PCOS and Skin – Harvard Health Blog


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Often times, the skin can be a window into what is happening inside your body. For women with PCOS, or PCOS, this could mean acne, hair loss, excessive facial or body hair growth, dark spots on the skin, or any combination of these issues.

What is PCOS?

Skin and hair problems can be the most easily recognizable feature of PCOS, and thus sometimes a reason to seek medical attention. However, PCOS features also include menstrual irregularity, polycystic ovaries (when the ovaries develop several small follicles and do not secrete 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 It indicates hormonal imbalances, especially excess testosterone (also known as hyperandrogenism) and insulin resistance. PCOS is the most common cause of female infertility. Hormonal imbalances in PCOS disrupt ovulation, and without ovulation pregnancy is not possible. PCOS is on a spectrum, which means that not every woman with PCOS has the same signs and symptoms. Due to the difference in characteristics of this syndrome, it can be difficult to diagnose.

How do I know if I have PCOS?

there There is no specific test That can be used to diagnose PCOS, so thoughtful and thorough work is needed, including lab tests and imaging. Lab tests usually include measuring levels of various hormones, such as androgens. Imaging tests may include ultrasound of the ovaries. Seeking care from an experienced team, including primary care physicians, gynecologists, endocrinologists, and dermatologists, can determine the diagnosis.

What are the skin manifestations of PCOS?

Acne associated with PCOS often appears on the lower face, including the jaw line, chin and upper neck. Although it is not a hard and fast rule, these areas are considered a hormonal pattern for treating acne. Women with PCOS may notice that their acne lesions are deeper, larger, and slower to heal. The acne in PCOS usually worsens around the time of menstrual periods. Dermatologists often recommend the use of a birth control pill or 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 clearing acne.

Hirsutism, or excessive hair growth in places where there is no or little hair, is another dermatological sign of PCOS. Common areas of hirsutism include the chin, neck, abdomen, chest, or back. However, baldness or hair thinning may be seen on the scalp. Both of these hair problems are caused by excess testosterone.

Occasionally, another skin condition called acanthosis nigricans appears, which are dark, velvety areas of skin, usually in creases of the skin such as around the neck and under the armpits. This type of skin disease is also associated with insulin resistance and may be caused by the stimulation of skin cells by insulin, leading to their overgrowth.

Tailored treatment options and approach

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

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

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