PCOS Symptoms & Causes The Link Between PCOS and Excess Facial Hair By Nicole Galan, RN Updated on December 31, 2023 Medically reviewed by Chioma Ndubisi, MD Print Table of Contents View All Table of Contents Symptoms Causes Diagnosis Other Signs Treatment Abnormal facial hair growth in and of itself is not an indication that you have polycystic ovary syndrome (PCOS). With that said, the symptom—known as hirsutism—is commonly seen in people with PCOS (a hormonal disorder that causes fluid-filled cysts on the ovaries). If hirsutism is accompanied by other symptoms like irregular periods, acne, unexplained weight gain, and male pattern hair loss, then PCOS should be investigated as a cause. This article explains what causes PCOS hirsutism, along with other symptoms of a condition that affects as many as six million people in the United States. It also explains how PCOS is diagnosed as well as treatments to remove excess facial or body hair. Philipp Nemenz / Getty Images Symptoms of Hirsutism Under normal circumstances, females usually have fine, light-colored, and barely noticeable hairs (called vellus hairs) that grow above the lips or on the chin, chest, abdomen, or back. This is sometimes referred to as "peach fuzz" and develops normally during childhood. People with PCOS hirsutism have coarse, visible, dark hairs growing in these parts of the body. These hairs are referred to as androgenic hairs; the term "androgen" refers to male hormones like testosterone. Causes of Hirsutism If your body makes too many androgens, you may experience unwanted hair growth. This most often affects the central part of the body such as between the breasts, around the belly button, or in the inner thighs. It can also affect the face. In addition to PCOS, several other conditions can cause hirsutism. All of these directly or indirectly involve the endocrine system which regulates and produces hormones: Cushing syndrome: A condition that produces too much of the stress hormone cortisol Congenital adrenal hyperplasia: An inherited disorder that increases testosterone production Hyperthecosis: A condition where the ovaries produce too many androgens Acromegaly: A condition where the body produces too much growth hormone Endocrine tumors or cancers: Especially those affecting the adrenal gland and ovaries Medications: Including testosterone, progestin, anabolic steroids, and DHEA Diagnosing PCOS as a Cause If you think PCOS is the cause of your hirsutism, you should see a healthcare provider. If needed, you may be referred to an endocrinologist who specializes in hormonal disorders. Although there is no definitive test for PCOS, the diagnosis can be made if certain criteria are met and other possible causes are excluded. Your healthcare provider will start by taking a full medical history and performing the following tests and procedures: Pelvic examination: Used to look for signs of PCOS (such as swollen ovaries or hirsutism) Blood tests: Measures hormone levels and checks for metabolic abnormalities associated with PCOS (including high blood sugar and high cholesterol) Transvaginal ultrasound: Involves a wand-like device inserted into the vaginal that can visualize the ovaries using reflected sound waves Criteria for Diagnosis According to the American Congress of Obstetricians and Gynecologists, PCOS can be diagnosed if you have at least two of the following three symptoms and all other possible causes have been excluded:Irregular periods or no periods caused by the lack of ovulationincreased androgen levels resulting in hirsutism, acne, or thinning scalp hairMultiple cysts on your ovariesThe presence of ovarian cysts isn’t enough to make a diagnosis as many people with PCOS do not have cysts. Other Facial and Physical Changes With PCOS PCOS hirsutism is only one of the consequences of increased androgen levels, known as hyperandrogenism. With hyperandrogenism, a person with PCOS may start to develop secondary male characteristics and experience dysfunction of the female reproduction system. In addition to hirsutism, other signs and symptoms of PCOS hyperandrogenism include: Irregular periods (dysmenorrhea) Absent periods (amenorrhea) Very heavy periods (menorrhagia) Bleeding between periods (intermenstrual bleeding) Severe, late-onset, or persistent acne that does not respond to usual treatments Weight gain or trouble losing weight, especially around the waist Male pattern hair loss (androgenic alopecia) Patches of thick, dark, velvety skin (acanthosis nigricans), especially along the neck, groin, or underneath the breasts Infertility (inability to conceive after 12 months of trying) Treatment Options PCOS hirsutism is generally a long-term condition that may require one or more treatments to reduce unwanted hair on the face and/or body. Options include: Manual removal: Methods include shaving, plucking, or waxing. Depilatory agents: These are topical gels, lotions, or creams that remove facial or body hair. Hormonal medications: These include birth control pills that increase estrogen levels and anti-androgen drugs like Aldactone (spironolactone) that decrease testosterone levels. Electrolysis: This technique kills the growth center of a hair with electricity. Laser hair reduction: This technique, which kills hairs with a laser, works best on fair-skinned people with very dark hair. For overweight people or those with obesity, weight loss can also help reduce PCOS hirsutism. PCOS Diet: What to Eat to Manage Symptoms Summary Hirsutism, or abnormal facial or body hair growth, is a symptom of PCOS. It is caused by increases in male hormones (androgens) due to the enlargement and dysfunction of the ovaries. PCOS may be diagnosed if there are problems with your periods, multiple cysts on your ovaries, and evidence of hyperandrogenism (high androgen levels). Treatments for PCOS hirsutism include shaving, waxing, plucking depilatories, hormonal medications, electrolysis, and laser hair removal. 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Office on Women's Health. Polycystic ovary syndrome. Endocrine Society. Polycystic ovary syndrome. Mihailidis J, Dermesropian R, Taxel P, Luthra P, Grant-Kels JM. Endocrine evaluation of hirsutism. Int J Women Dermatol. 2015;1(2):90-94. doi:10.1016/j.ijwd.2015.04.003 American College of Obstetricians and Gynecologists. Polycystic ovary syndrome. Agrawal N. Management of hirsutism. Indian J Endocr Metab. 2013;17(7):77. doi:10.4103/2230-8210.119511 By Nicole Galan, RN Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit