Symptoms of PCOS like hair loss can significantly reduce quality of life. Androgenic alopecia in PCOS is caused by the excess of androgen hormones associated with the condition. So, what can we do to treat or reverse hair loss in people with PCOS?
What is PCOS?
Whilst the exact cause of polycystic ovary syndrome is unknown, the symptoms commonly associated with the condition have been widely recognised. One of the symptoms known is thinning hair and/or hair loss from the head, known as alopecia.
This is one of a variety of symptoms, and a diagnosis of PCOS does not mean this is a symptom you will have, as how the condition presents can be different for everyone. Other PCOS symptoms can also include irregular periods or no periods, fertility issues, excessive hair growth (hirsutism), particularly facial hair, rapid weight gain and acne.
What is hair loss?
It is important to recognise that hair loss is a normal part of life. We shed between 50 to 100 hairs every day. However, if the body sheds significantly more hair then you may want to investigate further.
Alopecia or hair loss is when something occurs that stops the hair from growing. Common causes of hair loss include:
- Some drugs and treatments
- Hereditary hair loss
- Immune system overreaction
- Hairstyles that pull on the hair
- Harsh products
- A compulsion to pull out hair
- Hormonal imbalance
- Stress on the body
Does PCOS cause hair loss?
PCOS is linked to a specific type of hair loss known as androgen alopecia. Androgen alopecia is caused by hormonal imbalances, particularly high androgen levels. Stress may also contribute to high testosterone levels, contributing to androgenetic alopecia.
One of the three main features of PCOS (required for diagnosis) is excess androgen levels in the circulation. This increase in androgens i.e. male hormones, particularly testosterone, is thought to be the main catalyst and influence of alopecia. Testosterone switches off hair growth in scalp hair follicles in susceptible individuals. There is a high genetic predisposition to hair loss and hair thinning.
High insulin levels are often present in people with PCOS because of the insulin resistance associated with the condition. Elevated insulin levels can contribute to raised testosterone levels too.
Stress has been found to have an increased impact on individuals with PCOS, who are found to have elevated levels of cortisol and other stress hormones. Increased stress can disrupt hormonal balance and increase testosterone levels, contributing to the onset of androgen alopecia.
Symptoms of PCOS hair loss
Androgenic alopecia in PCOS presents in a variety of ways:
- Areas of hair loss
- Fragile and thinning hair
- Bald patches
- Fuzzy hair patches
In comparison to “female pattern hair loss” or “female pattern baldness”, PCOS-related hair loss tends to be more pronounced at the front and top of the scalp.
PCOS hair loss treatment
PCOS hair loss can be a challenging symptom to live with. There are a variety of treatments you can try including home remedies, medication, supplements and nutritional changes with the aim to reverse PCOS hair loss. Keep reading if you are curious about how to stop hair loss from PCOS.
Various medications can be prescribed by a healthcare professional for PCOS hair loss treatment including anti-androgens, Minoxidil and oral contraceptives.
Anti-androgens work by occupying the same space on the hair follicle that testosterone would usually latch onto (the androgen receptor). Examples of this type of anti-androgen include cyproterone acetate, spironolactone and flutamide.
Or, they block the conversion of testosterone to dihydrotestosterone, testosterone’s more potent cousin. Examples of this type of anti-androgen include finasteride and dutasteride.
Minoxidil is a topical medication that’s often used to treat hair loss. It works by stimulating the hair follicles, leading to thicker, more visible hair. It’s not a cure for hair loss, but it can help manage the symptoms.
It has been recommended as a treatment for hair loss caused by androgen excess by the Multidisciplinary Androgen Excess and PCOS Committee.
Oral contraceptives can help regulate hormone levels, which can be particularly beneficial for people with PCOS. By regulating hormone levels, oral contraceptives can help control symptoms like hair loss.
If you have PCOS and hair loss, you may want to speak to your doctor or GP about having some blood tests conducted. Testing for underactive thyroid levels may be necessary. Testing for iron, zinc and vitamin B12 may also be appropriate.
Iron for PCOS hair loss
Iron is a mineral and is important for making blood cells in the body. Iron deficiency, known as anaemia, can cause hair loss. A literature review concluded that more evidence is required, but iron supplementation has been seen across various studies to improve hair loss.
Zinc for PCOS hair loss
Zinc is a mineral that is essential for enzymes in the body to carry out chemical reactions. Zinc deficiency may cause hair loss. An 8-week study found that supplementing with 50 mg/day of zinc among people with PCOS had beneficial effects on alopecia.
>> Read more | Zinc for PCOS: food sources and supplements
Vitamin B12 for PCOS hair loss
Vitamin B12 is a water-soluble vitamin also known as cobalamin. It is vital for the metabolism of fatty acids and amino acids, for normal blood formation and neurological function. Vitamin B12 deficiency has been associated with hair loss.
Indirectly, metformin may cause hair loss because of its link to vitamin B12. You may have been prescribed metformin, an insulin sensitiser, to help with your symptoms of PCOS. Taking this medication long-term increases the risk of vitamin B12 deficiency, which has been linked to hair loss.
Read more | Vitamin B12 for PCOS: 7 signs of deficiency
Biotin for PCOS hair loss
Biotin is a B vitamin, also known as B7, that plays a vital role in maintaining healthy hair, skin and nails. This is because it is involved in the production of keratin – the major protein that makes up hair. Biotin deficiencies can lead to hair thinning and loss. These deficiencies are rare and can be diagnosed via testing for urinary 3-hydroxyisovaleric acid and biotin.
A healthy diet can also support hair health. Eating a balanced diet rich in fruits, vegetables, lean protein, and healthy fats can provide your hair with the nutrients it needs to grow and stay healthy.
Are there certain foods for PCOS hair growth?
There are several foods that you may find beneficial to add to your diet to help with hair loss.
Eggs are both a source of protein and biotin, both of which contribute to hair health.
Omega-3 fatty acids are also beneficial for hair health, so try adding oily fish to your diet. If you are vegan or vegetarian, eating plenty of omega-3-rich foods like chia seeds, walnuts and flaxseeds may be helpful. If you struggle to get enough omega-3 into your daily diet, try taking a fish or algae supplement to top up your levels.
You should also ensure you’re eating enough. Many people with PCOS are told to lose weight, and in turn, go on restrictive diets or remove whole food groups from their daily diets. Your hair requires a variety of nutrients including protein, iron, and vitamins A, C, D, E and B vitamins to thrive. Restricting your calorie intake may lead you to be deficient in these vital nutrients.
Rapid weight loss can also impact your hair health. A sudden or significant drop in weight can shock your body, triggering hair loss. This is known as telogen effluvium.
Some people find that natural remedies, such as scalp massages and essential oils, can help improve hair health. However, it’s important to remember that while these remedies might help manage symptoms, they won’t cure PCOS or hair loss.
There are some recommendations for herbs for PCOS hair loss including rosemary. Rosemary oil has been used for generations in traditional medicine for a variety of ailments. In terms of PCOS hair loss, rosemary oil is thought to stimulate blood circulation, act as a DHT blocker (i.e. blocking the potent dihydrotestosterone hormone that contributes to hair loss) and may even have anti-inflammatory properties.
More research is required on herbs for PCOS hair loss including rosemary, but they may be helpful and the evidence we do have is promising.
Stress management techniques
Additionally, as mentioned earlier, stress can lead to hair loss. Therefore, in addition to a healthy balanced diet, and recommended medications, stress management techniques such as yoga are recommended for individuals with PCOS.
Shampoo and hair treatments
You may also want to consider shampoo for PCOS hair loss and other at-home treatments. These products tend to work by stimulating the scalp to promote blood flow, and therefore new hair growth. They may also block the hormone DHT (a potent variation of testosterone) which contributes to hair loss. Some shampoos and hair treatments contain key ingredients like biotin, keratin and caffeine that may support healthy hair growth.
Seeing a specialist
If you’re struggling with hair loss due to PCOS, it’s important to seek help from a professional. A doctor, trichologist or dermatologist can help diagnose the cause of your hair loss and advise on appropriate treatment options.
How can excess hair growth on the body and hair loss on the head occur at the same time?
We get it, it can be confusing. How can bald spots show up on your scalp whilst struggling with unwanted hair growth on the body? Testosterone can work in different ways in different individuals. It can switch off hair growth in scalp hair follicles in susceptible individuals and confusingly, testosterone switches on body hair growth causing excess body hair on the face, stomach and chest. To be honest, we are unsure of how testosterone can work so opposingly in the body.
In the majority of people, acne appears first, then hirsutism and then alopecia in regards to the androgenic impact of PCOS.
Key takeaways: PCOS hair loss
Hair loss is a common and distressing symptom of PCOS. It’s primarily caused by high testosterone levels and stress, both of which are common in women with PCOS. However, there are treatments available, including medication, dietary changes, stress management techniques, and even certain dietary supplements. If you’re struggling with PCOS-related hair loss, don’t hesitate to seek help from a healthcare professional.
Founder and Editor | Registered Associate Nutritionist
Founder of Be The Collective LTD [The PCOS Collective & The Endo Collective] Alex Okell ANutr is a London-based reproductive health nutritionist with experience in research, private practice and digital media. She holds a Master’s degree in Nutrition from King’s College London and has co-authored papers with the University of Cambridge, King’s College London, The Food Foundation and the Food Standards Agency. Alex offers 1:1 PCOS support in our virtual PCOS clinic.