Is the Androgenetic Hair Loss in PCOS Permanent or Temporary ?

A Closer Look at PCOS and Androgenetic Hair Loss

I’ve selected this question below for this week’s question of the week. It allows us to review androgenetic hair loss that happens in the setting of PCOS.

Question:

I have polycystic ovarian syndrome (PCOS) and my doctor has put me on metformin. I also have hair loss adn a biopsy suggests androgenetic alopecia. He says that once the hormone levels stabilize and the insulin resistance issues are fixed the hair will grow back fully and I won’t need lifelong treatments like other women do when they have androgenetic hair loss. Is this true?

Answer

Thanks for your question.

The short answer is that if you have AGA the treatments will be lifelong regardless of the underlying cause. There were no differences with PCOS.

There are many causes that ultimately lead to androgenetic type hair loss. For some it’s what we call classic androgenetic alopecia where there are no additional predisposing factors other than genetics and endogenous normal hormone levels. However, a variety of other issues can give an androgenetic alopecia type hair loss including polycystic ovarian syndrome (like you mention), Cushing syndrome, anabolic testosterone supplements and adrenal and ovarian tumors. This is only a partial list.

Androgenetic hair loss in PCOS is no different than androgenetic hair loss from other classic causes. Treatment is needed forever and not just short term. Certainly, it’s critically important to make sure your blood pressure, sugars, insulin resistance, weight and cholesterol levels are normal as this will help you optimize your health. Some of these steps may help your hair. But the steps alone will not stop androgenetic hair loss once it is set in motion. In part, this is because androgenetic hair loss is so complex and caused by more than just insulin resistance or metaboic dysfunction.

If a person has androgenetic hair loss associated with no underlying conditions, treatments will be lifelong.

If a person has androgenetic hair loss associated with PCOS, treatments will be lifelong.

If a person has androgenetic hair loss associated with Cushing syndrome, treatments will be lifelong.