormone in theca cells in the ovaries. Androstendione then turns into testosterone, which then turns into the DHT hormone, increasing hair growth. The second reason why insulin increases lead to increased hair growth is that insulin reduces the production of SHBG (sex hormone binding globilin) in the liver. Thus, since testosterone binding will decrease, the amount of free testosterone will increase.
WHAT OTHER DISEASES EXCEPT PCOS CAUSE HAIR?
Note: 95% of the reason for hair growth is due to increased androgen production in the ovaries, such as poly cystic ovary syndrome. The diseases described below are rare diseases that account for only 1 to 5% of hair growth in women. These diseases are as follows;
1- Increased activity in the adrenal gland, the best example of which is Cushing's syndrome.
2- Tumors: androgen-secreting tumors in the ovaries or adrenal gland are very rare.
3- Enzyme deficiencies, 21 Hydroxylase and 11 Beta hydroxylose enzyme defects.
4- Pregnancy: hair growth may increase due to the increase in hormones during pregnancy.
5- Menopause: E1, which is an inactive estrogen in menopause, turns into testosterone in the skin. transformation result u is formed.
WHAT ARE THE LABORATORY TESTS TO BE REQUESTED IN HAIR?
1- Testosterone (both total and free)
2- 17-OH progesterone< br /> 3- DHEAS
4- Prolactin
5- Thyroid tests (if there is hair loss)
6- If hyperinsulinemia is considered (if the patient is obese), insulin triggers and 2-hour 75 gram glucose load test
/> 7- Ultrasonography
8- If a tumor is suspected; further examinations
HOW IS THE TREATMENT FOR HAIRRACE?
The treatment to be mentioned here is the treatment of hair growth originating from the ovary, which is the cause of 95% of hair growth.
1- Birth control pills (oral contraceptives): They have the following effects in the treatment of hair growth.
a) They reduce the increased LH.
b) They increase the production of SHBG (sex hormone binding globins). . Thus, circulating free testosterone decreases.
c) In the skin; It reduces the production of DHT, which is the more active testosterone, by decreasing the 5 alpha reductase enzyme activity.
2- If there is hair growth due to a tumoral cause, special treatments are applied.
Read: 0
