A Narrative Review on Cutaneous Manifestations in Polycystic Ovary Syndrome: Pathophysiology, Diagnosis, Management, and Psychosocial Impact

March 2025 in “ Annals of Medicine and Surgery ”

Muhammad Farhan, Ariana Seyfi, Abdulla Alnuaimi, Maya Alamour, Sarah Alwarafi, Haya Elastal, Muhammad Hashir Nazir, Balakrishnan Kamaraj, Hrithik Dakssesh Putta Nagarajan, Deborah Delianne, Shyamala Ganesan, Tirath Patel

polycystic ovary syndrome PCOS acne hirsutism androgenic alopecia hyperandrogenism insulin resistance hormonal interventions dermatological interventions lifestyle interventions

Studysummary This review discusses the pathophysiology, diagnosis, management, and psychosocial impact of skin manifestations in PCOS and emphasizes the need for holistic, personalized care without reporting new results.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

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research Quality of Life and Its Association With Androgenetic Alopecia Patients in Shanghai: A Cross-Sectional Study

December 2022 in “Clinical, Cosmetic and Investigational Dermatology”

This study found that patients with androgenetic alopecia, especially those who are young, less educated, and single, experience significantly reduced health-related quality of life.

research Study of Cutaneous Manifestations of Polycystic Ovarian Syndrome

1 citations , March 2020 in “International journal of reproduction, contraception, obstetrics and gynecology”

In this study, hirsutism was the most prevalent skin manifestation among women with PCOS, and a significant association was observed between certain skin changes and hormonal abnormalities such as insulin resistance and elevated prolactin levels.

research Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee

49 citations , February 2019 in “The Journal of Clinical Endocrinology and Metabolism”

This review offers evidence-based recommendations for diagnosing and treating female pattern hair loss, emphasizing clinical assessment and starting treatment with minoxidil, while noting that measurement of certain hormones and vitamins is optional.

research Quality of Life in Adults with Androgenic Alopecia

1 citations , January 2019 in “Indian Journal of Public Health Research and Development”

This study found that androgenic alopecia significantly impairs quality of life among adults, with higher impairment observed in males and those who are employed.

research Long-Term Response of Hirsutism and Other Hyperandrogenic Symptoms to Combination Therapy in Polycystic Ovary Syndrome

13 citations , June 2018 in “Journal of Womens Health”

This study found that in women with PCOS, suppressive therapy using spironolactone plus oral contraceptives improved hirsutism more effectively than either treatment alone, with initial scores predicting success.

Combined Oral Contraception and Bicalutamide in Polycystic Ovary Syndrome and Severe Hirsutism: A Double-Blind Randomized Controlled Trial

research Combined Oral Contraception and Bicalutamide in Polycystic Ovary Syndrome and Severe Hirsutism: A Double-Blind Randomized Controlled Trial

25 citations , December 2017 in “The Journal of Clinical Endocrinology & Metabolism”

This study found that using an oral contraceptive with bicalutamide significantly reduced hirsutism in women with PCOS compared to an oral contraceptive alone, although it increased total cholesterol and LDL levels.

research Cutaneous Manifestations of Polycystic Ovary Syndrome: A Cross-Sectional Clinical Study

28 citations , January 2017 in “Indian Dermatology Online Journal”

In this study, skin manifestations such as hirsutism and acne were prevalent among women with PCOS, highlighting their importance in diagnosis and symptomatology.

research Genetic, Hormonal, and Metabolic Aspects of PCOS: An Update

258 citations , July 2016 in “Reproductive Biology and Endocrinology”

This abstract reviews the characteristics and health risks associated with polycystic ovary syndrome and does not report new findings, highlighting the syndrome's multifactorial nature.

research Hirsutism Management Needs to Be More Patient Oriented

July 2016 in “British journal of dermatology/British journal of dermatology, Supplement”

Hirsutism treatment should focus more on patient needs and quality of life.

research Demographics of Women with Female Pattern Hair Loss and the Effectiveness of Spironolactone Therapy

26 citations , September 2015 in “Journal of The American Academy of Dermatology”

In this study, spironolactone was reported to stabilize or improve female pattern hair loss in 74.3% of treated women, especially those with signs of hyperandrogenism.

research Hirsutism and Health-Related Quality of Life

11 citations , January 2015 in “Modern Chemistry & Applications”

This study found hirsutism negatively affects quality of life and psychological wellbeing in women, suggesting effective medical treatment alongside psychotherapy might better address these issues than psychotherapy alone.

research Correlation of Skin Changes With Hormonal Changes in Polycystic Ovarian Syndrome: A Cross-Sectional Clinical Study

19 citations , January 2015 in “Indian Journal of Dermatology”

In this study, researchers observed that 90% of patients with PCOS had cutaneous manifestations, with acne most common, and found associations between these skin conditions and high insulin or testosterone levels.

research Polycystic Ovary Syndrome: A Review for Dermatologists

60 citations , October 2014 in “Journal of the American Academy of Dermatology”

This review examines the definition, etiology, pathogenesis, and clinical features of polycystic ovary syndrome but reports no new clinical findings.

research Cutaneous Manifestations of the Subtypes of Polycystic Ovary Syndrome in Korean Patients

16 citations , March 2014 in “Journal of the European Academy of Dermatology and Venereology”

This study found that acne was the most common dermatological manifestation in Korean women with polycystic ovary syndrome, particularly those with a specific combination of symptoms, showing distinct variations in serum hormonal and metabolic parameters.

Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

research Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

378 citations , November 2011 in “Human reproduction update”

This review discusses the epidemiology, causes, diagnosis, and management of hirsutism in women, noting that effective treatment requires addressing the root cause as well as the hair growth.

research The Androgen Excess and PCOS Society Criteria for the Polycystic Ovary Syndrome: The Complete Task Force Report

1540 citations , October 2008 in “Fertility and Sterility”

This review discusses the definition of polycystic ovary syndrome proposed by the AE-PCOS Society Task Force, emphasizing hyperandrogenism, ovarian dysfunction, and excluding related disorders, while noting potential variations needing more research.

research Dermatologic Manifestations of Polycystic Ovary Syndrome

76 citations , January 2007 in “American Journal of Clinical Dermatology”

This review discusses the dermatologic features of PCOS as potential early indicators of the syndrome and notes that treatment of these conditions may enhance quality of life and psychological well-being, but it reports no new clinical results.

research Relative Prevalence of Different Androgen Excess Disorders in 950 Women Referred Because of Clinical Hyperandrogenism

352 citations , January 2006 in “The Journal of Clinical Endocrinology and Metabolism”

This study reported that classic anovulatory PCOS was the most common androgen excess disorder, followed by mild ovulatory PCOS and idiopathic hyperandrogenism, among patients evaluated for clinical hyperandrogenism.

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome

4809 citations , January 2004 in “Fertility and Sterility”

This review discusses polycystic ovary syndrome, emphasizing its broad range of manifestations and associations with risks like type 2 diabetes and cardiovascular events, but reports no new clinical results.

research Metformin or Antiandrogen in the Treatment of Hirsutism in Polycystic Ovary Syndrome

192 citations , September 2003 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study suggests that metformin may be more effective than Dianette in treating moderate to severe hirsutism in women with PCOS, while also reducing markers of insulin resistance.

research Female Pattern Hair Loss

226 citations , September 2001 in “Journal of The American Academy of Dermatology”

Hair loss in women is genetic, diagnosed by examination and biopsy, and treated with minoxidil, finasteride, or transplantation.

Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

research Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

416 citations , September 1997 in “Journal of Investigative Dermatology”

People with hair loss have more androgen receptors and enzymes in certain follicles, with men and women showing different patterns.

A Prospective Study of the Prevalence of Clear-Cut Endocrine Disorders and Polycystic Ovaries in 350 Patients Presenting with Hirsutism or Androgenic Alopecia

research A Prospective Study of the Prevalence of Clear-Cut Endocrine Disorders and Polycystic Ovaries in 350 Patients Presenting with Hirsutism or Androgenic Alopecia

135 citations , August 1994 in “Clinical Endocrinology”

In this study of women with hirsutism or androgenic alopecia, diverse underlying endocrine disorders including polycystic ovaries and various enzyme deficiencies were detected, often associated with elevated testosterone levels.