Abstract Introduction Although guidelines exist for managing skin conditions within the general population, there is paucity of data on how these are managed in women with polycystic ovary syndrome (PCOS) in real world setting. This study aimed to describe the clinical characteristics of women with PCOS presenting to specialist clinics, and to understand the trends in treatments offered to women with PCOS-related skin concerns. Methods A multi-centre retrospective observational study was conducted across the UK, Turkey, Greece, Georgia, and India. Patients referred to a PCOS clinic between January 2020 and December 2023 were included. Data, including details of the PCOS- related skin conditions and treatments offered after the specialist clinic consultation, was recorded on standardised Google Forms. The Chi-square test and Wilcoxon-rank- sum test were used to analyse categorical and continuous variables respectively using SPSS v30.0. Results A total of 1313 participants with a diagnosis of PCOS were included, of which 1041 participants had PCOS-related skin concerns. The median age of the participants was 27.0 (IQR 24.0-31.0) years. Most participants were White (52.7%), followed by Asian (33.1%). Hirsutism was the most common skin manifestation across all five countries, affecting 90.1% of the cohort. Metformin and progesterone-only pill (POP) were the most prescribed first and second treatment options respectively. However, treatment options differed between countries; metformin was the most prescribed first treatment in the UK, Georgia, and India, whereas POP and spironolactone were the most prescribed first treatments in Greece and Turkey respectively. In the UK subgroup, 407 out of 506 participants had PCOS-related skin concerns. Metformin and spironolactone were the most prescribed first and second treatment options respectively. There were also differences in the treatments offered by the UK centres; metformin was the most prescribed first treatment in two centres, whereas spironolactone and POP were the most prescribed first treatments in the other two centres respectively. Conclusion There were significant differences in the treatments prescribed across the five countries and between UK centres. Future work focusing on understanding the barriers and facilitators for variation in clinical practice and standardising the treatment of PCOS-related skin concerns for the best possible outcomes is needed.
Chu et al. (Mon,) studied this question.
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