Does PCOS Cause Acne? Treatment Options and More

• Polycystic ovary syndrome (PCOS) is a common hormonal disorder that can cause enlarged ovaries, sometimes with numerous small cysts on their outer edges.
• PCOS is known for affecting a woman’s fertility, but can also cause a number of other side effects, among them hormone-induced acne.
• Although the exact cause of PCOS is unknown, with careful and thorough treatment, managing PCOS acne is possible.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. Up to 10% of women are affected by PCOS, and acne is among its most common symptoms. 

PCOS acne can be mild or severe, and emotionally distressing for some women, but having an understanding of this disease and its many possible courses of treatment can help to keep the hormonal acne which often accompanies it under control (or eliminate it altogether).

What Is PCOS?

Hormonal imbalance is at the heart of PCOS. Your body relies on signals sent by the pituitary gland in order to produce estrogen, progesterone, and testosterone in the correct amounts. PCOS disrupts these signals, causing estrogen and progesterone levels to fall and testosterone levels to rise. 

Those with PCOS may have enlarged ovaries containing many very small cysts, also known as follicles. The presence of these cysts creates an environment in which eggs are only rarely released, and so the chances of pregnancy can be lessened. The cysts are not cancerous and need not be removed surgically. Some women have ovaries with a normal appearance yet still suffer from the hormonal imbalance. Typically, PCOS symptoms start around the time menstruation begins.

PCOS is known for causing a variety of symptoms, including irregular periods, weight gain, hirsutism (excess facial and body hair), and acne, which can at times be severe and cystic. In the long term, PCOS, if left unaddressed, can also increase one’s likelihood of developing type 2 diabetes, fertility problems, and cardiovascular disease, however, the condition affects some women more severely than others.

Research shows the causes of PCOS to be complex, but imbalanced hormone levels and  insulin resistance (when the body’s cells don’t respond normally to the hormone insulin) are among the main factors. 

Does PCOS Cause Acne? 

Yes, PCOS acne is among the condition’s most common symptoms. PCOS, along with any other condition which affects hormone levels, can trigger acne. Acne, along with excess body hair are more likely to develop if a young woman’s body is overproducing testosterone. 

PCOS and hormonal acne

What is hormonal acne? How can you tell if PCOS is causing it specifically?

Hormonal acne is often known simply as acne or acne vulgaris. It is often termed hormonal acne due to the way skin problems can develop in response to certain hormonal changes–particularly an increase in androgens like testosterone. 

While it is normal for a woman’s ovaries and adrenal glands to produce a low level of testosterone, higher levels often lead to excess sebum production (an oily substance secreted by your glands), which can in turn clog pores and facilitate the growth of propionibacterium acnes (acne-causing bacteria), as well as increase inflammation in the skin.

PCOS and acne scars

In cases of severe PCOS acne (which can at times be cystic, and deep under the skin), scars typically appear after a breakout has cleared. The cysts associated with severe acne ruin skin tissue which is not replaced during the skin mending process. When facial cysts drain and heal, indented scars may be left in their place. If acne appears on the chest and back, however, scars can sometimes be raised, or hypertrophic instead. 

Is PCOS Causing Your Acne?

Many women suffering from PCOS aren’t diagnosed until they experience struggles with their fertility, while others discover they have PCOS while looking for cosmetic solutions to issues like acne, excess hair, and weight gain. 

If, along with your acne, you experience irregular menstrual cycles, more intense breakouts around your period, above average facial hair growth, or thinning hair on the scalp, there is a good chance that your acne has hormonal causes–possibly PCOS in particular. 

If you suspect your acne may be caused by PCOS, it’s important to discuss testing with your dermatologist or your gynaecologist to find out for sure. They may run blood tests and/or perform an ultrasound to examine your ovaries. If it is determined that PCOS is the cause of your acne, it is easier to treat properly.

How to Treat PCOS Acne

Typical over-the-counter (OTC) acne medications often rely on benzoyl peroxide and salicylic acid to help treat acne. Although these common skin care ingredients can be very helpful for mild to moderate breakouts, they are often not enough to treat PCOS acne. Treating the hormonal imbalance underlying PCOS is the only way to clear PCOS acne. 

Once diagnosed with PCOS, your doctor or dermatologist may prescribe one or more of the following courses of treatment:

Birth control 

The synthetic hormones found in some combination birth control pills work to lessen sebum by balancing your androgen levels. As a result, the breakouts which accompany high testosterone often subside. Oral contraceptives are often prescribed to treat hormonal acne, whether caused by PCOS or not. 

However, women with PCOS who have cardiovascular issues or weight problems may not be the best candidates for oral contraceptives. Be sure to discuss the risks thoroughly with your doctor. 

Supplements

Vitex, also known as chaste tree berry is typically found in tinctures and sold in health food stores. Some studies suggest that daily use over a sustained period of time can increase progesterone levels and balance out testosterone. Vitex has been shown to help improve PCOS symptoms like cysts, acne, and PMS.

N-Acetyl-Cysteine (NAC) is an amino acid and antioxidant necessary to overall health. One study found NAC helped to rectify weight problems, irregular, menstruation, hirsutism, blood sugar levels, and testosterone imbalances associated with PCOS acne. 900-1800 mg daily is considered an optimal dosage of NAC.

A combination of zinc and saw palmetto can also help your body eliminate the excess testosterone that causes PCOS acne. They work to reduce the enzyme 5-alpha-reductase which turns testosterone into a more potent androgen known as DHT (which intensifies testosterone’s effects). The result is reduced acne, among other PCOS symptoms. 

Topical retinoids

While OTC retinoids are typically used to fill in the appearance of fine lines and wrinkles and improve uneven skin tone, some topical retinoids (usually cream or gel) are also used to treat PCOS-related acne. When applied to the skin, retinoids can unclog pores and reduce acne outbreaks by preventing dead cells from clogging pores in the future. These retinoids are usually prescribed in conjunction with oral contraceptives as part of an ongoing PCOS maintenance routine.

Skin Care Routine for PCOS Acne 

Regardless of which PCOS acne treatment you choose to follow in order to treat underlying causes, it is also necessary to follow a proper skin care routine for best if you wish to effectively manage PCOS acne. 

As a general rule, be sure you wash your face two times a day, in the morning and evening before bed. If you must wear makeup, choose a noncomedogenic (non-clogging) variety. And no matter what, always avoid touching, picking or scratching your acne.

Try the following skin care routine for your PCOS acne.

Morning

1. Wash your face with a cleanser containing anti-inflammatory niacinamide, also known as vitamin B3, to normalize pores, regulate oil production, and fade red blemishes over time. 
2. Rinse with warm water.
3. Follow up each cleansing with an oil-free moisturizer suited to your skin type.

Evening

1. Wash your face with a more intensive cleanser containing L-mandelic acid to keeps oil under control and salicylic acid to reduce excess sebum and dead skin cells–ultimately preventing blocked pores. 
2. Massage the cleanser into your face thoroughly.
3. Rinse with warm water.
4. With a cotton pad, apply an exfoliating toner containing 5% glycolic acid to slough off dull skin cells that mix with excess sebum and lead to acne.
5. Apply a few drops of topical retinoid cream over your cleansed and toned face to further support your effort to unclog pores, and to prevent future breakouts. 

When it comes to specific ingredients to work into your skin care routine, what works for one person may not work for another. There is no particular topical product that works better on PCOS-related acne than other acne forms. If you suspect your acne is caused by PCOS, it is always best to consult with a doctor or dermatologist on your best course of treatment.

Takeaway

PCOS is the most common reproductive disease affecting women of childbearing age. Its effects, which may include mild to severe hormone-induced acne, can be distressing and isolating for sufferers.

Together with your doctor or dermatologist, it is possible to diagnose PCOS acne in order to treat it more effectively than one might treat other forms of acne. 

The best approach to PCOS-induced acne is a multi-layered approach which includes a healthy lifestyle, the daily use of certain medications or supplements, and a suitable skin care routine.