An estimated one in ten women experiences polycystic ovarian syndrome (PCOS), a condition causing a hormonal imbalance of androgens, progesterone, insulin, estrogen and LH. Women with PCOS may experience irregularities with the menstrual cycle, difficulties with getting pregnant, thinning of the hair, unwanted hair growth, and acne.
An estimated one in ten women experiences polycystic ovarian syndrome (PCOS), a condition causing a hormonal imbalance of androgens, progesterone, insulin, estrogen and LH. Women with PCOS may experience irregularities with the menstrual cycle, difficulties with getting pregnant, thinning of the hair, unwanted hair growth, and acne.
In this article, we will take on PCOS acne specifically, and shine a light on how it develops, the most common symptoms, and potential treatment options to improve its appearance.
Understanding PCOS Acne
What Is PCOS?
Polycystic ovarian syndrome is a metabolic condition characterized by abnormal hormone levels. Those with PCOS have high levels of androgens. A higher level of resistance to insulin, the hormone that controls blood sugar, is also common in those with PCOS. PCOS acne is one of the symptoms but the condition can also be accompanied by other symptoms such as irregular periods, and a lack of ovulation.
How PCOS affects skin
PCOS can affect your skin in the form of hormonal acne, hair loss, excessive facial or body hair, dark patches, or any combination of these symptoms. Acne from polycystic ovarian syndrome tends to be concentrated on the jawline, chin, and upper neck. Skin PCOS symptoms often show up in the form of hormonal patterns for acne (e.g. jawline acne) but are not necessarily the same for everyone.
Common Symptoms of PCOS Acne
Acne appears in the most hormonally sensitive parts of the face
The following areas of the face are considered to be the most sensitive to hormonal fluctuations:
- Cheeks
- Jawline
- Chin
- Upper Neck
Because the root cause of PCOS is elevated androgens, PCOS-related acne is most likely to develop in these areas.
Acne persists into adulthood
Individuals between the ages of 12 and 24 are most likely to experience acne. However, if acne persists beyond the age of 25, this could be a sign that the acne is PCOS-related.
Acne begins in adulthood
If you never had acne as a teenager but have developed it as an adult, PCOS could be the cause. If you are experiencing other PCOS symptoms, it might be a good idea to speak with your doctor.
Acne tends to flare up around period
When acne is PCOS-related, it tends to flare up before and during your menstrual period, but it is also common that acne persists through the menstrual cycle. If you think your acne is hormonal, try to keep track of any flare-ups in a notebook and compare that to the dates of your period.
Causes of PCOS Acne
Hormonal imbalances
One of the primary causes of PCOS is hormonal imbalance, specifically when androgen levels are too high. Androgens are hormones that focus on growth and reproduction in both males and females and they are known to cause acne. Many women with PCOS also have heightened levels of insulin, which can also lead to the production of too much testosterone, or one of the androgens.
In addition to acne, the hormonal imbalance due to PCOS can also cause unwanted hair growth on the body and face, male pattern baldness, and missed periods.
It can be hard to track and understand your cycle when you have PCOS. To better understand your cycle, you can track your actual hormone concentrations with the help of a digital fertility analyzer. The Mira digital fertility analyzer tracks hormone levels and gives you actual LH levels throughout your cycle. Together with the companion app that uses smart learning to track your cycle over time, you’re able to track personalized information on par with what you would get at a doctor’s office. You can get precise daily hormone level readings, similar to those from a lab, and monitor your hormonal map over time through dynamic charts on your smartphone – clearly pinpointing your ovulation patterns.
If you don’t have a PCOS diagnosis yet, but are still struggling with symptoms like hard acne, heavy bleedy, and excessive hair growth you may be able to gain a better perspective on your hormones through a single at-home lab test like Mira’s Panorama Fertility Lab Test. This convenient kit tests 5 hormones that affect your ovulation, cycle regularity, and ability to get pregnant and can help identify hormonal signals that can lead to PCOS. You get 5 individual and personalized hormone reports with actionable steps to understand what those numbers mean for your fertility health.
Insulin resistance
PCOS can make your body more susceptible to insulin resistance. This means that the body has a difficult time converting sugars from foods into energy, and as a result, insulin and sugar build up in the bloodstream. When insulin levels are high, this causes the body to ramp up the production of certain male hormones.
Inflammation and androgens
Androgens are hormones that focus on growth and reproduction in both males and females and they are known to cause acne. Research has shown that those with PCOS may have a type of long-term, low-grade inflammation that contributes to the production of androgens. This increase in androgens can then lead to acne from polycystic ovarian syndrome.
Medical Treatments for PCOS Acne
Topical treatments
PCOS acne treatment can include topical treatments and skincare. Some of the most commonly recommended ones for PCOS include benzoyl peroxide, salicylic acid, azelaic acids, retinoids, and topical antibiotics.
Oral medications
The most common medical treatment for the appearance of PCOS acne is oral contraceptives, as they can help to stabilize hormones and reduce the appearance of acne. Another common PCOS medication that may help with the appearance of acne is anti-androgens, which help to prevent the production of testosterone and block androgen receptors.
If you are trying to become pregnant, oral contraceptives and anti-androgens will not be an option to treat your PCOS acne. We recommend speaking with your dermatologist and doctor about potential medications that are safe to use while trying to conceive.
Natural Remedies for PCOS Acne
Dietary Changes
Low glycemic index foods
Heightened levels of insulin can stimulate the production of testosterone. This in turn can make PCOS symptoms such as acne or unwanted hair growth even worse.
To prevent spikes in blood sugar and insulin, you may want to incorporate foods with a low glycemic index (GI) into your diet. Unlike carbohydrates that can cause blood sugar levels to spike and then crash, low GI foods take longer to digest – keeping your blood sugar (and insulin) levels regulated.
Foods with a low GI include:
- Non-starchy vegetables such as broccoli, mushrooms, peppers, and leafy greens
- Whole grains, brown rice, and oats.
- Lean proteins such as fish, beans, and chicken
- Healthy fats such as olive oil, avocados, and nuts
Anti-inflammatory foods
Omega-3 fatty acids have been found to reduce inflammation, and one recent research study found omega-3’s to be a suitable treatment for PCOS and insulin resistance.
To incorporate more omega-3 fatty acids into your diet, you can try any of the following:
- Oily fish including salmon, mackerel, herring, sardines, anchovies, and oysters.
- Seeds and nuts such as flaxseeds, chia seeds, pumpkin seeds, and walnuts.
- Beans such as soybeans, edamame, and kidney beans.
Supplements
There are certain PCOS acne supplements you can take that may improve the appearance of acne caused by PCOS. Omega-3 supplements, for example, have been shown to help lower testosterone levels and even regulate the menstrual cycle.
Other supplements that may help to improve acne symptoms include Vitamin D, Zinc, and Inositol.
Make sure to speak with your doctor before starting any PCOS acne supplement – especially if you are trying to conceive.
Zinc
Zinc is an essential mineral for all humans and plays a role in many bodily functions including cell growth, hormone release, and reproductive functions.
Women with PCOS have shown positive results from zinc supplementation especially in terms of insulin resistance, but it’s also been shown to help other PCOS symptoms like acne, hair growth, hair loss, as well as improve hormonal imbalances and ovulation.
Fish oil
Fish oil has anti-inflammatory properties and can improve insulin resistance making it a key supplement for those with PCOS. Research has also demonstrated that supplementing with fish oil can help improve ovulation, ovarian reserve, and overall fertility.
Aside from helping with PCOS treatment, fish oil has a host of other health benefits for women including brain and eye development for a baby as well as preventing heart disease and declining mental function.
Vitamin D
Vitamin D isn’t found in the foods we eat, so most people need to supplement it in some other way. Whether that’s through getting adequate sunshine or vitamins, getting enough vitamin D may lower inflammation, improve insulin resistance and regulate your menstrual cycle.
Studies show that up to 85% of women with PCOS experience vitamin D deficiency so adding this to your treatment plan may be particularly helpful. Vitamin D is critical to your endocrine system and also helps regulate the absorption of calcium. Supplementing with vitamin D can help with menstrual regularity and ovulation for women with PCOS in addition to its many other benefits.
Inositol
Up to 70% of women with PCOS have some level of insulin resistance. Insulin is the hormone that helps regulate blood sugar and also plays a role in signaling the ovaries to produce certain hormones.
When the signaling system isn’t working properly, the body reacts by producing even more insulin which in turn causes a host of knock on effects that can impair follicle development and disrupt ovulation. Inositol is well known for its ability to improve insulin resistance and has been well studied. Its host of other benefits like promoting egg quality and improving ovarian function make it one of the best supplements for women with PCOS.
Mira’s PCOS Supplements
Mira’s own PCOS supplements help alleviate symptoms of PCOS with a powerful combination of ingredients including Inositol. Scientists have carefully studied different ratios of Myo and D-Chiro Inositol and have found 40:1 to be the most effective ratio to restore ovulation and cycle regularity. Mira’s formulation, created by experts and fertility doctors, follows the 40:1 formula for PCOS treatment. Created to nourish your body’s natural rhythm with expertly blended ingredients and carefully designed to support your journey with PCOS.
Herbal treatments
Spearmint tea
Some research has shown that spearmint tea may be helpful in the treatment of acne from hormones on chin and PCOS face due to its anti-androgenic effect. These effects may result in a decrease in testosterone levels thereby helping PCOS acne.
Saw palmetto
Although not as well studied, saw palmetto also shows promising results for its anti-androgenic effect for those with PCOS. The logic is that by helping to balance androgens it will help your skin PCOS symptoms as well.
Skincare Routine for PCOS Acne
Cleansing and exfoliating
If you don’t already have a skincare routine, try to get into the habit of washing your face each morning when you wake up and before you go to bed – especially if you have makeup on. Depending on your skin and what works for you, you may want to incorporate a cleanser, toner, and moisturizer into your routine for the best results.
You should also make sure to wash your face after working out, as sweat and dirt from the gym can clog your pores and cause irritation.
Moisturizing
Keep your skin hydrated and moisturized with natural oils or ingredients to help calm inflammation and reduce acne.
Choosing the right products
Hydrating your skin without clogging your pores starts with the right products. Choose non-comedogenic (won’t clog pores) products so that you can not only fight those hormonal pimples but improve the appearance of your skin.
Lifestyle Changes to Manage PCOS Acne
In addition to trying PCOS acne supplements and medications, you can also try to make a few lifestyle changes to improve the appearance of acne caused by PCOS.
Exercise and physical activity
You don’t need to become a fitness guru overnight, but small changes can potentially make a big difference. Take a walk, or take the stairs instead of the elevator to get your physical activity in, all while eating a balanced diet.
Stress management
When the body is stressed, it releases cortisol and adrenaline. When the body is stressed for a prolonged period of time, this can contribute to insulin resistance causing a rise in blood sugar levels. This not only contributes to weight gain, but it can also increase your risk of acne.
To reduce stress, you can try any of the following:
- Meditate for at least 5 minutes each day
- Say no to unnecessary commitments that stress you out
- Pencil in time in your daily schedule to relax and wind down
- Utilize breathing techniques
Sleep hygiene
Sleep is critical to overall health and hormone functioning. The National Sleep Foundation advises that all adults need around 7 to 9 hours of sleep each night.
If you struggle to get enough sleep, consider the following techniques to improve your sleep hygiene.
- Try to go to bed and wake up at the same time each day.
- Resist naps during the daytime.
- Limit caffeine intake, especially in the afternoon and evening.
- Follow a bedtime routine.
- Avoid using electronics in bed.
Hormone Health Clinic for Fertility
At Mira’s Hormone Health Clinic for Fertility, you can learn everything about the disorder and its influence on your hormones. Hormone Health Coaches specialized in PCOS can help with managing techniques, mental health support, effective dosage of PCOS supplements, as well as preparing a plan (if this is your goal) to get pregnant naturally and faster.
Frequently Asked Questions
How to cure PCOS permanently?
There is no way to cure PCOS permanently but the symptoms can be successfully managed (and improved) through a variety of treatments including lifestyle choices, medication, and supplements.
Does PCOS go away?
Unfortunately, PCOS is a chronic condition that cannot be cured but it can be managed. You can’t make the condition go away but there are a variety of options to help you treat the symptoms so it doesn’t feel like a burden. Working with your healthcare team or a fertility coach like Mira’s Hormone Health Clinic can help you with your treatment plan. We have coaches specialized in PCOS who can help you with your specific issues.
