PCOS — polycystic ovary syndrome — affects roughly 1 in 10 women of reproductive age. And one of its most visible and emotionally difficult symptoms is hair loss. Not the kind that happens in patches, but the slow, diffuse thinning that makes your ponytail feel smaller every month.
I bring this up because I’ve sat across from more women dealing with this than I can count, and most of them didn’t connect their hair loss to PCOS until someone — sometimes me — asked the right questions.
How PCOS affects hair
PCOS causes elevated androgens — male hormones like testosterone and its derivative DHT. DHT is the hormone responsible for male pattern baldness. In women with PCOS, elevated DHT causes the same process: hair follicles on the scalp miniaturize, producing thinner and thinner hairs until some stop producing visible hair altogether.
The pattern is usually different from male baldness though. Women with PCOS-related hair loss typically see thinning at the part line, the crown, and sometimes the temples — while maintaining their frontal hairline. It’s a widening part that gradually becomes more noticeable.
The cruel irony of PCOS: while hair thins on your head, androgens can cause excess hair growth on the face, chest, and back. Same hormone, opposite effects in different locations.
When to suspect PCOS
Hair thinning combined with irregular periods, acne (especially along the jawline), weight gain concentrated around the midsection, or difficulty losing weight. Any combination of these warrants a conversation with your gynecologist or endocrinologist.
Don’t wait until the hair loss is severe. PCOS-related hair miniaturization is progressive — the sooner it’s addressed, the more follicles can be preserved.
Treatment isn’t my department, but I know the basics
Medical management typically involves hormonal treatment — birth control pills, spironolactone (which blocks androgens), or metformin. Some dermatologists prescribe topical minoxidil for the hair specifically. These are conversations to have with your doctor, not your stylist.
What I can tell you from observation: clients who get their PCOS managed medically see gradual improvement in hair density over 6–12 months. It’s not overnight, and full restoration isn’t always possible, but stabilization and regrowth do happen.
What we can do in the salon
While you’re working with your doctor on the hormonal side, we address the hair you have right now. Davines Naturaltech Energizing scalp treatments support follicle health topically. Strategic cutting techniques — layers, texture, and movement — create the appearance of more volume and density.
For clients with significant thinning, we can discuss hair toppers or integration pieces that blend seamlessly with your natural hair. No judgment, just options.
And honestly, sometimes the most important thing we do is listen. Hair loss from PCOS can be isolating. Having a stylist who understands what you’re going through — who doesn’t make you feel like you need to explain or apologize — matters more than any product recommendation.
Book at Reverie if you’re dealing with this. We’ve been there with many clients, and we know how to help.
