Hormonal Acne, Hair Thinning & Hirsutism

The androgen connection

Androgens such as testosterone and DHEA-S act on oil glands and hair follicles. In PCOS, higher androgen levels or increased sensitivity to them can cause deep, tender breakouts along the jawline and chin, coarse dark hair on the face, chest or abdomen (hirsutism), and thinning hair on the scalp, especially at the part and crown (androgenic alopecia).

These symptoms can affect confidence more than any lab value. They are real medical concerns that deserve real treatment — not just cover-up advice.

Evaluation

Assessment includes a skin and hair exam, history of onset and progression, and labs including total and free testosterone, DHEA-S, thyroid function, iron studies and vitamin D. Iron deficiency and thyroid disease commonly contribute to hair shedding and are easily overlooked.

Treatment options

Because these symptoms are hormonally driven, the most effective treatments lower androgen production or block its effect. Combined oral contraceptives reduce ovarian androgen output and raise sex hormone binding globulin. Spironolactone, an androgen blocker, is commonly used for hormonal acne and hirsutism and is often combined with contraception.

Topical treatments such as retinoids and benzoyl peroxide support clearer skin. For scalp hair thinning, topical or low-dose oral minoxidil may be discussed. Improving insulin resistance lowers androgen levels at the source, which is why metabolic care runs alongside skin-focused treatment.

• Combined hormonal contraception
• Spironolactone
• Topical retinoids and acne care
• Minoxidil for scalp thinning
• Metformin and insulin-sensitizing strategies
• Laser or electrolysis referrals for established hair

Setting realistic timelines

Skin usually improves in two to three months. Hair changes are slower because hair grows in long cycles — expect six months or more to see meaningful change in hirsutism or scalp density. Consistency is key, and progress photos help you see improvements that are easy to miss day to day.

Safety considerations

Some androgen-blocking medications are not safe during pregnancy, so reliable contraception is discussed when they are prescribed. Potassium and blood pressure may be monitored with spironolactone. Every recommendation is matched to your health history and family plans.

Preparing for your visit

Coming prepared helps you get the most from an appointment about hormonal acne and hair changes. Take a few photos of your skin and hairline now so progress can be measured. List the acne products and prescriptions you have already tried, how long you used them, and what happened. Note any recent changes in weight, stress, diet or medications, and whether you are planning pregnancy, because some treatments must be avoided then.

JennWell Women's Health is located at 11844 Standing Stone Dr., Suite 200 in Gretna, inside Skilled Touch Health and Healing, and welcomes women from Elkhorn, West Omaha, Millard, Papillion, La Vista, Bennington, Lincoln and across Eastern Nebraska. To schedule, call (402) 800-8595 or request an appointment online. If you are unsure whether this service is right for you, a consultation is a no-pressure place to start the conversation and learn your options.