During recent physical examinations for children, parents often point to their child’s limbs or upper lip hair, worriedly asking, “Is this precocious puberty?”
Normal hair distribution mistaken for excessive hair by parents
In fact, dense body hair does not equal precocious puberty; this needs to be analyzed on a case-by-case basis. Some are physiologically hairy, and there may also be more serious issues. Today, let’s talk about this matter!
Why do some people have more body hair?
Genetic factors play a crucial role in hair growth, a force we can never ignore.
Research indicates that the amount, distribution, and density of body hair are largely influenced by parental genetic factors. If there are family members with abundant hair (e.g., Southern European, Middle Eastern descent), the child’s body hair may be more noticeable.
At the same time, skin tone can also create different visual effects. Children with lighter skin have more conspicuous hair due to the contrast, similar to pencil marks on white paper, not an actual increase in hair quantity, as seen in the first photo above.
When should excessive body hair be considered precocious puberty?
Precocious puberty refers to the appearance of secondary sexual characteristics before the age of 7.5 in girls and 9 in boys, or the onset of menstruation before the age of 10 in girls.
Secondary sexual characteristics appear prematurely, which is when precocious puberty should be considered.
Secondary sexual characteristics include: breast development, penis elongation, testicle enlargement, growth of pubic and axillary hair, development of the Adam’s apple, growth of facial hair, voice changes, etc.
Mention was made of hair, but not all body hair, mainly referring to pubic hair, axillary hair, facial hair, and other sexual hair. That is to say:
Excessive body hair + premature appearance of secondary sexual characteristics should be considered for precocious puberty.
Should we worry about children’s deep lip hair? Be vigilant for these situations of precocious puberty
Is excessive body hair always hirsutism?
Not necessarily.
As shown in the picture below, it is a normal baby with a lot of fine and soft lanugo hair covering the body (lanugo), which mostly sheds on its own within a few months. This is excessive body hair, but it is a normal physiological phenomenon.
True hirsutism refers to hair growth on any part of the body that exceeds the typical hair growth for individuals of the same age, race, and sex. It can be generalized or localized and may be isolated or associated with other abnormalities.
Primary generalized hirsutism is a rare condition where individuals have a large amount of long and fine lanugo hair covering their entire body, except for areas that typically do not grow hair (such as palms, soles, and mucous membranes).
Congenital generalized hirsutism, this image shows hirsutism on the back and upper limbs
Their facial, ear, and shoulder hirsutism characteristics are prominent.
The forehead, eyelids, nose, cheeks, and preauricular areas are evenly covered with hair, which can reach several centimeters in length. The hirsutism of the external ear is also typical, and if not trimmed, the hair will extend from the external auditory canal in the form of long curly hair.
Indian teenager Lalit Patidar
Congenital hirsutism can also be localized, among which lumbosacral hirsutism usually raises doctors’ vigilance, children may have associated diseases such as spina bifida and/or tethered cord syndrome, requiring further consultation with neurosurgery.
The congenital circular hair tuft on the top of the skull (“hair collar sign”) can also make doctors nervous, as it may indicate cranial clefts, ectopic brain tissue, or potential dermoid cysts.
For example, hirsutism induced by medications such as phenytoin, cyclosporine, and minoxidil. There are also reports of hirsutism occurring with long-term use of inhaled corticosteroids, which will resolve on discontinuation of the medication.
Facial hirsutism caused by cyclosporine
In addition to medications, there are various underlying diseases that may cause acquired generalized hirsutism , including but not limited to porphyria cutanea tarda, head injuries, and other brain diseases, malnutrition and anorexia nervosa, juvenile hypothyroidism, juvenile dermatomyositis, AIDS, etc.
Excessive hair growth in adolescent females is often influenced by androgens, with originally sparse and soft vellus hair transforming into thick, long, dark terminal hair within a short period of time (weeks to half a year), and the area of coverage also significantly increases.
Under normal circumstances, male body hair is mainly distributed on the chest, abdomen, back, arms, legs, etc., while female body hair is relatively less, mainly distributed in the armpits, pubic area, and legs. If women have excessive body hair on the chest, back, face, and limbs, this may indicate excessive body hair.
If women have excessive body hair on the chest, back, face, and limbs, this may indicate excessive body hair.
These later-developing excessive hairs are signaling us to pay attention to potential health issues, such as polycystic ovary syndrome, Cushing’s syndrome, adrenal hyperplasia, hypothyroidism, and severe insulin resistance.
However, increased body hair due to disease usually appears with other clinical symptoms.
For example:
Adrenal hyperplasia may lead to high blood pressure, electrolyte disorders; hypothyroidism may cause slowed metabolism, weight gain, dry skin, and other symptoms. Severe insulin resistance may lead to blood sugar disorders, obesity, cardiovascular diseases, etc.
Severe insulin resistance may lead to blood sugar disorders, obesity, cardiovascular diseases, etc.
The sudden appearance and rapid growth of long, fine, white to yellow lanugo hair on a large area of the body in older age is also not a good thing, this may be malignant lanugo, and within weeks to 2 years after the appearance of lanugo, an underlying malignancy may be diagnosed.
The most commonly associated malignancy is colorectal cancer, but cases related to gallbladder, pancreas, bladder, uterus, ovary, breast, bronchus cancer, lymphoma, and leukemia have also been documented.
Therefore, when abnormal increases in body hair are observed, we should not only focus on the surface of the skin but pay more attention to whether there are other related symptoms and actively seek medical attention from an endocrinologist for professional assessment and diagnosis.
Can daily skincare products cause hirsutism?
Indeed, some ingredients in topical skincare products may lead to increased body hair, such as high concentrations of niacinamide.
High concentrations of niacinamide may stimulate the dermis, causing capillaries to dilate and providing more nutrients for hair growth, thereby accelerating the growth rate of hair and making it more luxuriant.
However, not everyone will have this reaction to niacinamide, and individual differences are significant. Therefore, when choosing skincare products, one should also pay attention to the ingredients and perform a patch test on the skin to observe any adverse reactions.
For adults, when determining whether there is true excessive body hair, we need to consider factors such as the quantity, texture, coverage area of the hair, and whether there are other accompanying symptoms.
If there is confirmed abnormal increase in body hair, then please seek further help from an endocrinologist to determine whether there are endocrine diseases or other potential health issues.
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