Visit Website →
← Back to blog

PCOS Hair Growth: Causes, Treatments and What to Expect

November 7, 2026
PCOS Hair Growth: Causes, Treatments and What to Expect

PCOS hair growth, called hirsutism, is dark, coarse hair that appears on the face, chest, back or abdomen. It is driven by high androgen activity, and you can manage it. Treatment usually means combining hair removal with medical treatment from a clinician, and it takes months, not weeks. We wrote this guide to explain what you are seeing, why it happens, how doctors check it, and what to expect from each option.

Myhair
Track Hair Changes Over Time
MyHair uses scan-based assessments to help you follow hair changes over time and explore product recommendations tailored to your hair.
Download the app

TL;DR

  • PCOS is the most common cause of hirsutism, accounting for more than 70% of cases. The cause is excess androgen activity, often tied to insulin changes.
  • Doctors assess it with a visual score and, when indicated, a blood test for androgens. Sudden or severe new hair growth needs prompt medical investigation.
  • Options include shaving, waxing, electrolysis, laser, eflornithine cream, birth control pills and anti-androgen medicines. Your clinician chooses among them based on your health and pregnancy plans.
  • Hair often returns when medical treatment stops, so plan for months of consistent care and a follow-up visit.
  • We can help you track changes with photos over time, but we do not diagnose PCOS. Only a clinician can do that.

Table of Contents

What PCOS hair growth looks like

PCOS-related hirsutism is not the soft, fine fuzz most people have. It is terminal hair: thick, dark and coarse, in a pattern more often seen in men. According to Cleveland Clinic, it commonly shows up on:

  • the face, including the upper lip, sideburn area, chin and jaw
  • the neck
  • the upper and lower back
  • the upper arms and chest
  • the upper and lower abdomen
  • the inner thighs

The Mayo Clinic notes that PCOS-related excess hair is often noticed around the mouth and chin. It can develop over years, often starting in puberty, and it usually progresses slowly. That slow pace is why many people spend years assuming it is just how their hair is.

The key word is terminal. Medical guidance counts only terminal hairs toward the definition of hirsutism, and the threshold on the clinical scoring scale varies with ethnicity. A few stray chin hairs do not automatically mean a medical problem, and a clinician is the right person to judge where you fall.

Why PCOS causes extra hair

Hair follicles on the face and body respond to androgens, a group of hormones everyone produces. The NICE clinical knowledge summary explains that hirsutism happens because of higher androgen levels, because follicles are more sensitive to androgens, or because the body processes androgens differently in the skin.

In PCOS, the first factor is common. The NICHD describes higher androgen levels in people with PCOS, and says those androgens play a role in increased hair growth and acne. It also links insulin to the picture: when insulin runs high, the body makes more androgens, which feeds PCOS symptoms.

The Mayo Clinic frames PCOS as a condition driven by both androgen activity and changes in how the body uses insulin. This matters for treatment. Removing the hair deals with what you can see. Medical treatment works on the hormone signal behind it.

The FDA's women's health page on PCOS lists excess hair on the face, chest, abdomen and upper thighs among the signs of high androgens, alongside irregular periods.

How doctors assess it

The Ferriman-Gallwey score

Clinicians commonly use the modified Ferriman-Gallwey (mFG) scale. It rates terminal hair at several body sites. The cutoff for hirsutism is usually between 4 and 6, depending on ethnicity, according to the 2023 international PCOS guideline. That guideline says hirsutism alone should be considered predictive of biochemical hyperandrogenism and PCOS in adults.

Blood tests and referral

NICE advises testing in women with an abnormal hirsutism score. That means measuring serum total testosterone. If the level is above 4 nanomol/L, the next step is referral to endocrinology. This is UK guidance, so US practice may differ in thresholds and units. Your own clinician will interpret your results.

Signs that need prompt attention

The same 2023 guideline says new-onset severe hirsutism, or hirsutism that is getting worse, needs investigation to rule out androgen-secreting tumors and ovarian hyperthecosis. If extra hair appears quickly, spreads fast, or comes with a deepening voice or other marked changes, book an appointment with your primary care provider or an endocrinologist soon. Do not wait for the next routine visit.

For slower, long-standing growth, a primary care doctor, gynecologist, endocrinologist or dermatologist can all start the evaluation. If you are also thinking about pregnancy, say so at the first visit. It changes which treatments are suitable.

Treatment options for PCOS hair growth

No single treatment does everything. The NICE summary lists three layers: hair reduction or removal, eflornithine cream for facial hair, and a combined oral contraceptive for premenopausal women who have no contraindications. Specialist options include anti-androgens, insulin-sensitizing drugs and GnRH analogues.

Hair removal methods

Shaving, waxing and plucking remove hair temporarily. Electrolysis, lasers and intense pulsed light are the options for long-term reduction. The NICHD treatment page notes these can last longer but may take multiple sessions.

The evidence for light-based treatment is encouraging. A 2024 systematic review in JAMA Dermatology found laser and light-based therapies reduced hirsutism severity in women with PCOS and improved quality of life, with generally tolerable side effects. The authors also noted that the certainty of the evidence was limited. They highlighted combinations, such as diode laser with metformin or a combined pill, as possibly giving added benefit.

Provider performs facial laser hair reduction

Choose a licensed provider who treats your skin tone and hair color regularly, and ask what training they have. If you want to find clinics in your area, our hair clinics directory lists them, and one example is a laser hair removal and skin care clinic in Charlotte, North Carolina.

Eflornithine cream

Eflornithine is a prescription cream for unwanted facial hair. The NICHD explains that it slows hair growth by blocking an enzyme hair needs to grow, that it is FDA approved for unwanted facial hair, and that hair grows back when you stop using it. An evidence review for dermatologists gives an example of the benefit reversing within about 8 weeks of stopping. NICE lists it for women aged 19 and older.

That makes it a good partner to other methods, especially for the chin and upper lip, where visible hair bothers people most.

Birth control pills and anti-androgens

A JAMA guideline for premenopausal women with hirsutism suggests oral contraceptive pills as first-line medical therapy for women who are not trying to conceive. If hirsutism persists after 6 months on a pill alone, it recommends adding an anti-androgen. It also says medical therapy can be combined with photoepilation, electrolysis and topical eflornithine.

The dermatology review describes spironolactone as an effective anti-androgen for hirsutism, with a dose range of 25 to 100 mg per day. It is typically used with a contraceptive pill because of the risk of menstrual irregularity. Dosing is your clinician's call, so never start it, change it or stop it on your own.

Pregnancy plans come first

The NICHD stresses that some PCOS treatments can prevent pregnancy or may harm a fetus, and recommends discussing your fertility goals with your provider before choosing a treatment. If you might become pregnant in the next year or two, bring that up at the start of the conversation. It is the single most useful thing you can tell your doctor.

Will the hair go away or grow back?

Be realistic here, because this is where people lose heart. The American Society for Reproductive Medicine explains that in hormone-sensitive follicles, androgens can turn fine vellus hairs into terminal hairs, and a hair that has made that change usually does not change back on its own. It also says hirsutism often returns when medical treatment stops, and that laser or electrolysis may not always be permanent, since new hair can grow without ongoing medical treatment.

Two practical points follow:

  1. Give treatment time. NICE advises referral if treatment has not worked after at least a 6 month trial. That tells you slow early progress is normal. Hair cycles are long, so a medicine started this month will not show its full effect for a while.
  2. Think maintenance, not a one-time fix. The best results usually come from pairing a medical treatment with hair removal, then continuing the medical piece as your clinician advises.

The ASRM also covers the other side of the question people ask. Treating the hormones does not undo existing terminal hair, but it can slow the formation of new thick hair.

Everyday grooming between treatments

While medical treatment takes effect, you still need a routine that makes you comfortable. Shaving, threading or gentle waxing handle the day-to-day, and a good skin and hair routine helps you feel in control. If you want ideas for building a women's hair care routine, that guide covers the basics of keeping hair and scalp healthy.

A few habits make grooming easier:

  • Keep notes on which method you use and how long the results last.
  • Take photos in the same light every two to four weeks to see real trends.
  • Avoid stopping a prescribed medicine because progress feels slow. Talk to your clinician first.

Track your hair with MyHair

Extra body hair is only part of what PCOS can do to hair. If your concern also includes thinning on the scalp, you need a way to see what is changing and how fast. MyHair is an AI platform that analyzes your hair from scans, tracks changes over time, and suggests products tailored to your results. It also helps you find clinics and hair restoration doctors. Our analysis is a tracking tool for you and your care team and is not a medical diagnosis.

The Free Plan lets you start without paying. The monthly plan costs 9.99 USD per month. You can start on our homepage or see the subscription options.

Myhair

When you are ready for a professional opinion, our hair restoration doctors directory can help you find specialists. For more on options for women, see our guide to hair growth treatment for women, or read about treating androgenetic alopecia if your concern is thinning on top.

Our perspective

We see the same pattern in the questions people bring to us. They notice a change, they are unsure whether it is normal, and they have no record of how it started. With PCOS that gap hurts, because the hair changes are slow and the treatment decisions depend on trends over months.

That is why we built MyHair around scans and tracking. A consistent photo record gives you and your clinician something concrete to compare: is the chin hair spreading, is thinning at the part widening, is a treatment doing anything after three months? Our platform is designed to turn those scans into a clear assessment and product suggestions matched to what your hair is doing, so you spend less time guessing.

We also believe the decision about hormones belongs with a qualified clinician. So we pair tracking with a directory of clinics and doctors, to help you move from noticing a problem to getting a proper evaluation. Start tracking early, keep the habit going, and bring the record to your appointment.

Cyriac

FAQ

Can you get rid of PCOS hair growth?

You can reduce it a lot, but it often needs ongoing care. Electrolysis and laser can give long-term reduction, and medicines can slow new growth. Hair frequently returns if medical treatment stops, so most people keep up some form of maintenance.

What does PCOS hair growth look like?

It looks like thick, dark, coarse hair on the chin, upper lip, jaw, chest, abdomen, back or inner thighs. It differs from fine, light facial hair. It usually builds slowly over years, often beginning around puberty.

Can hair regrow after PCOS treatment?

Yes, extra hair can come back after treatment stops. Once androgens have turned a fine hair into a terminal hair, it usually does not revert on its own. Laser and electrolysis may also not be permanent without ongoing medical treatment.

Should everyone with unwanted facial hair be tested for PCOS?

An endocrine society-backed recommendation says women with unwanted dark, coarse hair on the face, chest or back should be tested for PCOS. Hair that appears suddenly or worsens quickly needs prompt medical investigation. A primary care provider or endocrinologist can order the right tests.

Sources