Terminal hair growth is driven by androgens; follicles in androgen-sensitive areas respond to testosterone and particularly dihydrotestosterone (DHT). Excess androgen levels or increased follicular sensitivity can cause hirsutism or male-pattern distribution of hair in women. 

 

Ingrown hairs (pseudofolliculitis) occur when shaved or tightly curled hairs re-enter or become trapped in the skin, causing inflammation.

 

Variations

• Idiopathic hirsutism (normal hormones but high follicular sensitivity). 

• Endocrine-related (e.g., PCOS).

• Ethnic variations in hair curl and density affect ingrown risk.

 

Severity & treatment approach

• Cosmetic, mild: waxing/shaving, topicals, and basic laser hair reduction.

• Moderate hirsutism or significant ingrowns: laser hair removal becomes a key tool; endocrine workup may be indicated for women with signs of androgen excess.

• Severe, rapidly progressive or virilizing signs: medical/endocrine assessment first; device treatments are adjunct once the cause is clear and stable.