Polycystic Ovary Syndrome (PCOS) is an extremely common hormonal disorder that affects up to 13% of women of reproductive age world-wide. Despite this yet, it remains undiagnosed in up to 70% of women who have it. In fact, most people are completely unaware of what polycystic ovarian syndrome is and its wide-ranging effects on the body including related skin symptoms. In this article we explore what it is, the symptoms of polycystic ovary syndrome and how it affects the skin. We’ll also discuss treatment options and
What is PCOS?
At its core, Polycystic ovary (or ovarian) syndrome is a complex endocrine (hormonal) disorder that largely affects women of reproductive age. It’s a condition where the ovaries produce an abnormal amount of androgens, these are the male sex hormones that are normally also present in women but in small quantities. These are usually accompanied by irregular menstrual cycles and polycystic ovaries which are small fluid sacs present on the ovaries when viewed on ultrasound. PCOS can manifest in a number of ways. These include fertility issues, metabolic complications like insulin resistance and obesity as well as cosmetic concerns like hirsutism (excessive hair growth on the body), acne and scalp hair thinning.
The exact cause of PCOS is still not known. However, it’s widely thought to be multifactorial and influenced by a combination of genetic, environmental and lifestyle factors. It’s important to note that, despite its name, not all women with PCOS have cysts on their ovaries. Also, having ovarian cysts doesn’t necessarily mean a woman has PCOS. That being said, PCOS is a serious condition that should be taken seriously if suspected. This is because it is a leading cause of infertility and also poses long-term health risks. These include type 2 diabetes, cardiovascular diseases and endometrial cancer. As such, early diagnosis and management is crucial.
Diagnosing Polycystic Ovary Syndrome
The process of diagnosing Polycystic Ovarian Syndrome is often difficult and depends on piecing together the signs and symptoms. This process requires a deep and nuanced understanding of the complexity of this disease. Unfortunately there aren’t any straightforward diagnostic tests, so a diagnosis of Polycystic Ovarian Syndrome hinges on a careful evaluation of the symptoms, physical examination, medical history and laboratory tests. The widely accepted Rotterdam criteria provides a good framework. It requires at least two of the following three symptoms for a diagnosis of Polycystic Ovary Syndrome:
- Irregular or absent menstrual cycles as these indicate abnormal ovulation
- Clinical or biochemical signs of hyperandrogenism (excessive male hormones),
- Polycystic ovaries visible through ultrasound
Blood tests can also play an important role. Doctors will measure levels of hormones such as testosterone, luteinising hormone (LH), and follicle-stimulating hormone (FSH) to fully assess the hormonal imbalances at play. At the same time, healthcare professionals often conduct tests to rule out other conditions with similar symptoms, such as thyroid disorders. Diagnosing PCOS is vital as it can help direct management. Since there isn’t a definitive treatment for PCOS, management is aimed around addressing the symptoms affecting the individual.
How PCOS Can Affect Your Skin
Polycystic Ovary Syndrome can have a huge impact on the skin but unfortunately this is an often overlooked aspect of this condition. The cause of the effects on the skin is directly linked to the hormonal imbalance inherent to PCOS. The main skin symptoms of Polycystic Ovarian Syndrome are:
- Acne & Oilier Skin
- Skin Tags
- Acanthosis Nigricans
- Hair thinning
The hormonal excess leads to increased sebum production, setting the stage for acne that is notably different from typical adolescent or adult acne. The acne associated with PCOS tends to be more persistent, severe, and primarily localised around the lower face, jawline and neck. These are the areas that are more sensitive to hormonal changes. The type of acne can range from deep, painful cystic spots to smaller and inflamed pustules. However, the impact of PCOS on skin health spans beyond acne. Women with this condition may also experience increased skin oiliness, further aggravating acne and contributing to a shiny complexion.
Beyond acne, PCOS can also cause skin lumps and discolouration in the form of skin tags and acanthosis nigricans. Skin tags are benign small and soft flesh coloured growths that often appear in skin folds such as the neck, armpits, and under the breasts. Although skin tags are not harmful they can catch on clothes and give discomfort. They may also cause self-consciousness especially if located in visible areas. PCOS sufferers may also develop a condition called acanthosis nigricans. This presents as dark, velvety patches of skin primarily in body folds like the neck, groin, and underarms. This condition is serious as it is a sign of insulin resistance which is a common metabolic disturbance in PCOS and can herald diabetes.
Poly Cystic Ovarian Syndrome can also cause hair symptoms. Sufferers may experience hirsutism, or excessive hair growth. This usually occurs areas typically seen in men, such as the face, chest and back. Conversely, there might also be hair thinning or loss on the scalp. This typically affects the temples and even the crown mirroring male pattern baldness.
Management and Treatment Strategies
The skin changes and symptoms in Polycystic Ovary Syndrome can profoundly affect self-esteem and emotional well-being. Given the complex nature of the condition and the link between internal and external symptoms, treatment often requires a multi-pronged approach. This aims to manage the underlying cause as well as directly address the problems. This involves a combination of:
- Lifestyle: Balanced diet and regular exercise can regulate hormones.
- Skincare: Specific skin treatments can manage acne and oiliness.
- Medical Treatments: For severe cases, treatments like hormonal therapy can help.
Navigating the dermatological symptoms of Polycystic Ovary Syndrome requires an interconnected approach. The key to managing PCOS skin is addressing the underlying hormonal imbalances. Lifestyle changes can also help especially a balanced diet low in processed foods and sugars, regular exercise and weight management. These play a significant role in regulating hormone levels and improving insulin sensitivity. For severe cases, Medical treatments may include hormone therapies such as the combined oral contraceptive pill and androgen blockers like spironolacatone. These can help balance androgen levels, thereby reducing symptoms like acne and hirsutism. Metformin, often used for managing insulin resistance, can also indirectly benefit skin health and treat conditions like acanthosis nigricans.
Skincare routines should focus on gentle hydrating products that calm the skin and support the skin barrier as well as protect it from the sun. Active skincare such as retinoids like Tretinoin and roaccutane can manage acne and oiliness. In some cases, professional treatments like laser therapy for hirsutism and hair loss as well as severe scars may help.
Recognising and addressing the skin symptoms of PCOS can hep to diagnose and manage this condition holistically. Early detection is crucial to avpid more serious side effects such as infertility, heart disease and diabetes so you should seek medical help as soon as you suspect PCOS. There is no single cure and so management of PCOS skin symptoms involves a blend of lifestyle changes, skincare routines and possibly medical intervention. It’s also important to note that the psychological impact of PCOS-related skin issues cannot be understated. The key is to understand and accept these changes in order to move forward and manage them.
At City Skin Clinic, we are absolutely committed to providing to personalised skincare. Our doctors offer safe effective treatments like Tretinoin and Hydroquinone through our online skin clinic. We treat a range of skin conditions such as acne, hyperpigmentation, melasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. Remember, the journey towards great skin starts here.