PCOS and Hair Loss: Why It Happens and What to Do About It, According to Experts
While excess body and facial hair is another difficult symptom that those with PCOS deal with, there's a sign on the flip side of that coin too: unexpected hair loss.
This hair loss or thinning hair due to PCOS is commonly known as female-pattern baldness or androgenic alopecia. Here's what you need to know about PCOS and hair loss, including why it happens, what you can do about it, and the support groups available to people who experience it.
Why does PCOS cause hair loss?
It's all about hormones here, Meggie Smith, MD, an ob-gyn who specializes in reproductive endocrinology and infertility in Nashville, tells Health.
"PCOS can contribute to hair loss as PCOS is associated with higher than normal levels of testosterone, which affects hair growth," she says. "This is known as androgenic alopecia and women often complain of hair loss around their temples and frontal regions of their scalp." (This is different than male-pattern baldness, which is characterized by a receding hairline and thinning on the crown of the head.)
However, hair loss is actually not a common side effect of PCOS, as compared to excess hair growth, because in order to have this type of hair loss, your androgen levels have to be pretty high, Lauren Streicher, MD, a clinical professor of obstetrics and gynecology The Feinberg School of Medicine at Northwestern University, tells Health.
Regardless of whether or not you have PCOS, people of all genders produce androgens, including testosterone, though men typically produce more (which is why you may sometimes hear androgens referred to as "male" hormones). Androgens are involved in the onset of puberty and initiate hair growth in the underarms and pubic areas. If you have PCOS, your body will experience extra androgen production, which will trigger excess hair growth in places like your face, neck, chest, and torso.
What can you do for PCOS-related hair loss?
In cases of male-pattern baldness, there's a complete loss of the hair follicle, meaning hair can never grow back in that spot naturally. With female-pattern baldness, that's not the case—the hair follicle remains alive, so there's a possibility of restimulating hair growth with certain treatments.
According to Dr. Streicher, treatment plans for PCOS-related hair loss are often tailored to each specific patient, depending on how bothersome or severe the hair loss is. One of the most effective lines of treatment, according to Dr. Streicher and Dr. Smith, is the medication minoxidil, more commonly known as the brand Rogaine.
Starting a birth control regimen is another commonly-used tactic for treating PCOS and its various symptoms. "One of the mainstays in managing many of the effects of PCOS is birth control pills, which help lower testosterone by increasing sex-hormone-binding globulin," says Dr. Smith. "However, this generally helps more with controlling hair growth...above the upper lip or chin."
There are some other less-studied methods too: Dr. Streicher recommends trying a daily hair and scalp massage, as well as a newer treatment option that involves a low-level laser therapy to stimulate hair growth. The oral medication spironolactone, commonly used to treat high blood pressure, may also be prescribed to treat androgenic alopecia, though it's not FDA-approved for this use.
That, of course, brings us to more natural remedies for boosting hair growth—vitamins and supplements like biotin, collagen, and zinc have all been linked to the possibility of stimulating hair growth. But, while Dr. Streicher says there's no harm in trying them (though you can ingest too much zinc, leading to zinc toxicity), there's no real research proving their efficacy either.
Whichever treatment you and your doctor choose, it's important to remember that patience is key, says Dr. Streicher. "It's important to manage expectations and know that it could easily be six months or more to see a difference in your hair," she says. "The reason for this is that the hair growth cycle itself isn't fast and takes a few months regardless of circumstances. It can be frustrating for someone going through this to wait for treatment to take effect."
When should you see a doctor for hair loss?
If you're experiencing unexpected hair loss, but haven't received an outside diagnosis like PCOS, it's important to be checked out, either by a family physician or dermatologist, who can they point you in the direction of a specialist, depending on their evaluation.
The same goes for signs and symptoms of PCOS—if you're experiencing any of those (that can include hair loss, but should be accompanied by irregular periods, increased acne, or unintended weight gain), you should see your ob-gyn to get an accurate diagnosis for that as well, says Dr. Streicher.
When it comes to PCOS-related hair loss specifically, it's important to with with a team—that could look like a dermatologist and ob-gyn or reproductive endocrinologist. "Some patients may get frustrated because they may feel like their gynecologist or endocrinologist or whoever is treating their PCOS isn't necessarily addressing things like hair loss," says Dr. Streicher. "Many people don't realize that dermatologists are hair loss experts and they're the ones who have the most expertise in treating this issue."
If you're dealing with PCOS-related hair loss, it's also important to know that you're not alone. Talking it through with a community of people dealing with the same thing can be emotionally helpful and may lead you to inquire about treatment options you may not have considered. Some potentially helpful resources include the Women's Hair Loss Project, Soul Cysters, PCOS Challenge, and myPCOSteam, all of which offer forums for sharing tips and providing emotional support to help each other cope with hair loss or other PCOS symptoms.
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