1st female case of excessive hair growth in gums reported

A woman in Italy is the first known case of excessive hair growth in the gums. This marks the sixth documented case of gingival hirsutism in the world, according to a case study published in the February issue of Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.

This case, which involved a 25-year-old woman with numerous eyelash-like hairs growing out of her maxillary and mandibular gums, was unique because all other known cases were reported in men. Also, in all but one case, only a single localized hair was found in their oral cavities, the authors wrote.

"We present the extremely rare case of a 25-year-old woman with numerous oral hairs involving the maxillary and mandibular gingivae," wrote the authors, led by Khrystyna Zhurakivska, DDS, of the department of clinical and experimental medicine at the University of Foggia in Italy (Oral Surg Oral Med Oral Pathol Oral Radiol, February 2020, Vol. 129:2, pp. e200-e203). "The case presented here is the first case involving a woman," they added.

How it began

When the woman was 19, she initially visited doctors at the University of Campania Luigi Vanvitelli in Italy, complaining that she had tiny hairs growing out of her gums directly behind her front upper teeth.

Doctors performed hormonal tests and an ultrasound scan and determined that she had polycystic ovary syndrome, a condition that results in abnormally high levels of male hormones. Women with the condition often experience unwanted hair growth in areas that follow a male pattern, such as the chin and chest. She was treated with birth control pills to control her hormone levels, and the clinicians removed all the hairs along her gums. After four months of continuing with the oral contraceptives, the oral growth was gone, according to the authors.

Six years after her initial diagnosis, she returned with a worsened case of gingival hirsutism. She had stopped taking her prescribed oral contraceptives for an unknown reason, and the hair grew back on her gums, as well as on her neck and chin.

The doctors again removed the hairs. A year later, the woman returned with eyelash-like hairs growing in "multiple oral sites," including both of her gum arches, according to the authors.

Other cases of hair in the oral cavity

When researchers began investigating the woman's case, they began looking for other cases of gingival hirsutism. The first documented case of gingival hirsutism dated back to the 1960s, and they were only able to locate five others, all of which involved males between the ages of 11 and 57. In two cases, the researchers thought hair growth likely was associated with aberrant sebaceous glands. In another, the link was thought to be related to the boy's diagnosis of alopecia. The last was linked to abnormally positioned squamous cells, according to the researchers.

Thoughts on the woman's case

The oral cavity is a complex structure derived by early development that isn't completely understood. The authors hypothesized that the oral hair growth in the woman in this case could be a case of ectopia, which is when tissues or organs are displaced within the body.

As the oral cavity of an embryo develops, numerous tissues grow, including developmental abnormalities. For instance, some tissues or sebaceous glands migrate and develop at sites where they don't normally grow, potentially causing hair to grow in unusual places.

Though the cause of gingival hirsutism remains unknown, in the current case, "it was important to perform a deep investigation of the individual's systemic health to identify the most appropriate and definitive treatment," the authors concluded.