Page Contents
OVERVIEW
This page is dedicated to providing more information about how to collect a medical history for female patients who complain of hairiness.
WHAT ARE THE GOALS OF THE INTERVIEW?
It can be difficult to evaluate a patient effectively if the goals of the patient encounter are not clear to the interviewer. In the case of collecting the medical history for a patient complaining of facial hair growth, here are some general goals that can help direct the history taking.
- How serious is this hair growth?
- What is the best medical term to describe the patient’s presentation?
- What could be the cause of the patient’s hair growth (what is most likely, what is most dangerous?)
HISTORY OF PRESENT ILLNESS
In the setting of this specific chief complaint here are elements of the HPI that are especially important to explore:
Onset:
When exactly the facial hair growth began can very much help contextualize the patient’s presentation. there are 3 major designations that can be made with regards to the onset of symptoms:
- Primary onset: this refers to hair growth that has occurred from birth/a very young age (before puberty)
- Secondary onset (premenopausal): hair growth that has occurred later on in life (after puberty), however before menopause.
- Secondary onset (postmenopausal): hair growth that has occurred later on in life, after menopause.
These distinctions are useful to make because they inform the differential diagnosis, and by extension the clinical workup (for example a primary onset is much more suggestive of congenital causes vs. a onset later on in life).
Course:
Essentially an appreciation of how rapid/acute the course of hair growth was can in part give perspective on the severity of the situation. A very acute progression of facial hair growth can be associated with disease processes (such as malignancies) that can quickly elevate androgen levels within the body.
Associated symptoms: Is this virilization?
It is always useful to ask patients to share any other symptoms they have been experiencing (as this may give clues that lead to a diagnosis). While this remains true for a chief complaint like facial hair growth in females, it is important to also uncover information that helps apply the most accurate medical term to the patient. In the realm of this chief complaint, the important distinction to make is if the patient has hirsutism or virilization. Patients with virilization will have some of the symptoms below (which is why they are worth asking about during the medical interview).
- Deepening of the voice
- Increased body muscle mass
How bothersome is this condition to the patient?
Understanding patient concerns revolving around the chief complaint is always an important component of a medical history/interview.
Hair control/removal
While limited in its diagnostic utility, it is important to ask patients what they have done in terms of hair removal/control. Symptom management can be an important component of this chief complaint (in addition to uncovering the etiology of the facial hair).
PAST MEDICAL HISTORY
Past diagnosis:
Medications:
Supplements:
Page Updated: 11.14.2016