Grading of hirsutism: a practical approach to the modified Ferriman-Gallwey scoring system

Introduction
The modified Ferriman-Gallwey (mFG) scale is accepted as a useful clinical scoring system in the evaluation of hirsutism. Aim: To prevent overlooking hirsutism diagnoses and facilitate patient examinations in ongoing pandemic conditions by simplifying the mFG score.

Material and methods
This study included 227 patients who were diagnosed with hirsutism and had mFG scores of ≥ 8. Hair distribution and hair growth intensity of nine different body regions in the mFG score were examined.

Results
Among our patients with hirsutism, terminal hair was present on the chin in 97.4% (n = 221), thighs in 96.5% (n = 219), upper lip in 94.7% (n = 215), and lower abdomen in 92.1% (n = 205), and this was significantly higher compared with the remaining five regions (p < 0.001 for each comparison). Terminal hair growth scored as ≥ 1 was found in 89% of the patients (n = 202) for the combination of the chin, thighs, and upper lip, and in 87.2% (n =198) for the combination of the chin, thighs, and lower abdomen. When the chin and thighs were evaluated together, 75.3% (n = 171) of the patients had ≥ 2 terminal hair growth.

Conclusions
In addition to the chin and thighs being the main regions of terminal hair growth, examination of the upper lip or lower abdomen can sufficiently help predict hirsutism. During the ongoing pandemic conditions when we need to follow social distancing rules, a practical approach to the mFG scoring system will facilitate the work of many physicians, including dermatologists, and will shorten the patient’s stay in the clinic.