While PCOS impacts how we feel inside, many people first notice the physical symptoms of the condition. These include changes to their hair and skin, like acne, pigmentation, hair growth and hair loss. 

Even in those without PCOS, there’s no normal when it comes to hair and skin. While some people aren’t bothered about where they have body hair, others enjoy the feeling of shaving, waxing or lasering it off. Spots are also a normal part of having skin and there should be no shame in outbreaks. 

However, knowing why you might be seeing changes in your hair or skin if you have PCOS is important. Not only will it help to normalise the symptoms, but often our skin and hair can tell us about what’s happening to our hormones.

Why does PCOS cause excess hair and hair loss?

Excess hair growth, known as hirsutism, is a common symptom of PCOS, impacting up to 80% of people with the condition. Typically, people deal with male-pattern hair growth, meaning thick hair around areas like their face, armpits or genitals. The hair growth is due to excess androgen hormones, including testosterone. 

These high levels of hormones can also incidentally cause hair loss or hair thinning in certain places, like on your head. 

How you deal with it is personal. If you want to remove the excess hair, the NHS advises plucking, shaving, threading, creams or laser removal. In some parts of the UK, laser removal of facial hair is available on the NHS, so it’s worth speaking to your doctor about your concerns. 

To stop the hair growth, the NHS also recommends trying a cream called eflornithine, which works within eight weeks. It can be available on prescription, though not all NHS authorities deem it effective enough to prescribe. 

To support hair growth or avoid more hair loss, you can try to be gentle with styling. Too much heat, brushing or pulling can cause more hair to fall out. It might be worth talking with a hair stylist about products or styles that will help you maintain volume and thickness. 

Some hormonal contraceptive pills are also recommended for excess hair growth and hair loss, as they suppress levels of androgen hormones with synthetic estrogen or progesterone. This treatment won’t be right for everyone, particularly those who are trying to conceive, so other ways of reducing testosterone may be beneficial. 

These include lifestyle factors including changing your diet to centre around meals with a low glycemic index and high antioxidant content, which research shows can reduce androgen levels.

However, always make sure you talk to your doctor before making any changes to your diet or taking medication for PCOS symptoms.

Does PCOS cause acne?

Skin problems are also prevalent in people with PCOS. Acne is thought to impact between 36% and 76% of people with the condition, while other skin conditions like seborrhea (scaly and inflamed skin, known as ‘dandruff’ when present on the scalp) and acanthosis nigricans (discolouration and dark pigmentation) are also associated with the condition. 

These also come down to hormonal imbalances, including high levels of testosterone and luteinising hormone. 

While the temptation may be to scrub and layer products to the skin, it’s best to avoid excess treatments that further disrupt the skin barrier or cause more oil. Instead, the NHS advises using topical retinoids and azelaic acid. While these can be purchased over the counter from mainstream cosmetic brands, it’s best to apply these safely: build up usage from once a week to every few days before applying daily to avoid reactions and always suncream when applying strong treatments as they can make your skin more sensitive. 

If these products don’t work for you, talk to your GP as they may be able to offer prescription medication for your skin, like benzoyl peroxide or antibiotics. They can also refer you to a dermatologist who can offer specialised treatments. 

The NHS also says contraceptive pills work for some people who have acne, again because they reduce the levels of androgen hormones. And when it comes to your skin, diet can play a large role. A recent study showed that acne is linked with insulin resistance, which can be common in people with PCOS but managed with a diet that supports blood sugar levels – think well-balanced meals that are high in protein and fibre.

If you are down about your skin or hair as a result of PCOS, try to remember that there is no normal, and most people don’t have the clear complexions or buoyant locks seen on Instagram. But there are ways to look after your hormones and health that can improve your acne and hair growth, so do talk to your doctor or other experts about ways to manage your symptoms.