….And What You Can Do to Take Control!
Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders affecting women, yet it remains widely misunderstood—especially when it comes to skin health. If you have PCOS, you may be struggling with persistent, cystic acne that doesn’t respond to traditional treatments. This is because PCOS acne is driven by deeper hormonal imbalances that affect your skin from the inside out. Understanding what’s happening in your body and how it manifests in your skin is key to managing breakouts effectively.
How PCOS Triggers Acne
PCOS is primarily an endocrine disorder that disrupts the balance of reproductive hormones, leading to elevated androgens (male hormones like testosterone and DHEA-S). These excess androgens trigger a chain reaction in the skin.
Higher androgen levels overstimulate the sebaceous glands, causing an increase in oil (sebum) production. This excess oil creates the perfect breeding ground for acne-causing bacteria, leading to clogged pores and inflammation. PCOS-related insulin resistance further worsens acne by increasing insulin-like growth factor-1 (IGF-1), which also stimulates sebum production and speeds up cell turnover, contributing to clogged pores. The result is often deep, cystic acne around the jawline, chin, and lower cheeks, which can be painful, slow to heal, and prone to scarring.
Inflammation is another major factor. Women with PCOS often have higher levels of systemic inflammation, which exacerbates breakouts, delays healing, and leads to post-inflammatory hyperpigmentation (PIH). Unlike typical teenage acne, PCOS acne can persist well into adulthood and often fluctuates with the menstrual cycle.
Supplements to Support Hormonal Balance and Reduce Acne
Zinc picolinate is a powerful anti-inflammatory mineral that helps regulate sebum production, reduce bacterial activity, and balance androgens. Studies have shown that women with PCOS often have lower zinc levels, making supplementation beneficial.
Inositol, particularly myo-inositol and D-chiro-inositol, is one of the most effective supplements for PCOS. It improves insulin sensitivity, lowers testosterone levels, and restores ovulatory function, all of which can help reduce acne over time.
Essential fatty acids (EFAs), especially omega-3s, help counteract the pro-inflammatory effects of PCOS. Omega-3s can lower androgens, reduce inflammation, and support a healthy skin barrier.
Spearmint tea has been studied for its anti-androgenic effects and has been shown to lower free testosterone levels in women with PCOS. Drinking two cups a day can help regulate hormone imbalances and may reduce acne severity.
N-acetylcysteine (NAC) is a powerful antioxidant that improves insulin sensitivity, reduces inflammation, and supports liver detoxification, all of which contribute to clearer skin.
Magnesium and B vitamins help regulate stress hormones, balance insulin levels, and reduce systemic inflammation, which can indirectly help with PCOS acne.
Lifestyle Considerations for PCOS Acne
Managing insulin resistance is key for controlling PCOS symptoms, including acne. A lower glycemic diet that focuses on whole foods, lean proteins, healthy fats, and fiber can help stabilize blood sugar levels and reduce the insulin spikes that drive excess sebum production.
Exercise, particularly strength training and moderate-intensity movement like walking, can improve insulin sensitivity and lower inflammation. Excessive high-intensity workouts, however, can sometimes spike cortisol and exacerbate hormonal imbalances, so a balanced approach is best.
Managing stress is crucial since chronic stress raises cortisol, which can further disrupt hormone levels and trigger acne flare-ups. Practices like meditation, breathwork, and prioritizing sleep can help regulate cortisol levels.
Hormone Supplements and Medications for PCOS Acne
For those with more severe PCOS acne, medical interventions may be necessary. The combined oral contraceptive pill (OCP) is often prescribed to lower androgens and regulate menstrual cycles, which can help clear hormonal acne. However, the pill is not a long-term fix and may have side effects, so it’s important to weigh the pros and cons.
Spironolactone is a commonly prescribed androgen blocker that can significantly reduce oil production and improve PCOS-related acne. It works by preventing testosterone from binding to androgen receptors in the skin, effectively reducing sebum production.
Metformin is sometimes used to improve insulin resistance in women with PCOS, which can indirectly help with acne by lowering IGF-1 and reducing sebum overproduction.
If you are considering hormone therapy or medications, working with a doctor who specializes in PCOS can help determine the best approach for your individual needs.
What About Skincare and Treatments?
A well-structured skincare routine is essential to manage the excess oil, inflammation, and breakouts caused by PCOS.
Cleansing with a gentle but effective face wash that includes ingredients like mandelic acid or salicylic acid can help keep pores clear and reduce breakouts. Overwashing can strip the skin and trigger even more oil production, so cleansing twice daily is ideal.
Exfoliating with chemical exfoliants like Micro Peel and Revitosin (Vitamin A) helps regulate cell turnover, unclog pores, and reduce post-inflammatory hyperpigmentation. Azelaic acid is particularly beneficial for PCOS acne because it also has anti-androgenic properties.
Hydration and barrier repair are key, even for oily skin. Using a lightweight, non-comedogenic moisturizer with ceramides, niacinamide, and antioxidants can help maintain skin balance and reduce inflammation.
Sun protection is critical since PCOS acne often leads to post-inflammatory hyperpigmentation, which can become worse with UV exposure. Daily use of a broad-spectrum SPF is essential.
Professional treatments can help accelerate results. LED therapy is excellent for reducing inflammation and speeding up healing. Chemical peels, particularly mandelic acid and lactic acid peels, can help control oil production and improve acne scars. Microneedling can be beneficial for treating scarring and improving skin texture over time.
Setting Realistic Expectations…
Unlike standard acne, PCOS acne is deeply tied to internal hormone imbalances, which means that topical treatments alone will not provide a full solution. Addressing PCOS acne requires a multi-faceted approach, including dietary changes, supplements, targeted skincare, and sometimes medical intervention.
Results take time. While some people see improvements within a few weeks of implementing changes, true skin transformation can take several months. Being consistent with a skincare routine, managing diet and stress, and staying committed to long-term health strategies will yield the best results.
PCOS acne can feel frustrating, but understanding what’s happening in your body and taking strategic action will help you regain control. If you’re struggling with PCOS-related acne, book a consultation with one of our experienced Dermal Clinicians at HÜD, and we’ll create a customised treatment plan tailored to your skin and hormonal needs.
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