Hirsutism, Acne, and Hair Loss: Management of Hyperandrogenic Cutaneous Manifestations of Polycystic Ovary Syndrome

August 2017 in “ Gynecology Obstetrics and Reproductive Medicine ”

Cenk Yasa, Ozlem Dural, Ercan Bastu, Funda Gungor Ugurlucan

hirsutism acne hair loss hyperandrogenism androgenic alopecia polycystic ovary syndrome PCOS androgens oral contraceptives antiandrogens insulin sensitizers gonadotropin-releasing hormone agonists topical medications cosmetic procedures birth control pills antiandrogen drugs insulin-sensitizing drugs GnRH agonists

TLDR Effective treatment for skin issues in women with PCOS includes oral contraceptives, antiandrogens, and other medications and procedures.

The 2017 study "Hirsutism, Acne, and Hair Loss: Management of Hyperandrogenic Cutaneous Manifestations of Polycystic Ovary Syndrome" by Cenk Yasa, Özlem Dural, Ercan Bastu, and Funda Güngör Uğurlucan from İstanbul University İstanbul School of Medicine, discussed the cutaneous manifestations of hyperandrogenism, such as hirsutism, acne, and androgenic alopecia, commonly observed in women with polycystic ovary syndrome (PCOS). The authors noted that these manifestations are primarily due to increased androgen production and tissue availability. These skin conditions, while cosmetic, can cause significant emotional distress and psychological morbidity. The treatment strategies outlined in the study included a combination of oral contraceptives, antiandrogens, insulin sensitizers, gonadotropin-releasing hormone agonists, topical medications, and cosmetic procedures.

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research Prevalence of Androgenic Alopecia in Patients with Polycystic Ovary Syndrome and Characterization of Associated Clinical and Biochemical Features

48 citations , April 2014 in “Fertility and Sterility”

Women with PCOS often have hair loss, which is linked to acne or excess body hair but not to worse hormone or metabolic issues.

research How to Diagnose and Treat Women with Excessive Hair

17 citations , January 2013 in “Dermatologic clinics”

Treating excessive hair in women requires a holistic approach, including medical, aesthetic, and emotional support.

research Specific Dermatologic Features of Polycystic Ovary Syndrome and Its Association with Biochemical Markers of Metabolic Syndrome and Hyperandrogenism

67 citations , February 2010 in “Acta Obstetricia et Gynecologica Scandinavica”

Hirsutism is a strong sign of high male hormones and metabolic problems in women with PCOS, but acne and hair loss are not.

research Spironolactone Versus Placebo or in Combination with Steroids for Hirsutism and/or Acne

112 citations , April 2009 in “Cochrane library”

Spironolactone may reduce excessive hair growth in women but its effectiveness for acne is not supported.

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

1540 citations , February 2009 in “Fertility and Sterility”

The report concludes that PCOS is mainly a condition of excess male hormones and its definition may change as new information is discovered.

research Medical Treatment of Hirsutism

66 citations , September 2008 in “Dermatologic therapy”

The conclusion is that the best initial treatment for hirsutism is usually oral contraceptives, with the addition of antiandrogens or insulin sensitizers if needed, and topical eflornithine or laser treatments as supplementary options.

research Insulin Sensitizers for the Treatment of Hirsutism: A Systematic Review and Meta-Analyses of Randomized Controlled Trials

121 citations , April 2008 in “The Journal of Clinical Endocrinology & Metabolism”

Insulin sensitizers may slightly reduce hirsutism but are less effective than other treatments.

research Dermatologic Manifestations of Polycystic Ovary Syndrome

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

Women with PCOS often have skin problems like excessive hair, acne, hair loss, and dark patches, which can be treated with hormonal and non-hormonal therapies.

research Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline

1744 citations , November 2006 in “The Journal of Clinical Endocrinology and Metabolism”

Polycystic Ovary Syndrome should be seen mainly as a condition of excess male hormones, with a focus on this in its definition.

research Diagnosis and Management of the Dermatologic Manifestations of Polycystic Ovary Syndrome

97 citations , July 2006 in “Dermatologic therapy”

The document concludes that accurate diagnosis and personalized treatment are important for skin problems in women with PCOS.

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

Most women referred for excess male hormone symptoms had polycystic ovary syndrome (PCOS), with other conditions being less common.

research Effective Treatment of Female Androgenic Alopecia with Dutasteride

33 citations , September 2005 in “PubMed”

Dutasteride successfully treated a woman's hair loss when other treatments failed.

research Treatment of Female Pattern Hair Loss With Oral Antiandrogens

179 citations , March 2005 in “British Journal of Dermatology”

Oral antiandrogens effectively treat female hair loss, with better results in higher hair loss grades.

research Finasteride Versus Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

39 citations , October 2004 in “International journal of gynaecology and obstetrics”

Finasteride and CPA-EE2 equally reduce hirsutism, but affect hormone levels differently.

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219 citations , April 2004 in “Journal of The American Academy of Dermatology”

5% and 2% minoxidil solutions effectively promote hair growth and reduce hair loss, with 5% being slightly more effective but having more side effects.

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947 citations , February 2004 in “The Journal of Clinical Endocrinology and Metabolism”

Most women with excess male hormones have Polycystic Ovary Syndrome, and hormonal therapy can improve symptoms but may cause side effects.

research Minoxidil: Mechanisms of Action on Hair Growth

397 citations , February 2004 in “British Journal of Dermatology”

Minoxidil boosts hair growth by opening potassium channels and increasing cell activity.

research Prevalence of Polycystic Ovaries in Women with Androgenic Alopecia

84 citations , November 2003 in “European journal of endocrinology”

Women with androgenic alopecia are more likely to have polycystic ovaries and higher androgen levels, which may indicate PCOS.

research Cyproterone Acetate for Hirsutism

78 citations , October 2003 in “Cochrane library”

Cyproterone acetate with estradiol may subjectively improve excessive hair growth in women, but it's not clinically better than other treatments.

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

Metformin is effective for treating excessive hair growth in women with PCOS and may work better than the standard treatment in some ways.

research Pharmacologic Treatment of Polycystic Ovary Syndrome

21 citations , January 2003 in “Seminars in reproductive medicine”

The document concludes that various drugs can manage symptoms and metabolic issues in women with PCOS.

research Finasteride for Female Androgenetic Alopecia

51 citations , October 2002 in “British Journal of Dermatology”

Finasteride increases hair density in female androgenetic alopecia, but individual results may vary.

research The Effect of Metformin on Hirsutism in Polycystic Ovary Syndrome

90 citations , August 2002 in “European journal of endocrinology”

Metformin improves hair growth and menstrual frequency in women with PCOS and hirsutism.

research Comparison of Diane 35 and Diane 35 Plus Finasteride in the Treatment of Hirsutism

63 citations , March 2001 in “Fertility and Sterility”

Diane 35 plus finasteride is more effective for treating hirsutism.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations , November 2000 in “Journal of The American Academy of Dermatology”

Finasteride doesn't effectively treat hair loss in postmenopausal women.

research Effects of Sex Steroid Deprivation and Administration on Hair Growth and Skin Sebum Production in Transsexual Males and Females

176 citations , August 2000 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Hormone treatments in transsexual individuals reduce hair growth and oil production in male-to-females and increase them in female-to-males.

research Comparison of Finasteride Versus Flutamide in the Treatment of Hirsutism

75 citations , October 1999 in “European journal of endocrinology”

Finasteride is a safe, effective treatment for hirsutism with fewer side effects.

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165 citations , February 1994 in “Fertility and Sterility”

Flutamide is more effective and has fewer side effects than spironolactone for treating hirsutism.

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40 citations , January 1994 in “Skin Pharmacology and Physiology”

Male hormones affect oil-producing skin cells differently based on their body location, and the drug spironolactone can reduce these effects.

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16 citations , January 1989 in “Springer eBooks”

Cyproterone acetate effectively treats female hair loss by increasing healthy hair and decreasing unhealthy hair, but doesn't change hair thickness.

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44 citations , June 1985 in “Fertility and sterility”

Combination drug therapy is effective for hirsutism that doesn't improve with just one medication.

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183 citations , March 1982 in “JAMA”

Spironolactone is a safe and effective treatment for reducing excessive hair growth in women.

12 / 12 results

research Cutaneous Manifestations of Polycystic Ovary Syndrome

5 citations , June 2020 in “Current Opinion in Endocrine and Metabolic Research”

Skin problems in PCOS, like excess hair, acne, and hair loss, may not always indicate high male hormone levels and need careful diagnosis for proper treatment.

research Clinico-Pathological Correlation in Indian Women Presenting with Cutaneous Features of Hyperandrogenism: A Cross-Sectional Study

January 2020 in “Medical journal of Dr. D.Y. Patil Vidyapeeth”

Indian women with skin signs of high male hormones often have related health issues.

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

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

Skin problems like acne, excessive hair growth, and oily skin are common in women with PCOS and can help with early diagnosis.

research Polycystic Ovary Syndrome in Childhood: Diagnostic and Therapeutic Challenges

July 2015 in “NEJM Journal Watch”

Diagnosing and treating PCOS in young people is difficult.

research Female Hyperandrogenism

9 citations , November 2013 in “Presse Medicale”

The document concludes that managing female hyperandrogenism requires a combination of identifying the cause, lifestyle changes, medication, and cosmetic treatments.

research Managing the PCOS-Related Symptoms of Hirsutism, Acne, and Hair Loss

1 citations , August 2013 in “Springer eBooks”

Birth control pills and anti-androgen medications help manage hair growth, acne, and hair loss in women with PCOS.

research Non-Polycystic Ovary Syndrome–Related Endocrine Disorders Associated with Hirsutism

39 citations , May 2011 in “European Journal of Clinical Investigation”

Hirsutism can be caused by various conditions besides PCOS, and it's important to treat the underlying issue and manage symptoms with medication and cosmetic approaches.

research The Dermatologic Manifestation of Hyperandrogenism: A Retrospective Chart Review

7 citations , February 2011 in “Journal of The American Academy of Dermatology”

Most women with hyperandrogenism first show acne, and skin conditions like hirsutism and acanthosis nigricans are good indicators of the condition.

research Polycystic Ovary Syndrome and Acne

10 citations , November 2010 in “Skin therapy letter”

Women with PCOS often have acne because of high androgen levels, and the article reviewed how to treat this type of acne.

research The Clinical Evaluation of Hirsutism

67 citations , September 2008 in “Dermatologic therapy”

Hirsutism is excessive hair growth in women often caused by polycystic ovarian syndrome, and identifying the cause is important for managing associated health risks.

research Dermatology of Androgen-Related Disorders

67 citations , July 2006 in “Clinics in Dermatology”

Androgens cause skin issues like acne and hair growth in women, often due to PCOS, and can be treated with medication and lifestyle changes.

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January 1993 in “Проблемы Эндокринологии”

Spironolactone effectively reduces symptoms of hyperandrogenism but has some side effects.