Diagnosis is based on the presence of comedones (pimples) and lesions at various stages of development. Left untreated, it can lead to both scarring and abnormal pigmentation.
It can be caused or exacerbated by elevated androgen levels. Androgen disturbances should be suspected when female adolescents have severe acne or when it persists into adult years, particularly when accompanied by other androgen-related effects such as hirsutism, infertility and weight problems.
If you have acne, hirsutism, or hair loss, these tests would be helpful in diagnosing the cause of your problems: serum levels of testosterone, DHEAS, LH, FSH, prolactin, cholesterol, triglycerides, and thyroid hormones. A two-hour glucose tolerance test with accompanying insulin levels should also be done.
Many PCOS women will have abnormal levels of one or more of these tests, although normal values do not rule out a diagnosis. Once your hormone imbalances are identified, the appropriate treatment can be recommended.