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Unwanted Hair: Patient vs. Clinician Perception

One of the symptoms of Polycystic Ovarian Syndrome (PCOS) in women is hirsutism, unwanted hair growth in a male-pattern distribution, which typically involves the face, chest, back, upper arms, abdomen, and thighs. Hirsutism has been linked to depression, worry, embarrassment, and social withdrawal in qualitative studies but there are few quantitative assessments of the effect of hirsutism on quality of life.

Typically treatment decisions are based on degree of hair growth, rather than quality of life. Previous studies have shown that patient self-ratings of hirsutism were generally higher than clinician ratings, thus the degree of hirsutism appears to depend on whether a clinician or the patient measures it.

A recent study published in JAMA Dermatology sought to determine whether patients’ quality of life may be a more relevant factor in determining treatment plans than the degree or clinical severity of hirsutism. The study looked at the correspondence between clinician ratings and self-ratings of degree of hirsutism, and evaluated the extent to which degree of hirsutism is associated with hirsutism-related quality of life and risk for depression.

The results showed that in this cohort of women with PCOS, patients rated themselves as being more hirsute than did the clinician. Additionally, a quantitative, validated, measurement tool confirmed that hirsutism has a significant negative impact on the quality of life of PCOS patients. Self-ratings were generally more strongly associated with severe quality-of-life impacts than clinician ratings.

The authors note that similar to findings about acne and alopecia, patients’ assessments of degree of hirsutism present a distinct picture and were more strongly associated with specific quality of-life impacts and with depression risk. The authors state that patient self-assessment of hirsutism is critical information for the full understanding of the effects on quality of life and should help direct treatment.

Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: June 6, 2016

Source: JAMA Dermatology

[Image: Wikimedia Commons / Charles Eisenmann]

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