For such multiple issues..for best results...please consult dietician/ doctor.

Skin darkening, particularly around the neck, underarms, or skin folds, can sometimes be associated with insulin resistance, which is commonly seen in PCOS. However, generalised skin darkening along with severe fatigue and weakness warrants further medical evaluation to rule out other hormonal, metabolic, or nutritional causes. I would recommend consulting an endocrinologist for a comprehensive assessment. Depending on your clinical history and examination, investigations may include fasting glucose, HbA1c, a lipid profile, vitamin B12, vitamin D, ferritin/iron studies, and other relevant hormonal or biochemical tests. Your doctor may also consider additional investigations based on the pattern of skin darkening and your other symptoms. Since you have experienced approximately 10 kg of weight gain after starting myo-inositol and D-chiro-inositol, please review the supplement, its dosage, and the timeline of your symptoms with your treating doctor. The association does not necessarily mean the supplement caused the weight gain. From a nutritional perspective, an individualised PCOS-friendly diet focusing on balanced meals, adequate protein and fibre, appropriate carbohydrate portions, regular physical activity as tolerated, and good sleep can help support metabolic health.

Good morning if you are looking for a long term sustainable result please try to connect directly for diet and lifestyle change consultation through app rather depending upon medicine solely which gives only short term result.

Your symptoms warrant medical assessment to rule out insulin resistance and other causes of pigmentation, fatigue and weight gain. Alongside review by a doctor/dermatologist, a personalised nutritional assessment can help evaluate your diet, supplement use, energy balance and blood-sugar management. I’d be happy to support you with a tailored PCOS-focused nutrition plan rather than relying on topical treatment alone.

Please connect over consultation with all details

Oral treatment for this does exist, but choosing between options like spironolactone or a hormone-based pill depends on your actual androgen and insulin values, which your thyroid and cortisol tests alone don't show. The weight gain, acne and darkened, thicker skin you're describing are a textbook insulin-resistance pattern in PCOS rather than a reaction to the inositol supplements.