With an approximate one in five Indian women suffering from polycystic ovary syndrome (PCOS), doctors say that more awareness is needed about the condition, especially because it can be controlled by proper diet, exercise and lifestyle changes. A major side effect of the hormone disorder? Acne and hair loss. These are also the symptoms that most patients present with first. We spoke to a dermatologist and a gynaecologist for their take.

Polycystic ovary syndrome (PCOS) is a condition where women produce higher-than-normal amounts of male or androgen hormones. This manifests as small cysts on the ovaries, which disrupt hormone levels and then cause irregular (or delayed periods) due to an ovulation imbalance. But what shows on the outsideacne, thinning hair and excess facial hair, is what patients usually consult their physicians for first.

PCOS disrupts your skin and hair texture. Because there is too much testosterone in the body, there is an increase in sebum and skin cell production, leading to acne. PCOS-induced acne shows up on the jawline, cheeks, chin and upper neck, shares Dr Gupta. Not only is hormonal acne uncomfortable, but it also can be painful, as the cysts and nodules can be hard and long lasting. In some cases, the skin texture becomes dry and there is darkening of the neck and underarms observed, adds Dr Mayur Das, consultant, obstetrics and gynaecology, Max Super Speciality Hospital, Delhi.

Hair growth is also thrown off balance. PCOS causes excess hair growth on face, chest or back. This is called hirsutism, and is a very common symptom. In a lot of cases, there is thicker hair growth on the face and body, but thinning of hair or hair loss near the frontal hairline, states Dr Das. Due to an overabundance of testosterone or androgen, hair may become thin or brittle, and begin to fall out without being immediately replaced.

The underlying cause is the hormonal imbalance, and the treatment for it is multifaceted. Doctors may prescribe oral contraceptives to decrease androgen production and regulate oestrogen, or may treat each symptom (like the hair loss or extreme acne) separately through medications or topicals.

Over-the-counter acne medications typically rely on benzoyl peroxide, salicylic acid, and sulphur to help treat acne. Although these ingredients can help with mild breakouts, they usually aren't enough to treat hormonal acne, says Dr Gupta and adds that the prescription treatment isotretinoin (a type of retinol) may be required in case of severe cystic acne and acne. The doctor may also prescribe antibiotics and spironolactone which helps lower testosterone levelswhich then reduces acne."

These same medications are used to reduce testosterone induced hair loss too, so it all works in tandem. In addition, doctors may suggest other therapies to kickstart hair growth once the hormonal imbalance is in control. PRP, mesotherapy and Progenra help to stimulate cell growth in the scalpan important addition to oral medicines.

Dr Gupta says that tamping down inflammation is important to reduce the intensity of the symptoms. Include leafy greens, seasonal fruits, high fat foods, nuts and seeds. Switch to a nutrient-rich diet with whole foods, less of refined and processed foods which are also heavy on preservatives. Stay away from carb-laden foods like white rice, potatoes, cakes and milk chocolates and cut down on sugar consumption to see a marked difference in your skin and hair texture, she says. Since weight gain and insulin resistance is another byproduct of PCOS, reducing these markers can go a long way in reversing the end result. Exercise is key tooit can lower blood sugar levels and prevent insulin issues. Reducing stress through exercise, meditation and other forms of mindfulness helps to deal with microstressors, which help to control the adrenal and cortisol levels of the body too.

Experts recommend supplementing the diet with omega acids, zinc and biotin to facilitate hair growth from within. Inositols are carbohydrates that can influence the body's insulin response, and when taken as a supplement may help improve metabolic and reproductive aspects of PCOS, explains Dr Gupta.

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How to manage and treat PCOS-induced acne and hair loss - VOGUE India