Illustration for: The Ferriman-Gallwey Score: How Bad Is My Hirsutism?

The Ferriman-Gallwey Score: How Bad Is My Hirsutism?

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Short answer: The modified Ferriman-Gallwey (mFG) score is the standard way doctors measure hirsutism. Coarse, dark hair is rated from 0 to 4 in nine body areas, for a total of 0 to 36. In Black and White women, a score of 8 or more usually counts as hirsutism, but the cutoff differs by ethnic background. Scoring yourself is a useful first step, but self-scores tend to run higher than a doctor’s. Any amount of hair that bothers you is worth discussing.

If you have ever wondered “how bad is my hirsutism?”, the Ferriman-Gallwey score is the tool doctors use to answer that question. (New to the term? Start with what is hirsutism?.) This guide explains where the score comes from, which body areas count, how to score yourself, and what your number does and doesn’t mean. You can use our interactive self-check below to add up your score.

Woman’s lower back above leggings

What is the Ferriman-Gallwey score?

The score is named after David Ferriman and J.D. Gallwey, two doctors at North Middlesex Hospital in London. In 1961 they graded hair growth at 11 body sites in 430 women aged 15 to 74. They noticed that hair on the forearms and lower legs was common in most women, while hair at the other sites was more likely to reflect hormone levels. So they created a “hormonal” score by adding up the grades from 9 of the 11 sites.[1]

The version used today is the modified Ferriman-Gallwey (mFG) score, introduced by Hatch and colleagues in 1981. It uses nine areas and drops the forearms and lower legs, because those areas grow hair even with very low androgen levels in healthy women.[2] Each area is scored from 0 (no terminal hair) to 4 (extensive, “frankly virile” growth), for a total of 0 to 36.[3], [2]

Visual scoring is semi-quantitative at best, and different examiners can give different scores. Still, a review of hair-scoring methods concluded that the mFG is a useful and practical tool, while more objective methods such as photography and microscopy are too complex and costly for everyday care.[4]

The nine body areas

The mFG score rates terminal hair, the coarse, dark kind, in these nine androgen-sensitive areas:[3], [2]

  1. Upper lip
  2. Chin
  3. Chest
  4. Upper back
  5. Lower back
  6. Upper abdomen (above the belly button)
  7. Lower abdomen (below the belly button)
  8. Upper arms
  9. Thighs

Fine, light vellus hair (“peach fuzz”) does not count, however much of it you have. Neither does hair on the forearms or lower legs.[2] The score also doesn’t include the sideburns, neck or buttocks, so hair in those areas may not show up in your total.

How to score yourself

Doctors score hair growth during an examination. You can do a rough version at home. These steps help you get a fairer result:

  1. Let the hair grow back first, if you can. Hair removal hides your true score. Expert guidance for clinical exams suggests no shaving for at least 5 days, no waxing or depilation for at least 4 weeks, and no laser or electrolysis for at least 3 months beforehand.[2] If that isn’t realistic for you, score what you remember from before you removed it, and keep in mind that this is less accurate.
  2. Use good light and a mirror. A hand mirror helps for the upper lip and chin. Ask someone you trust, or use your phone camera, for the back.
  3. Score each area from 0 to 4. 0 means no terminal hair. 4 means extensive coarse hair, similar to a typical adult man. Scores of 1 to 3 cover the range in between, from a few scattered hairs to heavy growth.[3]
  4. Add up all nine areas to get your total out of 36.
  5. Note which areas bother you most, even if their score is low. This is useful information for your doctor.

Hirsutism self-check

This self-check uses the modified Ferriman-Gallwey scale, the same scale doctors use to assess hirsutism. You’ll see 9 body areas. For each one, pick the drawing that comes closest to how that area looks without any hair removal. It takes about 2 minutes, and your answers stay in your browser.

Your result from the self-check is a starting point, not a diagnosis. For a broader view, including periods and other symptoms, try our hirsutism or just hairy? quiz.

What does my Ferriman-Gallwey score mean?

There is no single "normal" score. What counts as excess hair depends on your ethnic background, because normal body hair varies between populations.[2] The Endocrine Society guideline gives these cutoffs for women of reproductive age:[3]

PopulationScore that suggests hirsutism
Black and White women in the US and UK8 or more
Mediterranean, Hispanic and Middle Eastern women9-10 or more
South American women6 or more
Asian womenFrom about 2 to 7 or more, depending on the group

The 2023 international guideline for PMOS, previously called polycystic ovary syndrome (PCOS), uses a lower cutoff of 4-6 or more, depending on ethnicity.[5] A study of 633 unselected Black and White women found that a score of 3 or more already set apart the top 22% of women. Most of these women considered themselves hirsute, and the researchers concluded that a score of 3 or more identifies hair growth outside the norm.[6]

Mild, moderate or severe?

Many studies grade hirsutism by total score. A common scheme, described in the Androgen Excess and PCOS Society consensus, is:[2]

  • Mild: up to 15
  • Moderate: 16 to 25
  • Severe: above 25

These bands are not universal. For example, a Turkish dermatology study used 8-16 for mild, 17-24 for moderate and above 24 for severe. In that study of 227 women, 81% had mild hirsutism.[7] Severity on paper also doesn't tell you how much the hair affects your life.

A low score can still matter

Hair can be concentrated in one or two areas, most often the face, without pushing your total over the cutoff.[2] A score of 4 made up entirely of chin hair can be far more distressing than a score of 10 spread across the body. The Endocrine Society uses the term "patient-important hirsutism" for unwanted hair of any degree that causes enough distress to want treatment.[3] Your score helps your doctor decide which tests you need. It doesn't decide whether you deserve treatment.

The Ferriman-Gallwey Score: How Bad Is My Hirsutism?

How accurate is scoring yourself?

Self-scoring is useful but tends to overestimate. The Endocrine Society notes that self-scores agree only modestly with scores from trained examiners.[3] In a 2024 Brazilian study of 188 women, self-assessed scores were on average about 4.7 points higher than clinicians' scores.[8] Self-scoring rarely missed women who really had hirsutism: 95% of them scored above the cutoff. But many women without hirsutism also scored above it. The authors concluded that self-scoring is better for screening than for diagnosis.[8]

Doctors are not perfect either. Even trained examiners can disagree, because the score relies on judgment.[4], [2] If your score is close to the cutoff, focus on how much the hair bothers you and on other symptoms, such as irregular periods or acne.

What happens after scoring

The Endocrine Society recommends:[3]

  • A blood test for total testosterone in all women with an abnormal score
  • Further tests, such as early-morning free testosterone or 17-hydroxyprogesterone, depending on the result and your symptoms
  • No routine blood tests for women with regular periods who only have unwanted hair in one small area and a normal score

The most common cause of an abnormal score is PMOS. It accounts for 70-80% of women with hirsutism.[3] Read more about what causes hirsutism and the tests used to diagnose it.

Can treatment lower your score?

Evidence: Strong Yes. The mFG score is the main way clinical trials measure whether a treatment works. In a Cochrane review of hirsutism treatments, spironolactone lowered scores by about 7.7 points more than placebo, although the evidence quality was low.[9] Hormone treatments take about 6 months to show an effect.[3] Tracking your score every few months can help you and your doctor see progress. See hirsutism medication for treatment options.

When to see a doctor

See a doctor if your score is above the cutoff for your background, if any amount of hair bothers you, or if your periods are irregular or have stopped.[10] Ask for an urgent appointment, whatever your score, if hair growth starts suddenly or gets worse quickly, your voice deepens, your muscles get bigger or your clitoris enlarges. These can be signs of a rare androgen-secreting tumor.[3], [10]

Frequently asked questions

What is a normal Ferriman-Gallwey score?

For Black and White women, scores below 8 are usually considered normal, but about 1 in 5 women score 3 or more.[3], [6] Cutoffs are lower for many Asian women and higher for Mediterranean, Hispanic and Middle Eastern women.[3]

Is a Ferriman-Gallwey score of 8 bad?

A score of 8 is the usual threshold for hirsutism in Black and White women. It counts as mild on most grading schemes.[3], [2] It is a reason to talk to a doctor, not a cause for alarm.

Does facial hair count more?

No. Every area has the same 0-4 scale. That is one reason the score can underestimate how distressing facial hair is.[2]

Can I score myself if I shave or wax?

You can, but your score will be less accurate. Doctors face the same problem: recent hair removal makes accurate scoring difficult.[3], [2]

Key takeaways

  • The modified Ferriman-Gallwey score rates terminal hair from 0 to 4 in nine body areas, for a total of 0 to 36.
  • A score of 8 or more suggests hirsutism in Black and White women. Cutoffs differ by ethnic background.
  • Self-scores tend to be higher than doctors' scores, so use yours as a screening tool, not a diagnosis.
  • A low score can still matter, especially when hair is concentrated on the face.
  • An abnormal score usually leads to a testosterone blood test to look for the cause.

Sources

  1. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21(11):1440-1447. Link
  2. Escobar-Morreale HF, Carmina E, Dewailly D, et al. Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 2012;18(2):146-170. PubMed 22064667
  3. Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(4):1233-1257. PubMed 29522147
  4. Yildiz BO, Bolour S, Woods K, Moore A, Azziz R. Visually scoring hirsutism. Hum Reprod Update. 2010;16(1):51-64. PubMed 19567450
  5. Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469. PubMed 37580314
  6. DeUgarte CM, Woods KS, Bartolucci AA, Azziz R. Degree of facial and body terminal hair growth in unselected black and white women: toward a populational definition of hirsutism. J Clin Endocrinol Metab. 2006;91(4):1345-1350. PubMed 16449347
  7. Cebeci Kahraman F, Savaş Erdoğan S. Grading of hirsutism: a practical approach to the modified Ferriman-Gallwey scoring system. Adv Dermatol Allergol. 2022;39(4):744-748. Link
  8. Oliveira TF, Oliveira TF, Santana DC, et al. Comparison of self-assessed and clinician-assessed hirsutism diagnosed according to the modified Ferriman-Gallwey scale among female outpatients in Brazil. Arch Endocrinol Metab. 2024;68:e230271. PubMed 39420908
  9. van Zuuren EJ, Fedorowicz Z, Carter B, Pandis N. Interventions for hirsutism (excluding laser and photoepilation therapy alone). Cochrane Database Syst Rev. 2015;(4):CD010334. Link
  10. NHS. Excessive hair growth (hirsutism). Accessed October 2026. Link

This article is for education and is not medical advice. Talk to a doctor about diagnosis and treatment.

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