"Come one, come all! See the Bearded Lady and Werewolf Boy!"

Excess hair, especially on women, has a long history of sideshow exploitation (and legitimate employment) and has several possible causes.

Congenital hypertrichosis

Meaning “extra hair growth from birth”, congenital hypertrichosis is a very rare condition, but is also X-linked dominant, in several cases. When an affected female has a child, there’s a 50/50 chance they’ll be affected, and when an affected male has a child, they’ll be affected by the mutation 100% of the time. Interestingly, there are several mutations known to cause congenital hypertrichosis, but they’re all X-linked.

Acquired hypertrichosis

These forms of hypertrichosis appear after birth, and are most often caused by a reaction to medication, eating disorders, and internal malignancies (cancer). The most common form of acquired hypertrichosis is the coating of lanugo (soft insulating hair most often found on preterm infants) in anorexia nervosa patients. This extra hair will fall off naturally once the body begins to receive regular proper nutrition again.

Hirsutism

This is not a form of hypertrichosis, but some “bearded ladies” have had the condition known as “hirsutism”. Hirsutism is not a disease in and of itself, but is a symptom, where increased androgen sensitivity in women causes terminal hair growth in areas where vellus hairs normally grow - most notably the face and chest.

Polycystic ovarian syndrome is the most common cause of hirsutism, and is what the sideshow lady Annie Jones had. Obesity, Cushing’s disease, acromegaly, ovarian tumors, and type 2 diabetes can also cause excess androgenic hair. Of course, treating the underlying condition is the optimal way to reduce hirsutism, but many conditions that cause it can only be treated.

There are several medications that can be taken to reduce the levels of this hair growth, but as they’re all hormone-based and somewhat riddled with side-effects, most women who have hirsutism will opt for hair removal, instead. Or they’ll embrace it, like Harnaam Kaur!

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