Ultimate Guide to Dermatological Care for PCOS

Polycystic ovary syndrome (PCOS) affects up to 15% of women of reproductive age, with nearly 90% experiencing skin and hair-related symptoms. Common issues include acne, hirsutism (excess hair growth), androgenic alopecia (hair thinning), and dark skin patches caused by hormonal imbalances and insulin resistance. Treating these symptoms requires addressing both the visible effects and underlying causes.

Key Takeaways:

Skin Symptoms: Jawline acne, dark patches (acanthosis nigricans), and inflammation caused by elevated androgens.
Hair Concerns: Excess facial/body hair (hirsutism) and scalp hair thinning (androgenic alopecia).
Treatment Options: Oral contraceptives, spironolactone, eflornithine cream, metformin, laser hair removal, and topical therapies.
Daily Care: Gentle skincare routines, sulfate-free hair products, and sun protection.
Lifestyle Changes: Low-glycemic diets, regular exercise, and stress management.

For lasting results, combine medical treatments with consistent skincare, haircare, and lifestyle improvements. Regular dermatologist visits and telehealth services like Oana Health can simplify access to tailored care.

PCOS & Skin | Dermatologist Review

How PCOS Affects Your Skin and Hair

The skin and hair issues linked to PCOS stem from hormonal imbalances. Elevated androgen levels and insulin resistance are the key culprits, working together to trigger symptoms that often don’t respond to typical skincare routines. Let’s break down how these imbalances impact your skin and hair.

How Androgens Contribute to PCOS Symptoms

Increased androgen levels in PCOS overstimulate sebaceous glands, leading to an overproduction of sebum. This excess sebum mixes with dead skin cells and bacteria, clogging pores and causing inflammatory acne. PCOS-related acne is often more severe, appearing as deep, painful lesions that take longer to heal. These breakouts are commonly found on the lower face, including the jawline, chin, and upper neck area.

Hirsutism, or unwanted hair growth, is another common symptom, affecting 70% to 80% of those with PCOS. Androgens can stimulate hair follicles in areas typically associated with male hair growth, such as the face, chest, back, and abdomen, resulting in coarse, dark hair in these regions.

"Hirsutism, acne or androgenic alopecia are conditions that can be the result of increased production of male hormone, called androgens, in women with PCOS." – Cedars-Sinai

Interestingly, while androgens promote unwanted body and facial hair, they can cause the opposite effect on the scalp. High androgen levels may shrink scalp hair follicles, eventually leading to hair thinning or androgenic alopecia.

Insulin Resistance and Skin Changes

Insulin resistance is another hallmark of PCOS, further complicating the hormonal imbalance. It stimulates the ovaries to produce more androgens, creating a cycle that exacerbates symptoms.

One of the more visible effects of insulin resistance is acanthosis nigricans - dark, velvety patches of skin that typically appear on the neck, armpits, and sometimes the face. Alongside these patches, skin tags often develop in the same areas. These small, soft growths may improve as insulin levels are brought under control through treatment.

Addressing these skin and hair issues requires more than just surface-level solutions. Comprehensive care that targets these internal imbalances is key to managing PCOS symptoms effectively.

Medical Treatments for PCOS Skin and Hair Issues

When general treatments don’t fully address PCOS-related skin and hair concerns, prescription options can provide more targeted relief. These treatments work by addressing the hormonal imbalances - like elevated androgen levels and insulin resistance - that often drive these issues. By focusing on the underlying causes, they offer both symptom management and long-term improvements.

Prescription Creams and Medications

Oral contraceptives are a go-to treatment for managing acne and unwanted hair growth linked to PCOS. They help regulate menstrual cycles and reduce androgen levels. Combination pills containing ethinyl estradiol with low-androgenic progestins - like norgestimate, drospirenone, or norethindrone acetate - are especially effective. Another option is spironolactone, which blocks androgens from binding to receptors, reducing acne and hirsutism. However, spironolactone is not safe during pregnancy.

"Dermatologists often recommend the use of oral contraceptive pills or a medication called spironolactone to treat this type of acne. These treatments, when used in the right patients who have no contraindications to them, can be very helpful in clearing acne."
– Kristina Liu, MD, MHS, Contributor, Harvard Health

For facial hair, eflornithine (Vaniqa) cream provides a topical solution that slows hair growth. While it doesn’t remove existing hair, regular use can significantly reduce the rate of new growth.

Retinoids, available in oral and topical forms, are another option. They help unclog pores and reduce inflammation, making them ideal for the deep, painful acne lesions often seen with PCOS.

Metformin, a medication that targets insulin resistance, also plays a role in managing PCOS symptoms. A Cochrane review found it as effective as oral contraceptives for treating hirsutism, making it a valuable alternative for those who can’t take hormonal treatments.

Professional Dermatology Procedures

For those seeking long-term solutions, in-office dermatology treatments can help.

Laser hair removal targets hair follicles directly, offering a lasting reduction in hirsutism. After a full treatment course, patients can see a 70% to 90% reduction in hair growth. Studies show that six sessions can reduce hair counts by 31% on average, with some patients experiencing hair-free intervals longer than six weeks.

"Laser hair removal gives women with PCOS a way to manage excessive hair growth in a long-term, low-maintenance way. For PCOS clients, it's the most efficient option available."
– Express Med Spa

Chemical peels improve skin tone and texture while addressing acne and scarring. These treatments are particularly helpful for reducing marks left by PCOS-related breakouts.
Microneedling stimulates collagen production to smooth out uneven skin texture and diminish acne scars. It’s a safe option for all skin types.

Online Treatment Options with Oana Health

Oana Health

Telehealth platforms like Oana Health offer prescription therapies tailored to PCOS symptoms, delivered straight to your door. Through a quick 5-minute online consultation, you can receive medical approval from a licensed professional and have treatments shipped for free. With a $20 doctor fee and ongoing support, these services make specialized care more accessible.

One standout option is Hairless Hype, a custom formulation combining eflornithine, metformin lotion, and azelaic acid. Results can appear in as little as 8 weeks, with 81% of women reporting significant improvement within a year. Pricing starts at $115 per month.

"It's been a little over 5 weeks, and I've noticed a dramatic reduction in my facial hair growth. This has been such a relief for me. You really have to stick with it and be patient to notice results!"
– Allison L.

For insulin resistance, Oana Health provides topical metformin starting at $89 per month. This option offers the benefits of metformin without the digestive side effects often associated with the oral form.

"I'm so glad I discovered Oana's metformin lotion! I used to struggle a lot with the side effects for oral metformin and this is a great alternative for me. I get the same benefits but no more upset stomach and nausea, and this helps me stick with it a lot more consistently."
– Carrie S.

They also offer oral minoxidil for hair loss at $25 per month (billed quarterly). Many users see reduced shedding within three months and thicker, fuller hair by six months.

"Dealing with PCOS has been challenging, especially the hair loss aspect. I started taking oral minoxidil and the results have been incredible. After three months, I saw less shedding, and by six months, my hair was visibly thicker and fuller."
– Emily R.

Individual treatments like eflornithine, spironolactone, topical spironolactone, and oral minoxidil are also available, allowing you to customize your care plan. These medical solutions complement daily skincare and haircare routines, offering a well-rounded approach to managing PCOS symptoms.

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Daily Care for PCOS Skin and Hair

While medical treatments address the root causes of PCOS-related skin and hair issues, daily care routines are essential for maintaining and improving their condition over time. Incorporating the right products, techniques, and lifestyle habits can make a noticeable difference in your skin's appearance and your hair's health between visits to your dermatologist.

PCOS Skin Care Routine

PCOS-related acne often shows up around the jawline, chin, and upper neck, making a consistent and gentle skincare routine a must. The key is to focus on cleansing, moisturizing, and protecting your skin without causing irritation.

Cleansing Twice Daily: Use a mild cleanser with warm water every morning and evening. Keep the cleansing process under 30 seconds to avoid stripping your skin of its natural oils.
Weekly Exfoliation: Once a week, gently exfoliate with a toner containing glycolic or lactic acid to remove dead skin cells.
Toning and Treatments: Opt for a toner with soothing ingredients like rose water or chamomile to calm inflammation. If you’re dealing with dark spots from past breakouts, a vitamin C toner can help brighten your skin over time.
Daily Moisturizing: Even oily skin needs hydration. Choose oil-free, non-comedogenic moisturizers, such as those with jojoba or argan oil, to keep your skin balanced.
Sun Protection: Apply a broad-spectrum sunscreen with SPF 30 or higher every day. Look for lightweight, non-greasy formulas to avoid clogging pores.

Simple habits like removing makeup before bed and drinking 2 liters of water daily can further support your skin's health.

As you care for your skin, don’t forget that similar attention can benefit your scalp and hair.

Hair Care for PCOS

Hair changes caused by PCOS - whether it’s thinning on the scalp or excessive growth in unwanted areas - call for a gentle, nurturing approach to maintain scalp health and prevent damage.

Gentle Washing: Wash your hair 2-3 times a week using a sulfate-free shampoo. Follow with a diluted conditioner to strengthen strands without weighing them down.
Styling Tips: Avoid excessive heat styling, and always use a heat protectant if styling is necessary. Detangle hair gently with a wide-toothed comb, starting at the ends and working upward. Opt for loose hairstyles to reduce tension on your scalp.
Scalp and Natural Treatments: Regular scalp massages can improve blood circulation, which may encourage healthier hair growth. Weekly DIY masks made with ingredients like fenugreek, castor oil, aloe vera, or hibiscus can nourish and strengthen your hair.

Healthy hair starts from within, so a balanced diet and regular exercise are also crucial for supporting hair vitality.

Diet and Lifestyle Changes

What you eat and how you live can significantly impact PCOS symptoms, including skin and hair health. Since insulin resistance affects up to 75% of those with PCOS, dietary adjustments can be especially helpful.

Focus on Whole Foods: Choose low glycemic index options like whole grains, legumes, vegetables, and fruits. Anti-inflammatory foods - such as berries, leafy greens, fatty fish like salmon, and healthy fats from avocados, nuts, and olive oil - can help maintain hormonal balance.
Protein and Fiber: Incorporate lean proteins like chicken, tofu, or lentils alongside high-fiber foods like cruciferous vegetables, beans, and berries. Cut back on inflammatory foods such as fried items, sugary drinks, processed snacks, and refined carbohydrates like white rice.
Stay Active: Aim for 150 minutes of exercise weekly, blending cardio (like walking, swimming, or cycling) with strength training. Yoga is another excellent choice, as it reduces stress and supports hormonal health.
Manage Stress and Sleep Well: Practice mindfulness techniques like meditation or deep breathing to lower stress. Aim for 7–9 hours of sleep each night and stay hydrated by drinking at least 2 liters of water daily.

"If you are diagnosed with polycystic ovary syndrome, it doesn't mean that you are destined to have poor health. There is a lot you can do to take charge, minimize symptoms and keep yourself healthy."

– Amanda Stathos, M.S., R.D., L.D.N.

Why Regular Dermatologist Visits Matter

Daily skincare routines might be your first line of defense, but regular visits to a dermatologist play a critical role in managing PCOS-related skin issues. These appointments help track progress, fine-tune treatments, and catch potential problems early. Each visit provides an opportunity for a deeper evaluation of your skin's health.

Consistency and adaptability are crucial when dealing with PCOS-related skin concerns. Dr. Leslie Markle from U.S. Dermatology Partners explains:

"As a dermatologist, I can't address every symptom of PCOS, but I can help my clients develop a plan to manage PCOS-related skin symptoms. It's an ongoing process, but I can help patients find the right skincare routine and dermatologic treatments to improve the cutaneous aspects of the syndrome".

Because PCOS symptoms can shift over time due to hormonal changes, lifestyle factors, or treatment responses, what works today might not be effective in a few months. Regular check-ins ensure your treatment plan evolves alongside these changes, keeping your skin health on track and improving your overall well-being.

What Happens During Dermatology Appointments

When you visit your dermatologist, they’ll focus on areas commonly affected by PCOS, such as your face, neck, chest, and back, examining for acne and other skin changes. They’ll also review your treatment plan to see how well it’s working and make adjustments as needed. If your current medications aren’t delivering the desired results or are causing side effects, your dermatologist might modify dosages, switch treatments, or add new elements to your routine.

These visits are also a chance to refine your skincare regimen. Dermatologists can recommend specific products that work well with your prescription treatments, ensuring your daily skincare routine complements your overall strategy. This combined approach - daily care, medical treatments, and lifestyle adjustments - creates a more comprehensive plan for managing PCOS-related skin issues.

Additionally, dermatologists are skilled at distinguishing between normal skin changes and signs of worsening PCOS, allowing for timely interventions. Since skin and hair concerns are often among the first visible signs of PCOS, regular visits are essential for early detection and management.

Team-Based PCOS Care

PCOS impacts multiple systems in the body, which is why a team-based approach to care is often the most effective. Dermatologists are a key part of this multidisciplinary team, addressing skin-related symptoms like acne, hirsutism, hair loss, and conditions such as acanthosis nigricans. These specialists play a vital role not only in managing symptoms but also in diagnosing PCOS, especially since skin and hair issues are so common in those with the condition.

For example, hirsutism is one of the most distressing symptoms for many individuals, while acne affects 20–40% of women with PCOS. Dermatologists provide tailored care for these concerns, ensuring they are treated as priorities rather than secondary issues. They may also collaborate with other healthcare providers to coordinate hormonal treatments, creating a more cohesive care plan.

Telehealth services like Oana Health can also be valuable in this team-based approach. With licensed medical professionals who can prescribe treatments for acne and unwanted facial hair, telehealth providers can work in tandem with your dermatologist to ensure you have continuous access to care between in-person visits. This ensures that your treatment plan remains consistent and effective.

It’s important to note that addressing cosmetic symptoms alone isn’t enough. Without tackling the underlying hormonal and metabolic issues, these treatments provide only temporary relief. Regular evaluations by a dermatologist are an essential part of a long-term strategy, complementing daily routines and telehealth treatments. This collaborative approach ensures that skin and hair concerns are given the specialized care they deserve, especially since hormonal treatments like contraceptive pills aren’t always effective, and untreated acne can significantly affect mental health.

Taking Control of PCOS Through Skin and Hair Care

Managing the skin and hair challenges associated with PCOS requires a thoughtful, consistent approach. Combining medical treatments with daily routines and lifestyle adjustments can lead to noticeable, lasting improvements. As hormone expert Dr. Jolene Brighten puts it:

"Skincare can be considered the finishing touch if you think of hormone balance as the foundation for your PCOS care. It's tempting to only focus on the quick fixes, but if you want to look - and more importantly feel - your best, focusing on hormone and blood sugar balance is a must."

Understanding the scope of PCOS symptoms is a critical first step. Research highlights that many women with elevated androgen levels deal with excess hair growth, hormonal acne, and insulin resistance. These symptoms often go hand-in-hand, making a comprehensive care plan essential.

Even small changes can make a big difference. For example, losing just 5% of body weight can significantly reduce PCOS symptoms. This could involve adding more fruits, vegetables, and lean proteins to your meals, combined with regular exercise to improve insulin sensitivity. Stress management techniques like yoga or meditation can also help regulate hormones. These daily practices are building blocks for managing PCOS effectively.

Access to specialized care has also improved with telehealth services. Platforms like Oana Health are making it easier for women to get personalized PCOS care. A 2023 study published in Telemedicine and e-Health found that telehealth reduced out-of-pocket expenses for PCOS patients by 40%. Dr. Jessica Sanders, a Reproductive Endocrinologist at the University of Utah Health Center, explains:

"Telehealth is closing an enormous gap for women with PCOS who live far from specialized care. It's proving to be not only convenient but clinically effective."

Oana Health, for instance, offers science-backed treatments delivered right to your door, with a low $20 doctor fee. Their "Hairless Hype" treatment has shown impressive results, with 81% of women reporting significant improvement within one year, and some seeing changes in as little as 8 weeks.

Addressing PCOS-related skin and hair issues isn’t just about aesthetics - it’s about supporting your overall health. Persistent skin problems can contribute to anxiety and depression, which are more common among individuals with PCOS. By committing to consistent care, medical treatments, and expert guidance, you’re not only improving your physical appearance but also prioritizing your mental well-being. Every step you take is an investment in your health and quality of life.

FAQs

Making some shifts in your daily habits - like eating better and staying active - can make a big difference when it comes to managing PCOS-related skin and hair concerns. Regular exercise boosts insulin sensitivity and reduces androgen levels, which can help with acne, unwanted facial hair, and thinning hair.

When it comes to your diet, focusing on whole foods, plenty of fiber, lean proteins, and healthy fats while cutting back on processed foods and added sugars can help keep your hormones in check. These dietary adjustments are key to managing insulin levels, which play a major role in controlling symptoms like acne and hair loss. By sticking to these lifestyle changes, you’ll not only support healthier skin and hair but also enhance your overall health.

What are the best medical treatments for severe acne and excessive hair growth caused by PCOS?

When it comes to managing severe acne associated with PCOS, oral retinoids like isotretinoin (often recognized by the brand name Accutane) can be highly effective. They work by reducing inflammation and helping to clear up the skin. In addition to oral options, topical treatments - such as antibiotics or retinoids - may be recommended to address breakouts and improve overall skin texture.

For dealing with excessive hair growth, also known as hirsutism, hormonal treatments like combination oral contraceptives are commonly the first choice. These help regulate hormone levels and suppress the production of androgens, which contribute to unwanted hair growth. To enhance results, anti-androgens such as spironolactone, finasteride, or flutamide might be added to the treatment plan. These medications work to further lower androgen levels and slow hair growth. It's important to consult a licensed healthcare provider to find the treatment approach that works best for your individual needs.

Oana Health simplifies the process of addressing PCOS-related skin and hair concerns by offering expert care through telehealth. With remote consultations from licensed medical professionals, patients can access tailored, evidence-based treatment plans - all without ever stepping into a clinic.

Telehealth removes typical obstacles like travel, extended wait times, or the challenge of finding local specialists. This means patients can receive the care they need right at home. Plus, Oana Health ensures added convenience by delivering prescription treatments straight to patients' doors with free shipping, making the entire experience hassle-free.