Hirsutism in women, the growth of coarse terminal hair in part or all of the adult male distribution, can be very distressing. Local cosmetic treatments such as bleaching with peroxide, epilation with wax or the use of electrolysis may help in mild cases but rarely do so when hirsutism is severe.1 2 Suppression of adrenal or ovarian androgen production by prednisolone or progestagen + oestrogen has proved disappointing.3 The anti-androgen cyproterone acetate (Androcur - Schering) appears to offer more effective treatment in severe idiopathic hirsutism and hirsutism associated with polycystic ovaries, once other virilising diseases of the ovaries, adrenals and pituitary have been excluded. The product licence for cyproterone acetate does not extend to its use in the treatment of hirsutism and it should therefore be used only by endocrinologists, gynaecologists and dermatologists with appropriate experience.
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