The Link Between PCOS and Excess Facial Hair

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Facial hair growth by itself does not indicate that you have polycystic ovary syndrome (PCOS), though hirsutism (unwanted or excess body hair) is one of the most distressing symptoms of PCOS. 

In some cases, the exact cause of facial hair in women is never known, although it often runs in families.

A woman shaving face in mirror
Philipp Nemenz / Getty Images

Symptoms of Hirsutism

Most women have fine, light-colored, and barely noticeable thin hairs (called vellus hairs) that grow above the lips, on the chin, chest, abdomen, or back—this is usually referred to as peach fuzz and is normally developed in childhood.

When women have coarse, visible, dark hairs growing in the place of the vellus hairs in these areas, the condition is called hirsutism. These coarse hairs are referred to as terminal or androgenic hairs, which normally develop during puberty.

Causes

If your body makes too many androgens or male hormones, like testosterone, you may experience unwanted hair growth, especially in the central part of your body (between your breasts, belly button, inner thighs). 

Some causes of excess androgen productions, and thus hirsutism, may include the following conditions: 

Hirsutism is tied to the use of certain medicines and supplements, including but not limited to:

When PCOS Is to Blame

Though there is no definitive test for PCOS, a diagnosis is usually made after your doctor conducts an extensive review of your medical history and confirms the presence of symptoms such as: 

  • Irregular or absent menstrual periods
  • Signs of hyperandrogenism—like facial hair, hair loss, and acne—without another medical cause
  • Weight gain or trouble losing weight and/or diabetes
  • Skin tags in the armpit or neck area
  • Darkening skin, especially along the neck, groin, or underneath breasts

To distinguish PCOS from other conditions, your doctor will likely take a full medical history and perform a physical and pelvic examination to look for signs of PCOS (such as swollen ovaries or a swollen clitoris). Usually, they'll also order blood tests to measure the following hormone levels:

Other tests may also be ordered, such as:

Once all of the prescribed tests are complete, the doctor will look at all of the results and clinical information to come to a medical diagnosis. 

If you think your PCOS may be the cause of your hirsutism, you should see your physician about your symptoms.

Treatment Options

Since hair grows in different phases, in long six-month cycles, hirsutism is generally a long-term condition. There are multiple treatment methods for unwanted hair and some treatments are more effective than others. Some examples include:

For overweight or obese women, weight loss may help reduce excess hair growth.

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  1. Office on Women's Health. Polycystic ovary syndrome. Updated April 1, 2019.

  2. Cleveland Clinic. Excessive hair growth (hirsutism). Updated January 13, 2018.

  3. Mihailidis J, Dermesropian R, Taxel P, Luthra P, Grant-Kels JM. Endocrine evaluation of hirsutismInternational Journal of Women’s Dermatology. 2015;1(2):90-94. doi:10.1016/j.ijwd.2015.04.003

  4. American College of Obstetricians and Gynecologists. Ovarian cysts. Updated February 2020.

  5. Agrawal N. Management of hirsutismIndian J Endocr Metab. 2013;17(7):77. doi:10.4103/2230-8210.119511