After years of being undiagnosed, is diabetic hair loss reversible? I have PCOS. Diabetes and PCOS run in my family.

I have had diffuse hair loss for 2.5 yrs. I have PCOS and take Desogen (bcp). I just saw another hair loss doctor, and he thinks I'm either prediabetic or diabetic. Is diabetic hair loss reversible? He said I have diffuse hair thinning. He examined a follicle under the microscope and found it to be miniature. He said there are areas of normal hair and areas of thin hair. Also, I've read that Metformin can cause hair loss. Would a better alternative be insulin injections?

Doctor Answers 3

After years of being undiagnosed, is diabetic hair loss reversible? I have PCOS. Diabetes and PCOS run in my family.

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Diabetes does not cause hair loss directly. Many diabetics have a full head of hair. See a doctor for treatment options.

Diabetes does not cause hair loss directly. Many diabetics have a full head of hair.  Same is true for women with PCOS. See a doctor for treatment options. 

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
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Understanding hair loss from PCOS

Without getting all your medical information, I can only make a few generalizations about hair loss in women with PCOS

1. Hair loss occurs in many women with PCOS. Genetics combined with the hormonal changes can lead to hair loss. 

2. Minoxidil and oral contraceptives and hormone blocking medications are first line treatments for androgenetic hair loss in women with PCOS.  Other hormone blockers can be used too. Treatments like low level laser therapy (LLLT) and platelet rich plasma can also be considered. Other treatments you'll hear about have little or no evidence in treating hair loss in women with PCOS. 

3. The diabetic and pre-diabetic state is NOT a major contributor to hair loss. Diabetics, "insulin resistance" or "prediabetes" are increased in women with PCOS but they are fairly separate issues. About 40 % of women with PCOS have insulin resistance. Treating the diabetes or prediabetes does not lead to major improvements in hair growth. But treating the prediabetic state is very important - and so is treating any associated high blood pressure, high cholesterol, irregular periods, infertility and weight gain. These too are associated with PCOS. 

4.  The "prediabetic" state is due to insulin resistance in PCOS. The key treatment is metformin and other insulin sensitizers. Use of insulin injections are not the first step. They become necessary only when blood sugars can't be controlled with other means. 

4. Metformin can cause hair loss but that is rare. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.