PCOS dark inner thighs: Key reasons and treatment options

In a nutshell:

Acanthosis nigricans is a condition that causes dark, velvety areas (patches) to appear on different areas of your skin, including thighs, underarms, nape, etc. Due to hormonal imbalance and insulin resistance, PCOS dark inner thighs are commonly seen as symptoms. Treating dark patches is possible with the help of:

• Medical procedures like chemical peels and laser therapy
• Topical treatments
• Hormonal and insulin resistance medicines
• Natural remedies
• Lifestyle changes

Dark inner thighs aren’t uncommon in PCOS. Yet, this symptom can cause quite a lot of daily discomfort and even have a psychological impact, which is why it’s pivotal to understand why it happens and how to address the issue effectively.

Understanding PCOS and its symptoms

PCOS or polycystic ovary syndrome is a health condition that affects roughly 8-13% of females across the world, though the real number of cases can be significantly higher with most PCOS patients being undiagnosed. This condition implies the formation of many small sacs of fluid (cysts) on the outer edge of the ovary. Containing immature eggs, these fluid-filled cysts affect your ovulation function and cause hormonal imbalances.

The common symptoms of PCOS include:

• Irregular or prolonged periods.
• Increased levels of hormone androgen, which may result in excess hair and acne.
• Insulin resistance.
• Uncontrolled weight gain.

PCOS impact on the skin

Given the fact that our skin is often a mirror reflecting what’s going on inside our bodies, it’s not surprising that deep underlying conditions like PCOS might affect it. In PCOS females, hormonal imbalances may lead to multiple skin-related issues, including acne, excessive hair growth, and hair loss.

Dark patches (a condition known as acanthosis nigricans) might be a less frequent but possible effect of PCOS on your skin. This condition implies the appearance of dark, velvety areas on your skin, typically in such areas as the inner thighs, underarms, nape of the neck, etc.

What causes dark inner Thighs in PCOS?

PCOS skin discoloration might be a disturbing symptom to notice. Nevertheless, it’s quite natural and can be explained by two core reasons:

Androgens

As you already know, females with PCOS have their ovarian function hindered. This typically leads to excessive production of androgen hormones and testosterone, in particular.

Increased levels of testosterone in women can cause a number of issues, including hair loss, excessive hair growth, and acne. Additionally, studies in patients receiving testosterone therapy injections have shown that increasing levels of this hormone can lead to hyperpigmentation and acanthosis nigricans.

Insulin resistance

PCOS often affects one more hormone in your body - insulin, which is responsible for balancing blood sugar. Eventually, insulin resistance is thought to affect around 65-70% of PCOS women.

Insulin resistance, in turn, can result in skin issues. Stimulated by insulin, your skin cells may start reproducing at a rapid rate and overgrow. These new cells may have more melanin causing patches of skin that are darker than your natural skin shade.

Other factors contributing to PCOS hyperpigmentation

While hormonal imbalance and insulin resistance are the major causes, there are a few things that can speed up the development of dark skin patches in PCOS females.

First of all, obesity. Obesity is a common result of PCOS triggered by hormonal issues and insulin resistance, which both can make women put up a lot of weight. Overweight dark inner thighs is a frequent problem caused by constant skin friction.

A combination of lifestyle factors, such as your daily diet and physical activity level can also make a tangible contribution. A lack of exercise and poor eating habits can exacerbate insulin resistance and eventually make you get dark patches on your skin faster.

PCOS dark skin patches management options

Noticing darker spots on your skin can feel rather distressing for every woman. Such noticeable symptoms, first of all, have a psychological impact. Given the popularization of high beauty standards, they can affect your body image and self-esteem, which is why women with PCOS might want to know how to address the problem to prevent self-consciousness.

Here’s a brief overview of the most common PCOS dark skin patches treatment options that can help:

Medical treatments and procedures

When you have developed dark patches that you want to get rid of, there are a few dermatological options to consider, including:

• Chemical peels
• Laser therapy
• Microdermabrasion

Each of these medical procedures can offer improvement for your dark patches and sometimes, even get rid of them completely. However, it’s important to note that none of these medical treatments can be performed without the guidance of a healthcare provider. So be sure to see your primary care provider or a dermatologist for personalized advice.

Topical treatments for hyperpigmentation

In some cases of PCOS skin discoloration, it might be enough to leverage topical treatment to lighten dark patches or remove them. Some known topical remedies include creams containing the following ingredients:

• Hydroquinone
• Kojic acid
• Retinoids

Please note: Although many topical products are over-the-counter and don’t require a prescription, it’s always a good idea to talk to a healthcare provider first. A dermatologist might help you develop a personalized treatment plan, which might be more effective, quick, and safe than the treatment you pick up yourself.

Medications to address insulin resistance and hormonal imbalance

In order to treat dark inner thighs, you may want to address deep inner issues that cause it in the first place. That is, you may want to use treatments that target insulin resistance and hormonal imbalance.

The most common treatment options include:

• Metformin is one of the most common medicines prescribed to treat PCOS symptoms. This medicine targets blood sugar and insulin levels in your body and balances them. Hence, it can help address dark patches caused by insulin resistance.
• Birth control pills and anti-androgen medications can also help. These medications are prescribed to women with PCOS to normalize their hormone levels and thus, improve their fertility. By balancing hormones, these medications can also help you reduce other symptoms, including skin issues.

Natural remedies

If you don’t have a pronounced problem yet or just don’t want to resort to medical treatments right away, the good news is that there are quite a few natural remedies that you can try to lighten dark patches.

Some natural options to try include:

• Coconut oil
• Apple cider vinegar
• Aloe vera
• Lemon juice
• Turmeric
• Exfoliation

These remedies can sometimes help lighten skin in darker areas naturally. However, although they all are considered rather safe, don’t forget to make a patch test before using any of them to ensure you won’t get allergic reactions. And remember to use topical natural remedies with special caution in sensitive areas.

Lifestyle changes

Last but not least, due to the nature and causes of PCOS dark inner thighs, this symptom might be reduced or treated with certain lifestyle adjustments. In particular, it can help to modify your diet and daily activity levels to keep your insulin under control and maintain a healthy weight.

Here’s what you can do in particular:

• Implement a balanced, low-glycemic diet that doesn’t contribute to insulin resistance.
• Monitor your hydration levels.
• Integrate regular physical activity to improve insulin sensitivity.

Tips to prevent PCOS hyperpigmentation

Although hyperpigmentation is possible in women with PCOS, it may not affect everyone. And it may not appear right away. The good news though is that you can prevent it.

If you don’t have a dark patch issue yet, here are the top three tips that should help you prevent its appearance:

1. Maintain a healthy weight. Given hormonal issues and the likelihood of developing insulin resistance in women with PCOS, it’s crucial that you stick to a healthy diet and stay active in order to maintain a healthy weight.
2. Have regular medical check-ups. When you have been diagnosed with PCOS, it’s important that you consistently keep an eye on your health and monitor PCOS symptoms, hormonal levels, insulin, etc. This can help you notice any possible complications early and prevent many issues, including hyperpigmentation.
3. Create the right skin care routines. Finally, taking good care of your skin can also help you prevent or minimize skin darkening. First of all, this means creating skin care routines using the right products that prevent hyperpigmentation, such as those with niacinamide, retinol, vitamin C, etc. Additionally, consider aiding your skin by wearing breathable fabrics and using special powders to reduce friction (if necessary).

Final verdict

Does PCOS cause hyperpigmentation? - The short answer is “yes.” Among many other PCOS symptoms, hyperpigmentation in spots like inner thighs and armpits may not be as common but it’s still there.

As you now know, the two core factors triggering PCOS dark skin are androgen (testosterone) production and insulin resistance. However, additional factors, such as your daily activity and diet can also contribute to this symptom. Luckily, there are some ways to prevent dark patches on your skin or treat them if they already appeared. Use the information from this article as a guide and talk to your healthcare provider to come up with a personalized treatment plan!

References:

1. "Polycystic ovary syndrome (PCOS)." Mayo Clinic, 8, Sept. 2022. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439 
2. Kristina Liu, Janelle Nassim. "Polycystic ovarian syndrome and the skin." Harvard Health Publishing, Harvard Medical School, 29, Apr. 2021. https://www.health.harvard.edu/blog/polycystic-ovarian-syndrome-and-the-skin-202104292552#:~:text=Often%2C%20the%20skin%20can%20be,any%20combination%20of%20these%20issues. 
3. Basma Faris. "PCOS hair loss: Understanding the reasons and possible coping techniques." Aspect, 1, Nov. 2024. https://www.aspect-health.com/blog/pcos-hair-loss-understanding-the-reasons-and-possible-coping-techniques 
4. "Acanthosis Nigricans in Polycystic Ovary Syndrome." MSD Manual. https://www.msdmanuals.com/home/multimedia/image/acanthosis-nigricans-in-polycystic-ovary-syndrome# 
5. Karadag A, Kavala M, Demir F, Turkoğlu Z, Kartal I, Zemheri E. "A case of hyperpigmentation and acanthosis nigricans by testosterone injections." Hum Exp Toxicol, Dec. 2014. https://pubmed.ncbi.nlm.nih.gov/24505054/ 
6. Marshall JC, Dunaif A. "Should all women with PCOS be treated for insulin resistance?" Fertil Steril, Jan. 2012. https://pmc.ncbi.nlm.nih.gov/articles/PMC3277302/#:~:text=Overall%2C%20insulin%20resistance%20and%20the,25)%20women%20exhibiting%20these%20characteristics. 
7. Neil P. Johnson. "Metformin use in women with polycystic ovary syndrome." Annals of Translational Medicine, 27, Jun. 2014. https://atm.amegroups.org/article/view/3899/html#B10 
8. Basma Faris. "Best age to get pregnant with PCOS, precautions and unusual symptoms." Aspect, 30, Oct. 2024. https://www.aspect-health.com/blog/best-age-to-get-pregnant-with-pcos-precautions-and-unusual-symptoms 
9. "Why should you monitor your insulin?" Aspect, 30, Oct. 2024. https://www.aspect-health.com/blog/why-should-you-monitor-your-insulin 

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