1. PCOS

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PCOS Hair Loss: Effective Treatment Options for Hair Loss

PCOS-related hair loss can be one of the more troubling symptoms of polycystic ovary syndrome (PCOS), both on a physical and an emotional level. Whether there seem to be more loose strands in the shower or a receding hairline, understanding why hair loss occurs and what can be done about it can be helpful.

Yes, hair loss is one of the reported symptoms of PCOS. This is mostly due to the excess androgenic hormones that people with PCOS often have, which can lead to acne, thinning hair, and hair loss, as well as limp, lackluster hair that breaks easily and is dry and damaged.

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Medically, this hair loss is referred to as female pattern baldness, and treatment can be tricky. 

A hormone imbalance can lead to androgenic alopecia, or male pattern baldness, which can have the following characteristics:

  • Hair falls out mainly in the frontal and parietal (side) areas of the scalp.
  • The hair in the parting area becomes much thinner.
  • The hairline begins to recede above the temples.

To address the problem, it’s necessary to first balance the hormone levels. Gynecologists and endocrinologists can do this with a set of complex investigations and provide recommendations for hormonal therapy. A trichologist can prescribe a treatment to restore hair follicles.

There are also other factors that can make hair fall out:

  • Exposure to extreme temperatures
  • Chronic infections and diseases
  • Taking certain medications
  • Anemia (iron deficiency)
  • Lack of vitamins and trace elements
  • Stress

PCOS hair loss can lead to shedding more hair on a daily basis. There may be more hair on clothes or furniture than normal, and it’s also common for hair to collect on the pillowcase overnight. Hair may also come out in clumps in the shower.

PCOS hair loss can lead to shedding more hair on a daily basis. There may be more hair on clothes or furniture than normal, and it’s also common for hair to collect on the pillowcase overnight.

Hair loss with PCOS can come in the form of loss at the root, where the entire hair including the follicle comes out, but it can also occur as breakage since the hair is drier and more prone to damage from heat and brushing. This means that the scalp may be more visible, particularly at the crown and hairline, or there may be more frizz, which is the result of hair breakage.

The scalp may also be drier and itchier. Some people with PCOS also report buildup and dandruff. Hair may seem finer than usual and be harder to style without using a lot of product to increase body and fullness.

As a symptom of PCOS, hair typically falls out mainly in the frontal-parietal region and gets considerably thinner in the middle.

The Ludwig scale describes three stages of female pattern hair loss:

  1. There are small areas of hair loss, with fragile and thin hairs among the healthy ones.
  2. There are bald patches and many thin hairs.
  3. Hair is fuzzy and almost invisible.

Can hair loss from PCOS be reversed? Yes, PCOS-related hair loss can be treated if the underlying cause (usually a hormonal imbalance) is remedied. If PCOS is the problem — clinical symptoms, ultrasound, and blood tests can diagnose PCOS — a health care provider can suggest PCOS treatment options.

Comprehensive treatment is necessary to avoid critical hair loss in PCOS. Treatment will help:

  • Balance hormone levels (consult a gynecologist and endocrinologist, and take prescribed oral contraceptives or other medications that regulate the production of hormones)
  • Revive hair follicles (consult a trichologist)

Adopting a healthy lifestyle with regular exercise, a low-carb diet, and stress management practices may also be part of treatment.

PCOS hair loss treatments are available. Traditional over-the-counter remedies like specialized shampoos, hair treatments, and vitamins aimed at skin, hair, and nail health are all good places to start. If standard strategies aren’t working, a hairstylist or health care provider may be able to suggest other options.

The problem of PCOS-related hair loss needs to be addressed in a comprehensive way, both externally with the help of proper hair care and internally by taking care of the body with diet and exercise and consulting a health care provider about the potential benefit of medications.

It may take six months to a year to see the results of hair treatment. Medications should be taken on a strict schedule and hair care procedures should be regular (not just until the first positive results are noticeable, but until hair is fully restored).

It’s also important to keep in mind that if hair thinning is associated with hormonal imbalances, regaining hair health may be possible by balancing hormone levels.

A well-balanced diet with vitamins or supplements that a health care provider recommends may also help optimize hair health. 

Magnesium, zinc, iron (contained in nuts, legumes, mushrooms, and eggs), as well as vitamins A (found in carrots), B (available in seafood, cheese, bananas, and tomatoes), E (present in oatmeal), and F (found in fatty fish) are all great for health.

Iron deficiency is among the main causes of hair loss, and people with PCOS typically have lower ferritin levels. Eating foods that are rich in iron and/or taking iron supplements can help raise iron levels.

Hair growth is also greatly affected by zinc, selenium, silicon, biotin (vitamin B7), and choline (vitamin B4). Simple tests can determine how much of these vitamins and minerals there are in the body. Minor deficiencies are easy to address through dietary changes. Nuts and pumpkin seeds are rich in zinc, beans and broccoli in selenium, rice in silicon, peanuts and liver in biotin, and eggs and seafood in choline. If the deficiency is critical, it is worth consulting a health care provider for treatment.

Choosing the right hair products is also important for healthy hair growth. Hair care products should be free from wax and mineral oils, which can form a film on the scalp, thus interfering with normal sebum production. Products containing hydrolyzed proteins (keratin and collagen) and B vitamins can be beneficial for the hair.

High temperatures from blow drying or styling with a curling or flat iron and harsh chemicals from hair dyes, perms, straighteners, or relaxers can damage weakened hair.

Medical treatments are available for PCOS and hair loss related to the condition. A health care provider may prescribe oral contraceptives, antiandrogens, or a prescription-strength medicated shampoo to help control hair loss and scalp conditions like dryness and dandruff. 

Metformin can also be prescribed to people with PCOS to help regulate insulin levels, and the subsequent weight loss from taking this medication can have a positive effect on hormonal balance and hair loss.

There are also home remedies for PCOS hair loss. Using moisturizing shampoos and conditioners for damaged and color-treated hair can help keep hair healthy, and shampoos designed for thinning hair may encourage new hair growth and protect hair.

Other home remedies include using natural bristle brushes that are softer and gentler on hair than traditional synthetic bristles and using a pick on hair before brushing to avoid pulling on the hair too much and causing breakage. It’s also a good idea to avoid tight hairstyles like high ponytails or buns that can put extra pressure on the hair.

Using moisturizing shampoos and conditioners for damaged and color-treated hair can help keep hair healthy, and shampoos designed for thinning hair may encourage new hair growth and protect hair.

Many people also get good results from adding supplements like biotin and keratin to their vitamin regimen, but it’s always a good idea to talk to a health care provider before taking any supplements or adjusting the PCOS treatment plan. Even if a supplement is sold over the counter, concentrations vary widely, and it is possible to ingest too much, which can lead to other health issues. The quality of vitamins also varies from brand to brand. High-quality supplements shouldn’t have a lot of filler ingredients.

While some people may not consider hair loss to be a serious medical problem, if it negatively affects daily activities, hobbies, or relationships, it might be a good idea to talk to a health care provider.

If hair loss has become a problem or there are concerns that PCOS might be the cause, undergoing tests to assess hormone levels is a good first step. If a hormonal imbalance is the case, a health care provider can explain options for controlling PCOS and recommend possible treatments for hair loss.

If hair loss has become a problem or there are concerns that PCOS might be the cause, undergoing tests to assess hormone levels is a good first step.

For people who are experiencing PCOS hair loss, talking to a health care provider can help clarify how PCOS plays a role and what treatment options may be available. Effectively managing PCOS can take time and some trial and error to find what works, but it’s entirely possible to treat.

“Polycystic Ovary Syndrome – Treatment.” NHS Choices, NHS, www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/.

“PCOS | Polycystic Ovary Syndrome.” MedlinePlus, U.S. National Library of Medicine, 18 Nov. 2020, medlineplus.gov/polycysticovarysyndrome.html.

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