Understanding Skin Changes in PCOS: A Guide to Managing Symptoms

The Connection Between PCOS and Skin Changes

PCOS is a hormonal condition, and one of its main features is insulin resistance. This means your body isn’t using insulin as efficiently as it should. As a result, your pancreas pumps out more and more insulin to try to keep your blood sugar stable. High insulin levels don’t just impact blood sugar - they also affect your skin.

Acanthosis Nigricans: What You Need to Know

Acanthosis nigricans is the medical term for those dark, velvety patches that often appear on the back of the neck, underarms, groin, or even under the breasts. It’s not dirt, and it won’t wash off - so please don’t feel ashamed or scrub your skin raw (I’ve seen so many clients try this out of frustration!). These patches are your body’s way of telling you that insulin is running high, and your skin cells are multiplying faster than usual.

Skin Tags: Understanding Their Appearance

Skin tags are soft, fleshy little growths that often appear on the neck, underarms, or where skin rubs together. They’re totally harmless and painless, but they can feel annoying or affect your confidence. They also tend to pop up more if you have insulin resistance.

What Do These Signs Mean?

Both acanthosis nigricans and skin tags are visible clues that your body might be dealing with metabolic stress. They’re not dangerous on their own, but they’re worth paying attention to—because they can be early warnings of higher insulin levels, which over time increases your risk of diabetes or other metabolic issues.

The good news? These symptoms can absolutely improve when you address the underlying causes. And the best part is, you don’t need to resort to crash diets or extreme changes.

What Can You Do About Dark Patches and Skin Tags?

1. Tackle Insulin Resistance (Gently!)

• Balanced Eating: Focus on steady blood sugars with regular meals, fibre-rich foods, lean proteins, and healthy fats. You don’t need to cut out carbs, but pairing carbs with protein and fibre helps keep insulin levels more stable.

• Movement: Any movement counts - walking, dancing, strength training, or yoga. Find what you enjoy and make it a part of your routine.

• Small, Sustainable Changes: You don’t need to overhaul your life overnight. Even small steps, like adding an extra portion of veg or taking a brisk walk after meals, can add up over time.

• Inositol Supplements: There is good evidence that myo-inositol (and sometimes a blend of myo- and d-chiro-inositol) can help improve how your body responds to insulin. Many women with PCOS find that inositol can gently support blood sugar balance, reduce insulin resistance, and over time, may help improve skin changes like dark patches and skin tags. If you’re curious about how to use inositol safely, read my full article here or chat with your healthcare provider about whether it’s right for you.

  
  

2. Seek Medical Support

• Metformin: If lifestyle changes alone aren’t enough, your doctor might recommend metformin. It helps your body use insulin better and can reduce both skin changes and overall PCOS symptoms.

• Check Your Numbers: Let your GP know if you notice new dark patches or a lot of new skin tags, especially if you have a family history of diabetes. They might want to check your blood sugar, insulin, or cholesterol levels.

  
  

3. Caring for Your Skin

• Be Gentle: Avoid scrubbing or using harsh treatments! Instead, use gentle cleansers and moisturisers to care for your skin.

• For Skin Tags: If they bother you, a GP or dermatologist can remove them easily using methods like freezing, snipping, or cautery. Over-the-counter remedies are best avoided—they can irritate or scar your skin.

• For Dark Patches: Lotions with lactic acid, urea, or retinoids may help smooth the skin, but the real improvement comes from lowering insulin levels.

  
  

4. Emotional Support Matters

It’s totally normal to feel self-conscious or even frustrated by these symptoms. Remember: they’re medical signs, not a reflection of your hygiene or worth. You deserve support and understanding - never shame.

My Experience with Clients

I’ve had clients walk in feeling embarrassed and desperate to “scrub away” these dark patches. The relief they feel when I explain what’s really going on - and that it can get better - honestly, it’s one of my favourite moments in clinic. Your skin is just giving you helpful information; together, we can work on the root cause.

The Bottom Line: You Are Not Alone

If you notice dark patches or skin tags, you’re not alone, and you’re not doing anything wrong. These are common PCOS symptoms and a little nudge from your body to look after your metabolism. With gentle lifestyle tweaks, inositol, the right support, and some self-compassion, you can see improvement - on the outside and inside.

Conclusion: Embrace Your Journey

Navigating PCOS can be challenging, but understanding the signs your body is giving you is the first step towards better health. Embrace the journey, and remember that small changes can lead to significant improvements over time. Your skin is just one part of your overall health, and with the right approach, you can thrive.