Is My Thinning Hair From PCOS?What Studies Show

Polycystic ovary syndrome, PCOS, is known for irregular periods, acne and extra body hair. Thinning hair on the scalp gets less attention, but it’s common, and it raises a fair question: is the PCOS causing it?

How common it is

In a clinic study of 100 women with PCOS:¹

Skin or hair sign	Share of women
Excess body or facial hair	78%1
Acne	48%1
Female pattern hair loss	31%1
Dark, velvety skin patches	30%1

A later review agreed that female pattern hair loss is more common with PCOS, but noted few studies have looked at it closely.²

A poor clue on its own

At a specialist PCOS clinic in San Francisco, doctors examined 401 women referred for possible PCOS.³

• Excess body hair and dark velvety skin were the most reliable skin signs.³
• Scalp hair loss and acne were common but unreliable markers of high male hormones.³

Female pattern hair loss can happen with normal hormone tests.² An expert task force said isolated thinning shouldn’t be treated as a sign of excess male hormones when levels are normal.⁴

What experts recommend

The Androgen Excess and PCOS Society task force, made up of skin and hormone specialists, recommends:⁴

1. Checking for androgen excess in every woman with female pattern hair loss.
2. Considering tests for iron, vitamin D, zinc, thyroid and prolactin.
3. Starting treatment with 5% minoxidil, adding hormone-blocking medicines when hair loss is severe or male hormones are high.

The typical pattern is widening through the middle of the scalp, or thinning that’s heavier toward the front, like a Christmas tree.⁴

Treatment trade-offs with PCOS

Some treatments that help scalp hair can make unwanted body or facial hair worse, so the plan needs to weigh both.² Pregnancy plans should be discussed before starting any treatment.²

See female pattern hair loss after 50, what PCOS is and how much facial hair is normal.

Try: “I have PCOS and my part is getting wider. Could we check my hormone levels, iron and thyroid, and talk about treatment that won’t make my facial hair worse?”

Hair, Everywhere covers this in Chapter 10, “Less Here, More There,” in a section called “The Hormone Seesaw.” Its Hair Log keeps monthly photos of your part, hairline and chin side by side, so changes on the scalp and face are tracked together. See the book.