"The condition is thought to be caused by incorrect hormone levels," explains Dr Prudence Knight, online doctor at Push Doctor. "It is usually comprised by at least 2 out of 3 irregular or absent periods, cysts on the ovaries on ultrasound and abnormally high testosterone levels (male hormones) in the blood. Aside from absent or irregular periods, another symptom could be a difficulty becoming pregnant due to absent or infrequent ovulation," adds Dr Prudence, but PCOS can also manifest in many other physicalities, such as hirsutism (excess hair growth, typically on the face and also on the chest, buttocks and back), head hair thinning or loss, acne and weight gain.
For those living with PCOS, these skin-deep symptoms can be debilitating. According to support group PCOS UK, the condition affects women in different ways, so not all women will have these features, but for those who do, research has shown that acne, hair loss and excess hair growth in particular can have a profound psychological impact, affecting quality of life for many and even worsening anxiety and depression in some cases. While there is no cure for PCOS, a lot can be done to treat the symptoms.
"For example, acne may be more likely to respond to specific pills that reduce or block the amount of testosterone in the body," says Dr Prudence. Contraceptive pills are popular among those with PCOS, as is anti-androgen (male hormone-blocking) oral medication, spironolactone, for treating both acne and hair issues. "Off-label, spironolactone can help with both types of hair problem," says dermatologist and author of The Skincare Bible, Dr Anjali Mahto. "It can potentially improve both scalp hair growth and hirsutism. However, in this context it should only be prescribed by a consultant dermatologist with experience in its use as it is an unlicensed treatment." Excess hair growth can also be treated with the usual removal techniques, explains Dr Prudence, such as laser hair removal or IPL (intense pulsed light). "Special creams may also help, although it is important to remember that hair can grow back on stopping treatment."