Hair loss and acne linked to PCOS in young women
Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that affects millions of women worldwide.
Despite its prevalence, it’s often misunderstood and not diagnosed.
In addition to irregular periods and fertility issues, PCOS can appear in less obvious ways. These include acne and hair loss.
For many, these symptoms are the first clues that something deeper is at play.
Understanding the link between PCOS, acne, and hair loss is essential for early diagnosis and effective management.
What is PCOS?
Polycystic ovarian syndrome (PCOS) is a multi-system reproductive metabolic disorder and is generally widely misunderstood.
Women with PCOS experience raised hormone levels that cause metabolic imbalance and impact quality of life.
Doctors have diagnosed only 5-10% of women of reproductive age with PCOS.
The main symptoms of PCOS are excess male sex hormones (androgen hormone) such as testosterone and irregular menstruation.
To diagnose the condition, doctors require an ultrasound imaging that shows many cysts on the ovaries.
Cysts on ovaries are not normal!
Many people believe that many undiagnosed women suffer from PCOS. Some signs of PCOS include symptoms of early puberty. These can be more body hair, body odour, and excess oil on the skin and hair.
This can also look like hirsutism. Hirsutism is a condition that causes women to grow too much dark or coarse body hair in a male pattern. This means that hair is visible in places where women usually do not have dark, coarse hair. These areas include around the mouth and chin, the chest, back, buttocks, thighs, and pubic area.
This common symptom often occurs in about 60-70% of women with PCOS.
People with PCOS may have thick, dark hair growth in a male pattern. However, they can also face hair loss, known as androgenic alopecia.
Acne is a symptom of PCOS. About one-third of people with PCOS have hormonal acne or cystic acne.
Traditionally, people viewed acne as just a clogged pores and oily skin problem. However, recent studies show that acne has more complexity and links to conditions like PCOS.
Understanding PCOS
PCOS is a hormonal imbalance that affects how a woman’s ovaries function.
Its key features include:
- Hormonal imbalance: Elevated levels of male hormones (androgens) in women.
- Metabolic dysfunction: Insulin resistance and an increased risk of type 2 diabetes.
- Reproductive issues: Irregular ovulation, leading to fertility challenges.
Diagnostic Criteria (Rotterdam Criteria):
- Clinical signs (hirsutism, acne).
- Irregular or absent menstrual periods.
- Polycystic ovaries — detected via ultrasound showing multiple ovarian follicles.
Doctors diagnose when they meet at least two of these criteria.
Despite its name, not all women with PCOS have ovarian cysts, making diagnosis more complicated.
PCOS Symptoms and Diagnosis Breakdown
Key symptoms of clinical signs include:
- Hirsutism: Excessive hair growth in areas typical for male-pattern hair distribution.
- Acne: Often severe and resistant to conventional treatments.
- Alopecia: Thinning hair or male-pattern baldness.
Key symptoms of irregular or absent menstrual periods include:
- Infrequent menstrual periods.
- Lack of menstruation.
Key symptoms of metabolic symptoms include:
- Weight gain — particularly around the abdomen.
- Insulin resistance, leading to elevated blood sugar levels.
Many women with PCOS go undiagnosed.
Many women exhibit symptoms but remain undiagnosed because of such different presentations of the symptoms.
Some women have normal lab results but still experience symptoms.
How PCOS Causes Acne and Hair Loss
PCOS-related acne and hair loss stem from excess androgens.
Excess androgens stimulate sebaceous glands, resulting in increased sebum production. This overproduction clogs pores, leading to persistent acne.
These hormones also impact hair follicles, leading to two opposite but troubling effects. One is excessive hair growth in unwanted areas, known as hirsutism. The other is hair thinning or loss on the scalp, called androgenic alopecia.
The visible symptoms of PCOS, such as acne and hair loss, can take a significant toll on emotional well-being. Many individuals experience heightened anxiety, depression, and a notable drop in self-esteem because of the appearance-related concerns.
Beyond the emotional burden, the physical symptoms, often coupled with fertility challenges, can disrupt daily life. Struggling with these issues may impact one’s overall quality of life, affecting everything from social interactions to professional performance.
Treating these symptoms with medical care and lifestyle changes can reduce the physical and emotional effects of PCOS. This approach can lead to better health and well-being.
Recognising the Signs
Early symptoms of PCOS often include ongoing acne, especially around the jawline and chin.
You may also notice changes in hair growth. This can mean thinning hair on the scalp or extra hair on the face and body.
Many people also gain weight, especially around the belly. They may find it hard to lose weight, even if they live a healthy lifestyle.
What The Research Says
The African Journal of Reproductive Health looked at the link between PCOS, hair loss, and acne in women aged 21-45.
The study of 115 women found that 57% had PCOS symptoms.
Of this percentage, more participants had both acne and hair loss (59%) than those with just acne (52%) or only hair loss (57%).
Participants with regular menstrual cycles and normal hormone levels experienced PCOS symptoms. This is an important point to remember.
The study showed that young women and teenage girls with acne or hair loss should think about ultrasound pelvic testing for PCOS. This is important even if their periods and hormone levels are normal.
Diagnosing PCOS involves a combination of clinical evaluation, hormonal blood tests, and pelvic ultrasounds. Women with acne or hair loss should consider screening for PCOS, even if their periods seem normal.
Treatment Approaches
Managing PCOS requires a three-step holistic approach:
- Medical Therapies
- Oral contraceptives: Birth control pills help regulate menstrual cycles and reduce androgen levels.
- Anti-androgens: Oral antibiotics like spironolactone to decrease androgen effects.
- Metformin: Improves insulin sensitivity, aiding in weight gain, weight management, and ovulation.
- Dermatological Interventions
- Acne treatments: Including topical retinoid or salicylic acid, also prescription medication much as isotretinoin for severe cases.
- Hair loss solutions: Topical or oral minoxidil and anti-androgens.
- Hirsutism management: Laser hair removal.
- Lifestyle Modifications
- Diet: Emphasising low-glycemic foods to improve insulin sensitivity.
- Exercise: Regular physical activity to aid weight management and metabolic health.
- Stress reduction: Techniques like yoga and meditation to balance hormones.
Effective management of PCOS requires a combined approach with healthcare providers:
- Dermatologists: Address skin-related symptoms and improve quality of life.
- Gynecologists: Manage reproductive aspects and hormonal therapies.
- Endocrinologists: Oversee metabolic complications.
- Nutritionists: Provide dietary guidance.
Empowering Women Through Awareness
Left untreated, PCOS can lead to serious complications, including type 2 diabetes, heart disease, and fertility issues.
Recognising symptoms like acne and hair loss early allows for timely intervention, effective treatment, and better long-term outcomes.
Raising awareness about PCOS can empower women to seek help and take control of their health. Open discussions with healthcare providers and access to resources can make a significant difference.
Awareness is key!
It is important to know that symptoms like acne and hair loss can signal a hormonal disorder. This understanding helps with early intervention in PCOS.
Women experiencing these symptoms should consider seeking evaluation from healthcare providers for a comprehensive assessment to identify and address the condition.
Reducing the stigma surrounding PCOS through open conversations can also encourage earlier diagnosis and treatment, empowering individuals to manage their health more effectively.
Expert Opinion
Dr Lisa Byrom emphasises the importance of considering PCOS in young women presenting with acne and hair loss.
“Even if hormonal tests and menstrual cycles are normal, a pelvic ultrasound can provide valuable insights,” she explains.
Dr Byrom advocates for collaborative care to optimise patient outcomes.
Future Research and Advocacy
To improve the management of PCOS, we need better diagnostic criteria. This will help us understand the different ways the condition can show up.
Long-lead studies are important for following patients over time. They provide insights into how PCOS progresses and how well different treatments work in the long run.
Creating patient support groups can offer helpful resources and build a sense of community. This support helps those affected face the challenges of their condition with more strength and understanding.
PCOS is a complex condition.
Recognising the link between acne, hair loss, and hormonal imbalances empowers women to seek appropriate care.
By working together and raising awareness, healthcare providers can create complete treatment plans. These plans can help with both the physical and emotional aspects of PCOS, improving the lives of many women.
For women struggling with these symptoms, knowledge truly is power.
Reference: Mumin B, Wani I, Shahbaz Q, et al. Deciphering gynaecological pathologies in women with acne and alopecia: an imaging experience. Afr J Reprod Health 2023;27(5):30-40. doi: 10.29063/ ajrh2023/v27i5.3 [published Online First: 2023/08/16]
