Polycystic ovary syndrome and skin – Harvard Health Blog


Often, the skin can be a window into what is going on in your body. For women with polycystic ovary syndrome or PCOS, this can mean acne, hair loss, excessive growth of facial or body hair, dark spots on the skin or any combination of these problems.

What is PCOS?

Skin and hair problems can be the most easily noticeable features of PCOS and therefore sometimes the reason for seeking medical attention. However, the characteristics of PCOS also include menstrual irregularities, polycystic ovaries (when the ovaries develop multiple small follicles and do not release eggs regularly), obesity, and insulin resistance (when cells do not respond well to insulin). ).

The cause of PCOS is not fully understood, however scientific evidence notes hormonal imbalances, specifically excess testosterone (also known as hyperandrogenism) and insulin resistance. PCOS is the most common cause of infertility in women. Hormonal imbalances in PCOS alter the process of ovulation, and without ovulation, pregnancy is not possible. PCOS exists on a spectrum, meaning that not all women with PCOS have the same signs and symptoms. Due to the varying characteristics of this syndrome, it can be difficult to diagnose.

How do I know if I have PCOS?

There is no specific evidence which can be used to diagnose PCOS, so thorough and thorough work is needed, including laboratory tests and imaging. Laboratory tests usually involve measuring levels of various hormones, such as androgens. Imaging tests may include ultrasound of the ovaries. Requesting care from an experienced team, including primary care physicians, gynecologists, endocrinologists, and dermatologists, can establish the diagnosis.

What are the cutaneous manifestations of PCOS?

PCOS-related acne often erupts on the lower face, including the line of the jaw, chin, and upper neck. While not a hard and fast rule, these areas are considered a hormonal pattern for acne. Women with PCOS may notice that acne lesions are deeper, larger, and slower to resolve. Acne in PCOS usually gets worse during the menstrual period. Dermatologists often recommend the use of oral birth control pills or a medication called spironolactone to treat this type of acne. These treatments, when used in suitable patients who have no contraindications, can be very helpful in eliminating acne.

Another dermatological sign of PCOS is hirsutism or excessive hair growth in places where hair is usually absent or minimal. Common areas of hirsutism include the chin, neck, abdomen, chest, or back. On the scalp, however, baldness or thinning of the hair can be seen. Both hair problems are motivated by excess testosterone.

Sometimes, another skin disease called acanthosis nigricans appears, which are dark, velvety areas of the skin, usually in wrinkles of the skin, such as around the neck and armpits. This type of skin disease is also associated with insulin resistance and may be due to the stimulation of skin cells by insulin, which causes them to grow too much.

Treatment options and a tailor-made approach

Although there is no cure for PCOS, there are many treatment options to control various symptoms of this syndrome. The types of treatments used depend on the woman’s priorities and symptoms. For example, having a healthy weight can lead to improved symptoms, so lifestyle changes in nutrition and exercise can help. Hirsutism can be treated with laser hair removal or electrolysis. Some patients may try birth control pills to improve menstrual regularity. Metformin, a commonly used medication for diabetes, can be used to help improve the body’s response to insulin.

Treatment planning is tailored to each person and depends on whether or not pregnancy is a short-term goal. Some medications, including spironolactone and retinoids for acne, should be avoided if a woman tries to get pregnant.

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