How are vellus hair and terminal hair differentiated in the evaluation of hirsutism?

Updated: May 01, 2020
  • Author: George T Griffing, MD; Chief Editor: Michel E Rivlin, MD  more...
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The initial task in the evaluation of hirsutism via the physical examination is to quantitate the disorder. [11] This task requires that terminal hair, which depends on androgen, be differentiated from vellus hair, which is androgen-independent.

  • Vellus hair is fine, soft, and lightly pigmented. An excess of vellus hair (hypertrichosis) is usually idiopathic, but may be associated with metabolic disorders (eg, hyperthyroidism, anorexia nervosa, porphyria) and with some medications (eg, phenytoin, diazoxide, minoxidil, glucocorticoids, cyclosporine, hexachlorobenzene).

  • By contrast, terminal hair is coarse, curly, and pigmented. Because small amounts of terminal hair are normal in women, quantitation is important.

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