Myo-Inositol for Cutaneous Manifestations of Polycystic Ovary Syndrome: An International Delphi Consensus Recommendation for Dermatology Practice
Abstract
Purpose: Acne and hirsutism are among the most distressing features of polycystic ovary syndrome (PCOS), yet current guidelines largely emphasize metabolic and reproductive aspects, offering limited guidance for dermatologic management. Myo-inositol (MI), an insulin-sensitizing agent with endocrine benefits, has emerged as a promising nonhormonal option; however, its role in managing cutaneous symptoms remains unclear. The purpose of this study was to develop expert consensus on the use of MI alone and in combination with folic acid and vitamin D₃ for PCOS-related dermatologic manifestations.
Methods: Eleven statements were generated through a rigorous literature review and subsequently evaluated by 133 experts through a two-round online Delphi process. Consensus was defined as ≥70% agreement; statements with 50% to <70% agreement were revised and reassessed.
Results: Consensus endorsed MI as an effective and well-tolerated intervention for acne and hirsutism. Continuous MI supplementation at 4 g/day for ≥6 months was recommended. MI + folic acid + vitamin D₃ and MI + D-chiro-inositol were favored for metabolic dysfunction and hyperandrogenism.
Conclusion: MI-based therapy, particularly early initiation and strategic combinations, should be integrated into multimodal management of PCOS-related cutaneous manifestations.
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