Ferriman - Gallwey score in quantification of hirsutism

Last reviewed 07/2021

In 1961, Ferriman and Gallwey described a scoring system to determine the degree of hirsutism

• scored the density of terminal hairs at 11 different body sites (i.e., upper lip, chin, chest, upper back, lower back, upper abdomen, lower abdomen, arm, forearm, thigh, and lower leg).
  • for each of these areas, a score of 0 (absence of terminal hairs) to 4 (extensive terminal hair growth) was assigned
    
    
  • hair growth over the forearm and lower leg was noted to be less sensitive and subsequent modifications of the Ferriman-Gallwey method have excluded scoring of these areas and hence nine body areas are used in the modified method (1)
    
    
  • subsequent studies showed that three body areas, the buttocks/perineum, the sideburn, and the neck-lower jaw, contributed more substantially to the total hirsutism score than did the nine body areas in the modified Ferriman- Gallwey (mFG) scoring system (2)
    
    
  • nonetheless, the mFG (i.e., only 9 body areas considered) scoring system still continues to be the most widely used method for visually scoring excess terminal body or facial hair growth for the clinical or investigational assessment of hirsutism
    • Upper lip
    • Chin
    • Chest
    • Upper back
    • Lower back
    • Upper abdomen
    • Lower abdomen
    • Upper arms
    • Thighs
    • in this scoring system, a total score of 8 is accepted as hirsutism [3]

Reference:

• 1) H. Hassa, H.M. Tanir, A. Yildirim, T. Senses, M. Eskalen, F.S. Mutlu The hirsutism scoring system should be population specific Fertil Steril 2005; 84:778-780
• 2) G.P. Redmond Clinical evaluation of the woman with an androgenic disorder G.P. Redmond (Ed.), Androgenic disorders, Raven Pres, New York (1995), pp. 1-20
• 3) Azziz R et al.. Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline J Clin Endocrinol Metab 2006; 91: 4237-4245