Managing PCOS Skin And Hair: Top Tips From A Dermatologist
PCOS, or polycystic ovary syndrome, is a very common condition that affects the workings of a woman’s ovaries. Polycystic means “many cysts”, which are present on the surface of the ovaries. The root causes of PCOS are not yet completely clear, but evidence suggests that hormonal imbalances are the major culprit, often resulting in varying symptoms from menstrual irregularities, to insulin resistance, to skin and hair issues. (You can read more about how our hormones affect our skin in this journal entry).
Since symptoms are on a spectrum, PCOS can be difficult to diagnose. It is important to connect with your doctor who will be able to offer advice and relevant testing. There is no cure for polycystic ovary syndrome, but the symptoms are often able to be managed through treatments, medication and lifestyle adjustments.
In today’s journal, I am going to share how the condition affects the skin and the hair, as well as offering my expert advice on how to manage these symptoms.
PCOS Hair Loss, Thinning And Growth
People suffering with polycystic ovary syndrome often report two separate hair complaints: excess hair growth across the face and body and hair thinning across the scalp:
Hirsutism refers to the growth of excess hair. The hair is often coarse and dark, and appears across the face, chest, stomach, back, arms and legs.
Androgenic alopecia is where hair falls from the root, and women commonly notice this as hair thinning along the parting, temples or increased visibility of the scalp.
Both hirsutism and androgenic alopecia are thought to be the result of excess androgen, a male hormone that is heightened in women with polycystic ovary syndrome.
As with many symptoms of the condition, hair issues can partially be managed through lifestyle choices such as eating a healthy, low in sugar, nutrient-rich diet and ensuring plenty of exercise. Vitamin D is particularly vital for hair growth – if the body doesn’t have enough vitamin D, keratinocytes within hair follicles struggle to support the natural cycle of hair growth, in turn resulting in shedding and hair loss.
As well as lifestyle adjustments, your doctor may also prescribe oral medications, such as the combined contraceptive pill which can treat both unwanted hair growth and hair loss, or topical products such as eflornithine cream for unwanted facial hair or minoxidil for hair loss. Laser hair removal or IPL therapy can also support in removing unwanted hair, but make sure to check your clinic of choice is registered with the Care Quality Commission or British Medical Laser Association.
In terms of my in-clinic treatments for hair loss or hair thinning, following consultation, I may recommend light therapy or platelet-rich plasma therapy to help stimulate hair growth.
PCOS Skin
When it comes to polycystic ovary syndrome and the skin, there are four regularly seen symptoms: acne (more on that later), skin tags, skin discolouration and dry, itchy skin:
Skin Tags: Polycystic ovary syndrome can prompt an increase in skin tags, particularly in skin folds on the neck and armpits or under the breasts. Whilst completely harmless, they can be uncomfortable if they rub or catch on clothes, and many people prefer to remove skin tags for comfort and cosmetic reasons. Cryotherapy (freezing off the tag with liquid nitrogen), excision or electrosurgery (burning the tag off with a small electrical charge) are all available in my clinic.
Itchy Skin: It is common for women with this condition to experience dry and itchy skin. Again, this is thought to be linked to the increase in androgens which can cause inflammation, eczema or eczema like symptoms. It is important to ensure you are adequately hydrating the skin through daily moisturisation and using lukewarm water to shower.
Skin Discolouration: Women with polycystic ovary syndrome may also experience darker, velvety patches of skin in the neck, groin and underarms, which is called acanthosis nigricans. This symptom is more serious, as it can be a sign of insulin resistance, a potential precursor of diabetes. Therefore, it is important to consult with your doctor should you notice darkening of the skin in any area. In some cases, your doctor may prescribe a medicine like metformin, used for managing insulin resistance that can also treat the symptoms of acanthosis nigricans.
PCOS Acne
As I mention above, polycystic ovary syndrome can often cause flares of acne, particularly across the lower face including the chin, jaw and upper parts of the neck. Once again, this symptom is caused by an excess of androgens, which result in overproduction of sebum. These lesions may be larger, deeper and longer-lasting for women with PCOS, and usually will worsen across the time of her monthly period.
Acne can be managed through in-clinic means such as LED treatments or chemical peels, topical options such as benzoyl peroxide and retinoids, or oral medication like the contraceptive pill, antibiotics or roaccutane. Your doctor may choose to prescribe spironolactone, which can help treat excess androgens.
I treat acne scarring in my clinic through microneedling, intense pulsed light (IPL), iPixel or CO2 laser.
PCOS Skin Care Products And Routine
As I share above, the many symptoms of PCOS require varying treatment – and it is crucial that you take expert advice when it comes to managing your skin and hair. However, there are some hard and fast rules that will help manage the effects of this condition on your skin.
A Gentle Cleanse Is Crucial: Focus on hydrating cleansers that help support the skin barrier and effectively remove impurities and make up. I love SkinCeuticals Gentle Cleanser for the face, and Joonbyrd MOON SWIM Hydrating Body Wash for the body. If you are concerned about acne, La Roche Posay Effaclar Cleanser is my top choice for blemish-prone skin.
Make Sure You Moisturise Daily: Treating your skin with a gentle yet effective moisturiser each day will help protect the skin barrier and reduce water loss, treating dry, flaky or inflamed skin. I recommend Avene Hydrance Aqua Gel for the face and our lightweight Joonbyrd LITTLE LOVE Nourishing Body Lotion everywhere else. If you have acne-prone skin, opt for a non-comedogenic, oil-free moisturiser such as Tatcha the Water Cream.
Don’t Scrimp On Sun Protection: As ever, sun protection is non-negotiable when it comes to protecting your skin. Ensure use of a high-factor broad spectrum SPF daily such as Mesoestetic Mesoprotech Melan 130 Pigment Control for the face or La Roche Posay’s Anthelios range for the body. Again, if you are suffering from acne, a non-comedogenic option such as EltaMD UV Clear will be more suitable for your skin.
