PCOS Skin and Hair Problems: Understanding and Managing the Effects of Androgens
Women with Polycystic Ovary Syndrome (PCOS) often seek medical advice due to the visible effects on their skin and hair. These issues, which can lead to dissatisfaction with appearance and lower self-esteem, are mainly caused by higher levels of androgens (male hormones).
This article delves into how androgens affect the skin and the various ways women with PCOS can manage the associated symptoms, such as excessive hair growth, acne, and hair loss.
How Androgens Impact Skin and Hair
PCOS and higher androgen levels can lead to several noticeable skin and hair changes. These include:
Unwanted Hair Growth (Hirsutism)
Excessive hair growth, also known as hirsutism, is one of the most common effects of elevated androgens in women with PCOS.
This hair tends to be darker, coarser, and appears in places typically seen in men, such as the chin, upper lip, and around the abdomen. In society, women often feel pressured to maintain minimal body hair, making unwanted hair growth particularly distressing.
Hair Loss (Alopecia)
Another significant issue for many women with PCOS is alopecia, or hair thinning, particularly on the scalp.
This can be especially noticeable at the hairline or around the forehead, leading to frontal balding. While hair thinning can have other causes, in women with PCOS, it’s often linked to the hormonal imbalance caused by androgens.
Acne and Skin Oil Production
Increased androgen levels can also lead to acne by stimulating the skin’s oil production. This can make acne harder to treat and more persistent over time. For women with PCOS, acne may occur not only on the face but also on the chest, back, and shoulders.
Painful Skin Conditions
Women with PCOS may also experience painful skin conditions like Hidradenitis Suppurativa, which causes abscesses and scarring. This condition, while not exclusive to PCOS, is more common among women with the syndrome.
How to Assess Unwanted Hair Growth
In the UK, many women feel the need to have minimal body hair, which can lead to feelings of embarrassment or frustration if they experience excessive hair growth due to PCOS. To assess whether your hair growth may be due to androgen excess, consider the following:
- Is the hair growth darker and coarser than the fine hair on other parts of your body, like the upper lip or chin?
- Does the hair appear in places that are unusual for women, such as the chest, back, or face?
- Is it noticeable even in areas like your forearms or legs?
If you find that the hair meets these criteria, it may indicate hirsutism. It’s advisable to consult with a GP, who can refer you to a specialist for further evaluation and possible treatment.
Managing Unwanted Hair Growth
For many women with PCOS, lifestyle changes such as weight loss may help improve symptoms over time. However, medication is often needed for more immediate or long-term solutions.
Medications can help slow hair growth and prevent it from returning, especially when combined with hair removal techniques like laser treatment or electrolysis.
Medications for Hair Management
Medications can take several months to show noticeable effects, and it’s essential to remain patient during this process. Some common treatments include:
- Combined Oral Contraceptive Pills: These are often the first-line treatment for PCOS-related hair growth. These pills can help regulate hormones and reduce androgen levels, thus slowing down excessive hair growth.
- Antiandrogens: Medications like Cyproterone Acetate and Spironolactone block the effects of androgens on the body, preventing excessive hair growth. They are often used in combination with oral contraceptives for maximum benefit.
Side Effects and Risks of Medications
While medications can effectively manage unwanted hair growth, they do come with potential side effects. For example, the combined oral contraceptive pill may increase the risk of blood clots, particularly in women who smoke, are overweight, or have a history of certain medical conditions. Similarly, antiandrogens can cause side effects like dizziness, menstrual irregularities, and possible kidney issues when used inappropriately.
Hair Removal Options for PCOS
Several hair removal methods can provide relief from unwanted hair caused by PCOS, but they do come with varying degrees of effectiveness:
- Laser Treatment: This is the preferred method for women with darker hair, as it targets hair follicles to reduce hair growth. However, it can be costly and is typically not available on the NHS.
- Electrolysis: More suitable for those with lighter hair, electrolysis uses electrical currents to destroy hair follicles, preventing future hair growth.
- Shaving, Waxing, and Plucking: These methods offer a temporary solution by removing hair from the surface. While they may cause some discomfort, they are generally safe for most people.
- Hair Bleaching and Vaniqa Cream: For those who prefer not to remove the hair, Vaniqa (eflornithine cream) can slow hair growth, especially on the face. Bleaching can also help lighten hair, making it less noticeable.
Treating Acne Associated with PCOS
Acne treatment for women with PCOS often requires a multi-pronged approach. Some women benefit from topical treatments such as benzoyl peroxide or retinoids, while others may need oral medications like antibiotics or oral isotretinoin for more severe cases. Topical minoxidil can also help with hair thinning, although it is not widely available on the NHS.
Making the Right Treatment Decision
When managing PCOS skin and hair issues, it is crucial to address each symptom step by step. Many women find success with a combination of lifestyle changes and medications.
It’s important to tailor treatments to your specific needs and monitor their effectiveness over time. Consulting with a healthcare provider is essential in determining the best course of action.
FAQs
What is hirsutism and how does it relate to PCOS?
Hirsutism refers to the growth of dark, coarse hair in areas where women typically have fine hair. It is caused by elevated androgen levels in women with PCOS.
How can I manage acne caused by PCOS?
Acne can be managed with topical treatments like benzoyl peroxide or retinoids, and in more severe cases, oral antibiotics or isotretinoin may be prescribed.
Is laser hair removal effective for PCOS?
Laser treatment is effective for dark hair and can reduce hair growth, although it can be costly and is not always available through the NHS.
Can weight loss improve PCOS-related hair and skin issues?
Weight loss can help regulate hormone levels and improve PCOS symptoms, including hair growth and acne.
What are the side effects of antiandrogens?
Antiandrogens like spironolactone can cause dizziness, irregular periods, and kidney issues. Regular monitoring is necessary.