PCOS and the Skin

September is Polycystic Ovary Syndrome (PCOS) Awareness Month, an endocrine disorder that affects 1 in 10 women of childbearing age. While it is the leading cause of female infertility, it is also associated with other conditions from type 2 diabetes and endometrial cancer to skin issues like acne and excess body hair. PCOS is also closely associated with depression, some of which can be a result of insecurity with the surface level manifestations of the condition. As board certified dermatologists we see patients with PCOS all the time, and we’re so happy to work with their endocrinologists and OBGYNs to support the care of their skin so they can feel their best physically and emotionally.

What’s happening?

PCOS disrupts the ability for the pituitary gland to signal the body to produce the right amounts of estrogen, progesterone and testosterone. These levels become imbalanced triggering estrogen and progesterone drop and testosterone to increase.

What does this have to do with Dermatology?

• Excess facial and body hair can develop because of high levels of testosterone. We can treat with oral anti-androgen Spironolactone (Aldactone) which also helps acne, and oftentimes use laser hair removal.
• Acne can be severe and cystic in patients with PCOS. We often see patients respond well to Spironolactone, Oral Contraceptives and Topical Modalities like Retinoids, Salicylic Acid and Benzoyl Peroxide. In severe, scarring cases of acne we may also consider Isotretinoin (Accutane).
• Dry skin and Dandruff may present when hormone levels cause sebum production to plummet. We recommend using non comedogenic, fragrance free moisturizers on the face and body and love the CLn and Vanicream dandruff shampoos.

PCOS is also linked to insulin resistance, obesity and type 2 diabetes. These conditions are associated with two other skin presentations, that are common to find in folds of the skin.

• Acanthosis nigricans are brown-to-black, poorly defined, velvety hyperpigmentation patches on the skin. They are most often found in body folds, such as the posterior and lateral folds of the neck, the armpits, groin, navel, forehead and other areas.
• Skin tags are benign collections of blood vessels and collagen surrounded by an outer layer of skin cells attached to the body with a stalk and commonly triggered by friction and found in areas of skin to skin contact. In general, skin tags don’t require treatment. If skin tags hurt or bother you, you may opt to have them removed. Since they usually show up in skin folds, friction may play a role. Skin tags are made up of blood vessels and collagen surrounded by an outer layer of skin.

Learn more about PCOS and how to get involved with PCOS awareness month here.