Androgenetic Alopecia in Polycystic Ovary Syndrome: A Cutaneous Marker of Systemic Metabo-Inflammatory and Endocrine Dysfunction: A Narrative Review

This narrative review explores androgenetic alopecia (AGA) in Polycystic Ovary Syndrome (PCOS) as a marker of systemic dysfunction beyond hyperandrogenism. It proposes that AGA in PCOS results from a combination of local follicular metabolic signaling failures and genetic predisposition, exacerbated by insulin resistance and chronic inflammation. The review highlights that while androgen action is necessary, it is not sufficient alone to explain the condition. It emphasizes the roles of insulin, inflammatory mediators, and genetic variants as direct contributors to follicular distress. The review also offers a framework for managing PCOS-associated alopecia, suggesting that a systems-level understanding is crucial for developing personalized treatments that improve both skin and systemic health outcomes for women with PCOS.