What is the epidemiology of hirsutism by race?

Updated: May 01, 2020
  • Author: George T Griffing, MD; Chief Editor: Michel E Rivlin, MD  more...
  • Print

Ethnic origin significantly affects terminal hair growth in healthy women. Northern, fair-skinned Europeans have the least amount of terminal hair, whereas southern European, dark-skinned Mediterranean women have the greatest amount of terminal hair.

The difference in the racial patterns of normal terminal hair growth may be related to genetic differences of 5-alpha-reductase activity in the skin.

A study by Engmann et al reported that among patients with polycystic ovary syndrome (PCOS), aged 18-40 years, the prevalence of hirsutism was significantly greater in Hispanic women than in non-Hispanic white patients (93.8% vs 86.8%, respectively). [9]

A retrospective study by Afifi et al also found hirsutism in women with PCOS to be linked to ethnicity, as well as to Fitzpatrick skin type. Hirsutism in PCOS was most prevalent, and the modified Ferriman-Gallwey (mFG) hirsutism score was highest, in women of Hispanic, Middle Eastern, African American, and South Asian ethnicity. Moreover, a greater prevalence of hirsutism, along with an increased tendency toward truncal hirsutism, was noted with higher Fitzpatrick skin types. The investigators also determined that mFG scores in the truncal region and extremities tended to be higher in women of Middle Eastern and Hispanic ethnicity, while the score for the face was greater in African American and Hispanic patients. The least amount of hirsutism was found in women of Caucasian, Ashkenazi Jewish, East/Southeast Asian, and Native American ethnicity. [10]

With the exception of congenital adrenal hyperplasia (CAH), the actual prevalence of diseases that cause hyperandrogenism and hirsutism has not been shown to differ among persons of different races.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!