Polycystic ovary syndrome (PCOS) is a hormonal disorder that causes enlarged ovaries. Small cysts may form on the outer edges. In addition to affecting a woman’s fertility, PCOS can cause a number of hormone-induced side effects. This includes acne.
Keep reading to learn more about why this happens and what you can do to treat it.
Although conversations about PCOS often focus on the noncancerous growths that it causes, hormonal imbalance is at the heart of the condition. Your body depends on signals from your pituitary gland to produce the right amounts of estrogen, progesterone, and testosterone. PCOS disrupts these signals.
Without the right signals from the pituitary gland, your estrogen and progesterone levels drop, and your testosterone levels increase.
This can prevent ovulation and lead to symptoms like:
- irregular menstruation
- hair growth on your face, chest, or back (hirsutism)
- weight gain or difficulty losing weight
- patches of dark skin on the back of your neck or other areas (acanthosis nigricans)
PCOS is just one of many risk factors for acne.
In general, acne is caused by:
- excess oil production
- dead skin cells trapped deep in your pores
- bacteria (primarily from Propionibacterium acnes)
- excess hormone activity
Acne may also result from:
- hormonal changes, such as during pregnancy
- certain medications, such as corticosteroids
Certain behaviors can also increase your risk for acne. This includes:
- not washing your face regularly
- not drinking enough water
- using noncomedogenic skin care products or makeup
Over-the-counter (OTC) acne medications typically rely on benzoyl peroxide, salicylic acid, and sulfur to help treat acne. Although these ingredients can help with mild breakouts, they usually aren’t enough to treat hormonal acne.
Treating the underlying hormonal imbalance is the only way to clear PCOS-related acne. If you think your acne is related to PCOS, talk to your doctor or dermatologist. They may prescribe one or more of the following medications.
Oral contraceptives (birth control pills) are sometimes used to treat hormonal acne. However, not just any birth control pill will do.
Combination pills are the only birth control pills that will help stabilize your hormone levels throughout your entire menstrual cycle.
They usually contain a mix of ethinyl estradiol and one or more of the following:
- progestin norgestimate
- norethindrone acetate
Birth control pills aren’t for everyone, though. You shouldn’t use the pill if you’re over age 35 or have a history of:
Antiandrogen drugs are prescription medications that decrease testosterone levels. Although androgens are classified as “male” hormones, women have naturally occurring androgens too. The difference is that women have lower amounts.
Sometimes PCOS and other hormonal conditions can create too much testosterone in the body. This can increase sebum and skin cell production, leading to acne.
Not everyone with hormonal acne has high androgen levels, so your doctor will likely draw a blood sample to test your levels.
OTC retinoids are traditionally used to fill in the appearance of wrinkles and help with uneven skin tone. Some formulas are also used for acne, but these are most often geared toward teens.
If you have PCOS-related acne, skip the OTC retinoids and see your dermatologist about prescription-strength options. They can be taken orally or applied as a topical cream or gel. The oral retinoid isotretinoin (Accutane) is the most popular option.
Retinoids make your skin extremely sensitive to the sun’s UV rays, so it’s important to apply sunscreen liberally throughout the day. If your skin is left unprotected, your risk for hyperpigmentation and even skin cancer will increase.
If you opt for topical retinoids, you should only apply them in the evening. Applying them during the day can increase your risk for sun-related side effects.
Topical retinoids may also be drying at first. You might need to start by using the gel or cream every other day and gradually working your way up to the recommended dosage.
To date, there’s conflicting information about how diet can affect acne. Research has shown that junk food, such as chocolate and french fries, can’t lead to acne on its own.
The focus instead is on how foods can cause inflammation in the body. Inflammation can contribute to breakouts, especially if you have other acne risk factors, like PCOS.
Some foods are naturally anti-inflammatory. These include:
- olive oil
On the other hand, certain foods can contribute to inflammation. This includes:
- red meats
- white bread
- white potatoes
- sugary desserts
Although dietary changes alone aren’t enough to treat PCOS-related acne, they can be a crucial component of your overall treatment plan.
If your dietary changes aren’t producing visible results, ask your doctor about adding anti-inflammatory supplements to your routine. Popular options include:
- bromelain (an enzyme made from pineapples)
- turmeric (derived from curry powder)
- vitamins A and C
It’s important to know that even the best PCOS acne treatment will do little without a good skin care routine.
Make sure you:
- Wash your face twice a day.
- Follow up each cleansing with an oil-free moisturizer suited for your skin type.
- Avoid picking and scratching blemishes.
- Use noncomedogenic makeup only.
It’s important to remember that acne isn’t the only PCOS symptom you may deal with. Keep your doctor informed about any new or unusual symptoms. They may be able to modify your current treatment plan to better suit your needs.