I don't want to be a hairy princess!
May 17, 2016 5:19 AM   Subscribe

I've been recently diagnosed with PCOS, and the difficult part at the moment is the chin acne/facial hair - because I'm a fidget and tend to pick at things. And it makes me feel pretty rubbish about my appearance. PCOS people, what have you used that's helped? Were there any miracle products, or did dietary changes help too?

I know the two obvious answers here are 'see your GP' and 'see your derm'. So just to get those out of the way -

The GP I saw prescribed something which used to be a contraceptive pill until it lost its licence, and is now prescribed to regulate periods and help with acne. Thanks to family medical history, though, I have been told that it's not safe for me to take the pill, and nor should it be given to people with a history of depression (I have bipolar disorder) or migraines (I rarely get migraines with aura but I've had them since I was a child). (And I did mention all this at the time.) I also gain weight very easily on hormonal contraceptives, and I don't think that's a great result for someone with PCOS. So I decided no to those.

Getting a derm appointment in the UK is very difficult. You need to get a GP referral. My NHS GP will only refer for things like eczema, and the waiting list is looooong. I tried going through my private healthcare that I get from work, but they won't cover me because PCOS is a chronic condition, so I couldn't get referred that way either. There are private derms but either they are too expensive for me to look into, or seem to be essentially skincare consultants.

So. What can I do as an individual to help this? Anything to avoid/look for? I've looked on the Reddit for PCOS but most of the posts on there are about fertility issues which doesn't worry me right now. I just want to try and break the habit of damaging my skin!
posted by mippy to Health & Fitness (36 answers total) 10 users marked this as a favorite
 
I'm in the US, so I'm not sure if it is available in the UK, but I was prescribed spironolactone for hormonal chin acne, and it made a huge difference for me. It may be worth asking your GP about.
posted by Caz721 at 5:44 AM on May 17, 2016 [1 favorite]


fwiw, I was on spironolactone (which I got on the NHS from a dermatologist - wait wasn't that long but it was basically outsourced to a private clinic) for hair loss and eventually stopped taking it because it was damaging my liver and I had to have another pill to protect it. I decided in the end that small effect it had on my hair wasn't worth the damage to my liver and having to take loads of pills
posted by missmagenta at 5:58 AM on May 17, 2016 [1 favorite]


Could you attack the facial hair with laser hair removal? Also some people I know swear by this other laser skin treatment for acne that they get from an aesthetician/facialist/skin salon/whatever you call it. So: lasers.
posted by greta simone at 6:09 AM on May 17, 2016 [2 favorites]


When I had bad acne as a teenager I was prescribed Minocin by my GP. It was very effective after a couple of months and kept it clear until I came off it to go on the pill (as it's an antibiotic you can't use both at once). I didn't have any side effects with it and took it for a few years.

I'd also consider laser hair removal. I've had it done on my bikini line and it was really effective - I waited until I saw a good Groupon deal and got a course of 6 for a really cheap price.
posted by billiebee at 6:13 AM on May 17, 2016


Metformin/glucophage is a common treatment for PCOS in the US. It has helped control my PCOS symptoms. Also, a low carb diet has been shown to reduce symptoms. Diet and exercise is really the number one thing you can do to treat PCOS on your own. Myself, I'm horrible at it.

For my unwanted hair growth I pluck, wax and use a chemical depilatory depending on its location.
posted by PorcineWithMe at 6:30 AM on May 17, 2016 [2 favorites]


Metformin is offered in the UK as well.
posted by ellieBOA at 6:32 AM on May 17, 2016 [1 favorite]


I had a crappy break out that I needed to heal up fast -- and I tend to pick at things, too -- and in a weird google rabbit hole I found a forum for people who have Dermatillomania, which is a cut or two above my issues, BUT -- on that forum they were recommending calamine lotion to help heal places you've picked / blemishes in general.

I was skeptical, but a huge bottle of clear calamine was $2 at the store so whatever.

It works. I have no idea why. But there you go.
posted by Medieval Maven at 6:38 AM on May 17, 2016


For hair, just wax. I use one that I heat up in the microwave. Then I just go to it. It's quick, easy and inexpensive.

Hormonal acne is another thing altogether. There are skincare regimes that some people like, I used Clinique when I was a teen, and I was able to avoid all but the occasional pimple. Some people swear by Proactive, I don't know, but they've been in business for decades at this point.

A low carb diet is helpful, just make sure that your protein sources are not treated with hormones or antibiotics. Stay away from soy products as well.

I'll tell you what my Mom told me, "Keep your hands off your face!" Don't pick. It will cause scars. Learn some tricks for camouflaging your breakouts, then roll with it.
posted by Ruthless Bunny at 6:38 AM on May 17, 2016 [1 favorite]


MedievalMaven - I do have dermo. This is why I don't need any more spots! I will look into calamine (although the smell is somewhat unpleasant).

I'm trying to make changes to my diet but it is tough when you take medication that makes you constantly hungry.
posted by mippy at 6:46 AM on May 17, 2016


There are a lot of antiandrogens out there, including some that are approved in the UK but not the US. They've all got different side effects, and it's quite possible you'll be able to find one that works well for you. Many of them require regular blood testing to make sure your dosage is correct, but if you get your blood levels taken a few times a year — and lower your dosage or switch meds if the tests detect any problems — then they're safe to take long-term.

Anecdotally, I know dozens of trans women who take spironolactone or cyproterone acetate at similar doses to the ones you'd take for PCOS, and I only know one who's had to stop taking them due to side effects. So it does happen, but not often. It's up to you whether the risks, and the hassle of regular blood testing, are worth it.

For hair removal, yes, consider laser or electrolysis. Laser is faster and cheaper but not always permanent, and works better if you have medium-to-dark hair and medium-to-fair skin. Electrolysis is slower but more thorough, is guaranteed to be permanent if you do enough rounds of it, and works regardless of hair or skin color.
posted by nebulawindphone at 6:50 AM on May 17, 2016 [1 favorite]


Some people have had success with a low-fat vegan diet. Search PCOS with "vegan" and "McDougall." Evidence is anecdotal, but worst-case scenario is it doesn't work and you go back to the way you were eating. MeMail me if this interests you and you want more resources.
posted by FencingGal at 6:51 AM on May 17, 2016


For what it's worth -- I've found modern epilators are not the torture devices they once were. They're also useful if you have, say, hair in a place where you would rather have less hair but not no hair -- just give it a few quick passes with the epilator. Braun makes a well-reviewed one designed just for facial hair.
posted by kmennie at 7:01 AM on May 17, 2016


I was diagnosed with PCOS about a year ago (what a relief to know what was going on with my body!) I've always gone threading since I was 12, so I do that still. Much better on my sensitive skin, and so cheap if you're in a place like Atlanta where there's a lot of threading salons. If not, I go to one in the mall. I've also shaved my face (dermaplaning is the fancy term now I guess) with the small eyebrow razors and have never had issue with that myth of thicker hair growing back.

Actually, now being on birth control for a few years, my body hair has has considerably thinned and slowed down in growth than when I was in my teens. I've been on spironolactone for 6 months now and haven't had issues yet, and I like that it's slowing down my hair loss. It's padded my hairline nicely too and really helped my skin. But that could also be the retinA and AHA I use too.

I do notice that for me, weight is retained more easily and I can gain weight much faster than I used to. Low carb is not sustainable for me, I personally need carbs for energy. My colleagues have been studying PCOS and nutrition, and they have an inkling that high glycemic index foods may be more of a worry than carbs itself. Either way, I maintain my body from exercise and lots of it. Keeping a balanced diet does help, but for my body regular exercise keeps my weight in check. Plus, with the extra testosterone I'm a great weight lifter ;)
posted by buttonedup at 7:17 AM on May 17, 2016 [2 favorites]


Plus one for buttonedup's mention of shaving. It's not a fun or great fix, but it's faster and easier than waxing or threading. PCOS can cause hair growth that typical hair removal strategies just won't keep up with (and waxing every day or even multiple times a day is not efficient). In those cases, I think it's kind of a hidden secret that women shave. Or laser removal if you can afford the time & financial expense ... and even then, with PCOS the hair can grow back, although hopefully not for many, many months.
But if you can get a referral to an endocrinologist, you may find a way to regulate your hormones that works for you. I know, a referral and finding a good endocrinologist is much easier said than done. Best of luck to you, OP.
posted by areaperson at 7:34 AM on May 17, 2016 [1 favorite]


Nebula - my testosterone levels were near normal so I don't know!

areaperson - the GP basically said 'You have PCOS, there's a few things you can do, mostly losing weight. Didn't have any mention of an endocrinologist - perhaps because the testosterone was low and fertility wasn't an issue? That and my area is very, very oversubscribed for almost everything. the thing that annoys me are dark, thick, almost plasticky hairs that pop up on my chin - I'm very fair so they look really strange. The other hair is similar to vellus hair, just longer.
posted by mippy at 8:03 AM on May 17, 2016


The dark hairs I just pluck as they appear. For the lighter hairs, I use "beauty trimmer"
posted by missmagenta at 8:12 AM on May 17, 2016


I don't have PCOS but I have a good amount of chin hair, and plucking used to lead to blemishes and a general chin disaster area. I now shave my chin everyday and "poof"! No hair, no blemishes. With PCOS, you might have more difficulty with the spots, of course, but thought I'd share my shaving experience in case it helps.
posted by girlpublisher at 8:36 AM on May 17, 2016 [2 favorites]


Laser, laser, laser. There is no need to put up with those hairs!
posted by cecic at 9:09 AM on May 17, 2016


I have PCOS. Other posters are correct that Metformin and Spironolactone are commonly prescribed to address insulin and androgen imbalances. They were miracle workers for me. I never had much trouble with facial hair, but did have male-pattern hair loss. It's much better now that the underlying hormonal situation is addressed. You're going to have to take care of the underlying cause of the facial hair before you see long-lasting results. You can wax, bleach, laser, etc. for now, but it'll keep coming back until you get the PCOS under control. I'd recommend seeing an endocrinologist, in addition to your gynecologist. They'll probably do a glucose tolerance test and full blood panel to see where things are, then prescribe things from there. Good luck!
posted by jhope71 at 9:09 AM on May 17, 2016 [1 favorite]


My endocrinologist said that this lotion, Vaniqua, lessens the appearance and regrowth of chin hair. It is pricey so I have never tried it. I'm a waxing, plucking kinda gal, myself. The best thing for me was going on birth control and spironolactone.
posted by zoetrope at 9:12 AM on May 17, 2016


I've also been diagnosed with PCOS, I (thankfully!) don't have the acne issues but I use an electric razor pretty much every day for sideburns and chin area. I've actually been doing that for years, way before I was ever actually diagnosed with anything.

I also tend to pick at the hair and that caused me to have a lot of marks on my chin and neck so shaving it every day is the only thing that prevents me from doing it. The smallest amount of hair and I'll try to grab it.

We're going through fertility treatments right now so I'm much more focused on that then on treating the effects of it. Once we have our babies my plan was to get with a general endocrinologist and see if there is something better to be doing.
posted by magnetsphere at 9:26 AM on May 17, 2016


UpToDate, a resource for medical people, recommends OC as the first treatment, spironolactone as the second line, and eflornithine cream aka Vaniqa as the third. Also as a sidenote the vaniqa makes laser hair removal more effective. Metformin and flutamide are not recommended for hirsutism although metformin can be useful for acne in some situations. Flutamide has a risk of hepatotoxicity that generally outweighs any benefit.

I would go talk to your GP or derm and lay that out - you know what you need and you just need the specific prescription. Can you call their office and see if they can prescribe based on your past visits without seeing you? That might work for the vaniqa but probably not the spiro. Also apparently the generic eflora cream can be purchased online if you wanted to try that.

Hope this helps and good luck!
posted by divide_by_cucumber at 9:47 AM on May 17, 2016 [1 favorite]


Vaniqa works for around two-thirds of the people who use it, and it takes about two months for it to start working. It only slows hair regrowth, so you have to use it in conjunction with another removal method like tweezing. It's pricey, but still considerably cheaper than laser. I know people who have had pretty good results with it, so if you don't want to take more systematic drugs, it's worth a try.
posted by praemunire at 10:16 AM on May 17, 2016


I had a course of laser treatment on my chin hairs. The tech said laser is least successful on hormonal hair like chin hair. It was a little successful for a LOT of money spent. I then bought the home hair removal laser and used it almost weekly for a year. My chin hairs disappeared - and it magically coincided with going on the birth control patch (high estrogen).
When I went off the patch the hairs returned!
Don't waste your money on lasering something that won't go away. The hairs will stay with your hormones. Electrolysis might work, but waxing is best in my estimation.
posted by littlewater at 10:41 AM on May 17, 2016


I have PCOS; I eat a low-carb diet, take spironolactone, and lift weights regularly. All those things help me.
posted by culfinglin at 11:11 AM on May 17, 2016


Like girlpublisher, I shave my facial hair daily. I use an electric razor, it works fine, it's not a big deal for me. Cheap, fast, and effective. Good luck!
posted by Bella Donna at 11:26 AM on May 17, 2016


I used to have quite a few hairs on my chin and neck and found electrolysis to be very worthwhile. (I'm a redhead so laser wasn't an option.) It is time-consuming and the costs vary widely depending where you are, but I went roughly every two weeks for a couple of years fifteen years ago, and that hair is permanently gone.
posted by rpfields at 12:01 PM on May 17, 2016 [2 favorites]


I don't have PCOS but I am hairy and nthing electrolysis. I wish I'd started sooner -- it turned out to not be nearly as expensive or painful as I expected. And you can help manage the pain by putting lidocaine on the areas to be zapped and wrapping them in saran wrap for about an hour before your appointment. You can get over-the-counter lidocaine by buying RectiCare hemorrhoid cream.
posted by Jacqueline at 1:12 PM on May 17, 2016 [1 favorite]


I have PCOS. I too have the hormonal wiry dark chin hairs- HATE.

I just shave them with an electric razor. It takes like 30 seconds and works perfectly well.
posted by oblique red at 2:21 PM on May 17, 2016


Have you looked into a ketogenic diet? The /r/xxketo subreddit is for ladies who eat keto diets, and much of the discussion there is about the success women with PCOS have had. I have not been diagnosed but have many of the symptoms so I can't speak from experience, but it might be something to look into.

Keto is great because if you're hungry, you can just eat a ton of fat.
posted by moons in june at 6:08 PM on May 17, 2016


I don't have PCOS but I do get lots of hairs and acne of my jaw line and chin. I have taken to plucking the bigger ones and using one of those 'eyebrow razors' to shave the finer ones. My big secret is using the Paula's Choice Clearing Gel on the area every morning and night. I rarely get spots there any more and it is gentle enough for daily use. It's been my miracle.
posted by Youremyworld at 6:38 PM on May 17, 2016


Eating paleo cleared my skin right up, heavy exercise like HIIT made it even better and improved my well-being tenfold. Moderate aerobics is not enough, I bike commute daily and it does nothing. You have to sweat HARD (but thankfully not long!) to see a difference with PCOS.

Rather than pills, I'd suggest herbal tinctures to balance your hormones. You start one at full moon, 2-3x/day, then the other at new moon. Here's an example my doctor made me. It's the only thing that's ever regulated my cycles successfully. Contraceptives threw me for a terrible loop and nearly ruined my life, if you can avoid them, do! On the tincture I had minor emotional swings and bloating that leveled out after a month. No other side effects. A skilled naturopath should be able to whip this up for you.

Phase 1 - black cohosh root, dong quai, bitter fennel, alfalfa
Phase 2 - chaste tree, wild yam, dandelion, sarsaparilla, fenugreek

Instead of metformin, try 2 scoops of myo-inositol and 1 tsp of cinnamon daily. Both help with insulin regulation and blood sugar spikes. Avoid sugar and crap white processed carbs like the plague. If you do eat them, add a lot of fat (like butter or coconut oil) to avoid spikage. Some people are also sensitive to dairy.

Have you had a basic metabolic panel? If you have ferritin problems like many of us, consider iron transfusions to raise your levels. Amazing. Also Vitamin D and fish oil.

As for hair, what you already have won't go away or get significantly thinner. However, balancing your hormones can help you avoid future growth. I'd recommend electrolysis over laser for permanent removal – shop around for a good technician. Try a straight razor for a nice close shave. Work a stiff lather, rinse with lukewarm water, pat dry gently. No touchy!
posted by fritillary at 10:08 PM on May 17, 2016


I don't have a dermatologist or a gynaecologist. I see my GP for anything related to these, who will refer me for an appointment if they deem it necessary. Our system is quite different from the US - you don't have a standing appointment with a specialist. I have had eczema for twenty-five years and have seen a dermatologist once (when I got it over my eyelid).
posted by mippy at 3:28 AM on May 18, 2016


Thanks for the answers, all! I will look at diet changes I can make and I'm going to start going swimming as well. That seems like a good place to start for now!
posted by mippy at 3:38 AM on May 18, 2016


To counterpoint - I had years of weekly electrolysis treatments, that basically did nothing permanent or lasting. I have also had many years worth of laser treatments (more intensive at the outset, now just a few touch-ups per year.)

Laser wins for reduction*, in my experience. Now if a dark hair dares to grow, it is paler, thinner, softer, and can easily be trimmed away.

*permanent total hair removal is somewhat mythical - but if you can get a lasting reduction, it can help tremendously.
posted by 41swans at 4:54 AM on May 18, 2016


Electrolysis does permanently remove hairs but many of us keep sprouting new hairs as we age.
posted by Jacqueline at 5:51 AM on May 19, 2016 [1 favorite]


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