Dr. Sudaba Asgarova
Polycystic Ovary Syndrome (PCOS) is a gynecological, endocrine, and metabolic disorder that occurs in approximately 6–20% of women of reproductive age.
Diagnosis (Rotterdam Criteria)
The most widely accepted diagnostic criteria are the Rotterdam criteria:
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Elevated free testosterone and/or DHEA-S
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Fewer than 8 menstrual periods per year
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On ultrasound, more than 20 follicles in one ovary
If two of these criteria are present, PCOS is diagnosed.
Why PCOS Causes Skin Symptoms
The main cause of skin symptoms seen in PCOS is hormonal imbalance, particularly hyperandrogenism and insulin resistance.
Hyperandrogenism is primarily responsible for:
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Painful cystic acne
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Hirsutism (excess hair growth)
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Hair loss
Insulin resistance is mainly linked to:
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Acanthosis nigricans, which presents as darkened areas of skin, most commonly found in skin folds such as the neck, armpits, and groin.
PCOS and Cystic Acne
Increased androgen levels lead to enlargement of the sebaceous glands and increased sebum production.
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Sebum creates a favorable environment for the growth of Cutibacterium (Propionibacterium) acnes bacteria.
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Dead skin cells and excess oil cause pore blockage, resulting in inflammatory lesions and cystic acne.
Characteristics:
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Deep, painful acne in the chin, cheek, and neck areas
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Resistance to conventional acne treatments
PCOS and Hirsutism (Excess Hair Growth)
Free testosterone is converted into dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase in hair follicles.
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DHT transforms vellus hairs into terminal hairs (thick, dark, long).
Most commonly affected areas:
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Face (chin, upper lip)
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Chest, abdomen, back, thighs
PCOS and Hair Loss (Female Pattern)
DHT causes miniaturization of hair follicles (follicles shrink and produce weaker hair strands).
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The anagen (growth) phase shortens, and more hairs enter the telogen (shedding) phase.
Characteristics:
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Thinning at the crown/top of the scalp
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The frontal hairline is relatively preserved (different from male-pattern hair loss)
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