Woman Grows Hair in Her Gums: The Astonishingly Rare Medical Mystery

The Unbelievable Case of Gingival Hirsutism: A Rare and Mysterious Condition

Medical conditions are often unpredictable and fascinating, with some cases defying logic and stumping even the most experienced specialists. One such rare occurrence involves a young woman whose gums started growing hair—a phenomenon so unusual it has only been documented a handful of times in medical literature. This case of gingival hirsutism presents a complex conundrum for pathologists and medical professionals, and it may shed light on rare mechanisms of tissue growth, hormonal imbalance, and unexplained biological processes.

The Case of Gingival Hirsutism: An Overview

More than a decade ago, a 19-year-old woman walked into a clinic at the University of Campania Luigi Vanvitelli in Italy. She presented with a bizarre and entirely unexpected symptom: hair growth on her gums. Specifically, tiny, eyelash-like hairs were found growing in the soft tissues behind her upper front teeth, a location that’s far from the usual places where hair grows. This case was documented in 2019 and continues to intrigue medical professionals worldwide.

The condition was diagnosed as gingival hirsutism, a form of abnormal hair growth that occurs in an atypical location—the gingiva or gums. The medical team reported their findings in a study published in the journal Clinical Case Reports in August 2019. They described the growth of hairs on the sulcular epithelium of the retroincisor palatal papilla—an area of the gums located just behind the upper incisors. This description, though technical, essentially means that the woman had tiny hairs sprouting from an area of her mouth where they should not have been.

Interestingly, medical literature had only revealed five other similar cases prior to this one. All of the previous cases involved men, which makes this particular case noteworthy for its rarity in women. For years, the causes and mechanisms behind this unusual condition were shrouded in mystery. How does hair grow where it isn't supposed to? And why does it grow in such an unusual location?

Hormonal Influence and Polycystic Ovary Syndrome (PCOS)

After conducting several tests, the medical team identified a potential underlying cause: the woman had polycystic ovary syndrome (PCOS). PCOS is a hormonal disorder that affects women of reproductive age and is often characterized by irregular menstrual cycles, ovarian cysts, and elevated levels of male hormones (androgens). One of the most common symptoms of PCOS is hirsutism, which refers to excessive hair growth in areas typically associated with male pattern hair growth, such as the face, chest, and abdomen.

In the case of this patient, the hair growth in her gums was an unusual manifestation of hirsutism. Normally, hirsutism associated with PCOS affects body parts that already have hair follicles, such as the face, arms, legs, and chest. However, in this case, the hairs were ectopic—meaning they grew out of place, in areas where hair should not have been present, such as the gums.

The connection between PCOS and gingival hirsutism was not immediately apparent. However, hormonal tests and ultrasounds helped to confirm the diagnosis. Elevated androgen levels in women with PCOS can result in the growth of hair in areas where it is not normally found. In this patient, the excess androgens likely triggered the growth of hair follicles in the gums, leading to the unusual presentation.

The Role of Hormonal Imbalance and Treatment

To address the patient’s condition, the medical team initially removed the abnormal hairs through surgical excision. This procedure was aimed at providing immediate relief. However, knowing that the condition was linked to hormonal imbalance, the patient was also prescribed oral contraceptives. Birth control pills are commonly used in the treatment of PCOS as they help regulate hormone levels, especially androgens, which can reduce the risk of hair growth in inappropriate areas. For a time, this seemed to keep the condition at bay.

However, just six years later, the woman returned to the clinic, and the hairs had regrown. She had stopped taking the oral contraceptives, and her gingival hirsutism had resurfaced. This time, the doctors didn’t just remove the hairs again—they took a biopsy of the affected tissue to examine it more closely under a microscope.

The biopsy revealed that the tissues in the affected area were unusually thickened, and hair shafts were emerging from these tissues. This suggested that the tissue changes were permanent, and that the gingiva had become a site for ectopic hair growth due to the hormonal imbalance associated with her PCOS.

The Role of Tissue Development and Embryology

Understanding why hair was growing in the gums requires an understanding of both embryology and the biology of skin and mucosal tissues. The tissues inside the mouth (oral mucosa) share several characteristics with the skin, including the presence of oil-producing glands, called sebaceous glands. These glands can sometimes lead to the development of conditions such as Fordyce granules, which are small, painless bumps that appear on the inside of the lips or cheeks.

The key question, however, is why some tissues, such as the mucosal tissues in the mouth, develop hair follicles under certain conditions, while others do not. Some researchers suggest that this may have to do with the development of skin structures during embryonic development. At certain points in fetal development, the tissues that later become the skin can interact with other tissues, leading to the activation of hair cells. This might explain why, in rare cases, hair follicles can appear in atypical locations, like the gums.

However, the exact mechanism remains unclear, and there is still much to learn about why some tissues develop hair follicles while others do not. The lack of a clear explanation leaves this phenomenon firmly in the realm of the unknown.

Current Understanding and Further Research

Although this rare case of gingival hirsutism has been extensively documented, there are still many unanswered questions. Why does hair sometimes grow where it shouldn't? And why did this patient's PCOS seem to exacerbate the issue?

The researchers involved in this case study caution that there are still many gaps in our understanding of gingival hirsutism. While it is clear that hormonal imbalances, particularly those associated with PCOS, can play a significant role, more research is needed to understand the underlying mechanisms. Future studies may shed light on the embryological processes that lead to ectopic hair growth in the gums and help develop targeted treatments for individuals affected by this rare condition.

As for the patient in this particular case, it is not clear whether she has returned to her prescribed medications or whether her symptoms have worsened. There is also no information on whether the gingival hair growth has caused any other health issues or discomfort. Given the uniqueness of this case, it is important for medical professionals to be aware of the possibility of gingival hirsutism when faced with similar symptoms.

Conclusion: A Rare Medical Mystery

The case of the woman with gingival hirsutism is a remarkable example of how medicine can surprise us. Though rare, this condition provides important insight into the ways that hormonal imbalances can affect the body in unexpected ways. The occurrence of hair in the gums is an anomaly, but by studying these rare cases, doctors can gain a better understanding of how different tissues interact with each other and how the body responds to hormonal changes.

For medical professionals, this case serves as a reminder that anomalies in the body should never be dismissed—sometimes, they can lead to new avenues of research and greater understanding of the complex systems that govern human biology.