Getting any kind of medical diagnosis can be freaky and raise a lot of questions. And being diagnosed with polycystic ovary syndrome (PCOS) is no exception. One aspect of PCOS in particular that tends to cause some confusion is the facial hair growth that can happen as a result of the condition.
In case you’re not familiar with it, PCOS is a health condition caused by an imbalance of your reproductive hormones, per the U.S. Office on Women’s Health (OWH). That hormonal imbalance causes a problem in your ovaries, which typically make an egg that is released each month as part of your menstrual cycle. When you have PCOS, the egg might not develop the way it should or it might not be released each month.
PCOS can cause a range of symptoms, according to the OWH, including:
Acne on the face, chest, and upper back
Darkening of the skin
Excess hair on the face, chin, or parts of the body where men usually have hair
While every woman’s experience with PCOS is different, excess hair growth as a symptom is very common.
At least seven in 10 women with PCOS experience excess hair growth (a.k.a. hirsutism), according to the American College of Obstetricians and Gynecologists (ACOG).
Of course, your body is yours alone, and only you should dictate how it looks. But if you have excess body hair from PCOS and it bothers you, there are a few things you can do. Here’s what you need to know.
Why does PCOS cause facial hair?
It all comes down to hormones, says Joshua Zeichner, MD, director of cosmetic and clinical research at the Icahn School of Medicine at Mount Sinai. “One of the hallmark features of polycystic ovary syndrome is a higher than normal level of androgen hormones,” he says. “These hormones contribute to many of the skin manifestations we see in these patients, such as acne and facial hair growth.”
Androgen hormones stimulate hair follicles to grow “to a greater degree” than they normally would, Dr. Zeichner says. While all women have vellus hairs on their face (or peach fuzz), androgen hormones cause the follicles to make what are known as terminal hairs, which are darker and thicker, “like the hair found on the scalp, underarms, and genital areas,” he says. As a result, you can end up with dark, thick hair in areas where you might have otherwise had peach fuzz, he says.
Wait, so is having chin or other facial hair a possible sign of PCOS?
Cushing’s syndrome. This is a condition that happens when your body is exposed to high levels of the hormone cortisol, either from your body making too much or being exposed through medications like prednisone, according to the National Institutes of Health (NIH).
Congenital adrenal hyperplasia. This is an inherited condition where your adrenal glands make abnormal levels of steroid hormones, including cortisol and androgen, the NIH says.
Certain medications. Minoxidil (Minoxidil, Rogaine), the endometriosis treatment danazol, testosterone (Androgel, Testim), and dehydroepiandrosterone (DHEA) can cause excess hair growth, according to the Mayo Clinic.
A tumor. White it's rare, a tumor in your ovaries or adrenal glands that secretes androgens can cause excess hair growth.
Ultimately, if you’ve developed chin or other facial hair, it’s a good idea to check in with your doctor. “It should be addressed with a gynecologist or dermatologist to ensure there are no other underlying causes,” Dr. Shepherd says. Just know this: “Sometimes, there is no known cause [for excess facial hair],” says Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies.
Can PCOS facial hair growth be prevented or reversed?
If you’re diagnosed with PCOS early and receive proper treatment, it may be possible to prevent facial hair growth, Dr. Greves says. But, she adds, “A lot of times people don’t even notice that they could have it until the problem of excess hair growth or irregular periods arise.”
There’s no one test that will tell if you have PCOS, but your doctor will generally take you through the following steps to diagnose you, according to the OWH:
A physical exam
A pelvic exam to check to see if your ovaries are enlarged or swollen, or if your clitoris is enlarged—these are signs of PCOS
A pelvic ultrasound to examine your ovaries for cysts
Blood tests to check your androgen hormone levels
Treating your PCOS can help get rid of excess facial hair, Dr. Shepherd says. “It requires managing the disease first to help decrease the amount of testosterone circulating,” she says. That can involve lifestyle changes, like eating well, exercising regularly, and reducing how much sugar you eat, she says, along with taking certain medications.
On the medication front, these are options for treating PCOS, per the OWH. “I have had many patients whose facial hair melted away after starting these medications,” Dr. Zeichner notes.
Hormonal birth control. That includes the pill, patch, shot, vaginal ring, and a hormonal IUD. Hormonal birth control can also help make your period more regular and may improve acne on your face and body.
Anti-androgen medicines. These medicines block the effect of androgens and can help reduce hair loss on your head, the growth of body hair, and acne. Note: They’re not approved by the FDA to treat PCOS, although they're commonly used.
Metformin. While it’s not approved by the FDA to treat PCOS, the oral medication may help with symptoms. Metformin improves insulin's ability to lower your blood sugar and can lower your insulin and androgen levels.
How do I get rid of facial hair from PCOS?
Getting rid of facial hair from PCOS is pretty similar to getting rid of unwanted hair in any other situation. While taking medication may help get rid of this hair, you can also try more traditional ways of removing unwanted hair, Dr. Zeichner says.
“For resistant facial hair, laser hair removal is a great option,” he says. “It’s an effective and permanent way to remove the hair.” If you’re not into laser hair removal, waxing, shaving, threading, and plucking can also be helpful, Dr. Zeichner says.
Again, having facial hair is a very normal side effect of having PCOS. And, while it should go without saying, it never hurts to repeat: There’s absolutely nothing wrong with having facial hair. If it doesn’t bother you, great. If it does, you have options. Ultimately, what matters is that you do you.
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