Acromegaly and hirsutism: what to know

Hirsutism means coarse, dark hair developing in an androgen-sensitive pattern, such as on the face, chest, abdomen or back. It has several possible causes, and acromegaly is one less common hormonal association rather than an explanation that can be assumed from hair growth alone.

Acromegaly develops when the body is exposed to excess growth hormone, most often because of a non-cancerous pituitary growth. Changes tend to evolve gradually. Enlarging hands or feet, altered facial features, wider spacing between teeth, oily or thickened skin, heavy sweating, headaches, joint discomfort and changes to periods can accompany it.

A clinician looks at the whole pattern because hirsutism is more often associated with other androgen-related conditions. The timing and speed of hair growth, menstrual history, medicines, acne, scalp hair thinning and changes in voice or muscle bulk help guide the assessment.

Arrange a medical appointment if coarse hair is new, progressing, or accompanied by changes in your hands, feet, face, sweating or periods. The clinician may compare older photographs, examine hair distribution and skin, review medicines and arrange hormone blood tests. If acromegaly is suspected, endocrine assessment may include further blood testing and imaging of the pituitary gland.

Hair-management options can be discussed while the cause is being assessed. Shaving, waxing or depilatory products address visible hair; laser hair removal and electrolysis target follicles. Medicines such as spironolactone may suit selected patients but require clinical review, pregnancy precautions and monitoring.

Seek prompt assessment for rapidly developing coarse hair with a deepening voice, new muscle enlargement, missed periods or other marked hormonal changes. A severe or sudden headache, new loss of vision, double vision, confusion, fainting or vomiting needs urgent medical attention because symptoms around the pituitary region require timely evaluation.

Ask which features point toward an androgen disorder or a growth-hormone problem, which blood tests are appropriate, whether any medicine could contribute, and whether an endocrinology referral is needed. For hair treatment, ask which method fits your hair colour and skin type and whether medical control of the underlying cause should come first.