Hirsutism in PCOS: Why Treating the Root Cause Matters Most

Jodie Relf
Aug 4
4 min read

If you’re living with PCOS and have noticed coarse, dark hairs appearing on your chin, upper lip, or jawline, you’re definitely not alone. Hirsutism—unwanted facial and body hair in a “male-pattern” distribution—is one of the most visible and distressing symptoms of PCOS. It can feel unfair, embarrassing, and isolating.

I know how deeply this can affect your confidence, because I’ve been there myself. For years, I struggled with stubborn hair growth—especially in places that seemed “off limits” for someone as fair and fine-haired as me. I’ll never forget the discomfort of bikini waxes, and how beauticians would comment on how unusually coarse my hair was for someone so fair. The pain was honestly unbearable, and I thought maybe I was just overly sensitive. If only I’d known then that my PCOS was behind it—that it wasn’t my fault, and that there were kinder, more effective solutions. Knowing this now, I would have made very different choices and saved myself a lot of pain, both physically and emotionally.

But I want you to know: you’re not alone, it’s not your fault, and there are evidence-based options to help you manage it—without shame or harsh restriction.

Why Does PCOS Cause Excess Facial Hair?

The culprit is a hormone called androgen (like testosterone). In PCOS, the ovaries produce too much androgen, which can “flip the switch” on hair follicles in certain areas of the face and body, turning fine, light fuzz into thick, dark hairs. These hairs typically show up on the chin, upper lip, cheeks, neck, chest, stomach, or back—places where men usually grow hair. Genetics and ethnicity play a role too, so some women notice more hair growth than others.

Hirsutism isn’t just about looks—it can trigger anxiety, affect social life, and lead to a lot of time spent plucking, waxing, or worrying. It’s important to remember: this is a medical symptom of a hormonal imbalance, not a reflection on your hygiene or “effort.” It’s not your fault.

What Actually Helps with Hirsutism?

You deserve more than a lifetime of hair removal. The most important step is addressing the root causes—otherwise, new hair will keep appearing no matter what you do on the surface. Here’s where to start:

1. Lifestyle Changes to Address the Root Cause

Start here, because every other solution works better when you support your hormones from within:

Balanced Diet & Regular Meals: Focus on steady blood sugar—regular meals, whole grains, lots of fibre, protein at every meal, and healthy fats. This helps reduce insulin resistance, which in turn helps lower androgens.
Move Your Body: Enjoyable movement (like walking, yoga, strength training) supports hormone balance. It doesn’t need to be intense—gentle, consistent movement really does help.
Inositol & Spearmint Tea: There’s growing research showing that inositol supplements and drinking two cups of spearmint tea a day can help lower testosterone levels in women with PCOS. Curious about how this works (and my favourite spearmint tea brands)? Read my spearmint tea blog here.
Nurture Your Gut: A happy gut can help regulate hormone levels. Aim for plant diversity, plenty of fibre, and try fermented foods (like live yoghurt or kefir) to support gut health.
Gentle Weight Loss (if needed): If you have overweight PCOS, even 5–10% weight loss can reduce insulin and androgens—but remember, this is not the only answer, and improvement is possible at any size.
Prioritise Stress Management: Stress raises cortisol, which can drive up androgens too. Daily self-care—even a few minutes of deep breathing or a walk outside—makes a real difference.

If you start here, you’re working with your body, not against it. And when you address the root cause, new hair will often grow in softer, slower, and sometimes less visible—making every other strategy easier and more effective.

2. Medical Therapies (to Support the Root Work)

Birth Control Pills: If you’re not trying for a baby, the pill is often the first-line medical option. It reduces androgen production and raises a protein that “traps” excess androgens.
Anti-androgens (e.g. spironolactone): These block androgens from acting on the hair follicle, often prescribed alongside the pill for more effect. (Contraception is needed as these medicines can cause birth defects.)
Metformin: Useful if insulin resistance is part of your PCOS. Metformin can lower androgens over time and support your efforts.
Eflornithine Cream: A prescription option to slow new hair growth, often used alongside other treatments.

3. Hair Removal Methods (for Immediate Confidence—Not as the Only Solution)

Hair removal is valid and can boost confidence, but it’s only part of the picture. If you’re addressing the root cause, you’ll likely notice you don’t need to remove as much hair, or as often, over time.

Shaving, waxing, threading, depilatory creams: Safe and effective—choose what makes you feel good. There’s no shame in shaving your face!
Bleaching: Good for lighter hair or smaller patches.
Laser Hair Removal: Longer-lasting, especially when hormones are balanced. Combining this with medical or lifestyle strategies works best.
Electrolysis: Permanent but slow—useful for small areas.

My own experience taught me that listening to your body is key. If something feels painful or wrong, it might be your PCOS—not your fault. You don’t need to stick with methods that hurt just because it’s what everyone else does. Give yourself permission to choose what’s best for you.

4. What Doesn’t Help

Extreme diets, fasting, or cutting food groups: These do not “fix” hair growth, and can even worsen PCOS by raising stress hormones.
Expensive “miracle” supplements: If it sounds too good to be true, it probably is. Focus on proven, evidence-based steps.
Self-blame or shame: The most important thing to drop. This is a symptom of a real medical condition, and you are worthy of care and compassion.

The Takeaway: Real Solutions Start From Within

Managing unwanted facial hair is a journey, not a quick fix. It’s totally valid to want the immediate confidence boost of hair removal, but please don’t skip over addressing the root cause. The best, longest-lasting results happen when you combine lifestyle changes, possible medical support, and practical removal—with compassion, not restriction.

If you’re struggling, know this: