PCOS related excessive hair growth: Causes and treatment

Polycystic ovarian syndrome (PCOS) and excessive hair growth are strongly associated. The pattern of hair growth which is usually seen in PCOS patients is known as hirsutism. Hirsutism is the growth of coarse and long facial and body hair in females but in male-like patterns.

All women have hair growth on their face and body but most of them have very fine hair growth on certain areas of their body like above their face, abdomen, inner thighs, chest and back compared to the hair growth on their legs, arms, hands and feet. The hair is generally colourless, soft and so fine that the body part gives the impression of being hairless. But with the development of hormonal disorders like PCOS, the body hair texture changes to look more like male pattern hair growth which is coarse, long and dark.

PCOS is on the rise, especially among Indian women. One in every five women of childbearing age suffers from it. And almost 70% of PCOS patients suffer from unwanted hair growth or hirsutism. There are many other symptoms of PCOS, like irregular periods, acne, weight gain and pain in the lower abdomen. While excessive and abnormal hair growth isn’t the worst symptom, by far, it can lead to some women feeling more self-conscious about their body.

Causes of excessive hair growth in PCOS patients
Treatment of excessive hair growth in PCOS patients
- Medications for PCOS
- Cosmetic removal of hair in PCOS patients

Causes of excessive hair growth in PCOS patients

Androgens are a group of hormones. They are secreted in both male and female but males have increased levels of androgen as compared to women. In women, some amount of androgens are secreted by the ovary and adrenal glands under healthy conditions. But in PCOS, the level of androgens produced in the female body spikes. Genetically hair is sensitive to androgen, therefore, when the availability of androgen increases in the female body it changes the thickness and texture of the hair. So the spike of androgen makes the hair grow faster and coarser.

Alternatively, insulin resistance, being a characteristic feature of PCOS, might lead to hyperinsulinemia (increased levels of insulin in the body). Hyperinsulinemia, in turn, stimulates androgen secretion from the adipose tissue (fat tissue), thereby making room for more hair growth.

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Treatment of excessive hair growth in PCOS patients

Excessive hair growth on the female body, that too in male pattern and distribution, can affect the confidence of a woman. Thankfully, this doesn’t have to be a permanent problem and can be treated.

The best course of treatment for excessive hair growth in women who also have PCOS is the treatment of the root cause, that is polycystic ovaries.

PCOS may be treated in two ways - a change in lifestyle and medications. The suggested lifestyle changes can include adopting a healthier diet and exercising regularly with the goal of reducing weight. With the reduction in weight of the woman, androgen secretion goes down by a significant amount. This causes the symptoms of PCOS like hirsutism, acne, etc to reduce. Even the irregularity in the menstrual cycle may return to normal once the weight is managed.

Medications prescribed by your doctor may include hormonal therapy like birth control pills. But be patient. One hair follicle completes its life cycle in 6 months, hence, the effect of treatment might be visible only after 6 months. Cosmetic therapies to remove body hair can be employed in the meantime.

Medications for PCOS

Several medications can be prescribed by medical professionals for managing PCOS. These medications treat PCOS and, in turn, hirsutism.

Birth control pills: Oral contraceptives reduce the production of androgens from ovaries. According to experts, for women who do not wish to conceive, oral contraceptives are recommended as the first line of treatment. Birth control pills also help in gaining a normal menstrual cycle.
Anti-androgens: This medication blocks the secretion of androgen and makes hair follicles unsusceptible to available androgens. This drug is not recommended for women who want to conceive as it has teratogenic effects which means it can cause birth defects in the growing baby.
Insulin-lowering agents: As the name suggests, this group of drugs (such as metformin) lowers the level of insulin in PCOS patients. As the associated symptoms of PCOS alleviate, unwanted hair growth will also reduce. However, the effect might be a little slower.

Cosmetic removal of hair in PCOS patients

As PCOS treatment can take some time in showing visible results, you can turn to the various other alternative methods of getting rid of unwanted hair.

Shaving: The most common and easy way of getting rid of facial and body hair is by shaving. However, the downside is that one has to do it on a regular basis to maintain the effects.
Waxing: Waxing is done by applying a thin coating of heated wax and then by placing a waxing sheet over the wax. Once the wax cools down, the sheet is pulled to remove the hair from its shaft. If not done properly, redness and swelling may be seen post waxing. The hair grows back about 2-3 weeks after.
Depilatory and bleaching creams: Depilatory creams have the potential to dissolve the hair whereas bleaching creams lighten the colour of the hair and bring it close to skin tone. One could be sensitive to the chemicals present in these creams though. Make sure to do a patch test on your skin before applying it on a larger area.
Electrolysis: In this procedure for hair removal, a small needle is inserted into the hair follicles and an electrical current is passed. This damages the root of the hair follicle and disrupts the growth of hair. It requires multiple sessions for best results. This hair removal technique is comparatively painful and expensive.
Ointment: To slow down the growth of hair, eflornithine hydrochloride can be used in ointment form. It works by blocking an enzyme that is essential for hair growth. It does not remove the hair permanently and takes 6 to 8 weeks to show visible results. However, the growth returns back to normal once you stop using the cream in 8 weeks.
Laser hair removal: This procedure requires a trained professional to use lasers that target concentrated light into the hair follicle. This damages the hair follicle and inhibits the growth of hair. The hair loss isn’t permanent but there is a definite reduction and change in texture (finer and lighter). It is a comparatively expensive procedure and requires multiple sessions.