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Polycystic Ovary Syndrome (PCOS) is a hormonal disorder affecting 8–13% of women of reproductive age. Classic PCOS is characterized by the primary features—irregular periods, polycystic ovaries, and high levels of androgen.
While the exact cause of PCOS remains unclear, its effect on hormone balance is responsible for many of its symptoms, including infertility, weight gain, acne, and an irregular menstrual cycle.
Acne is a skin condition that occurs when hair follicles become clogged with dead skin cells and oil, leading to inflamed pores, pimples, and blackheads. Acne can appear on your face, back, chest, and shoulders.
It is common in adolescents due to hormonal changes, but women with PCOS may also experience persistent and severe acne due to hormone imbalance.
Why Does PCOS Make You Break Out?
The primary reason why PCOS causes breakouts is hyperandrogenism—the body produces higher than normal levels of androgens, such as testosterone. Androgens are naturally present in women but in low amounts, unlike men. When the levels become elevated, it brings about a lot of unwanted changes and symptoms.
Androgens stimulate the sebaceous glands to produce more sebum (oil), which can clog pores. This excess oil mixes with dead skin cells, creating the perfect environment for acne-causing bacteria (particularly Propionibacterium acnes) to grow, leading to inflammation and pimples.
Hormone disruption caused by PCOS leads to persistent breakouts that are often harder to treat than regular acne.
How PCOS May Cause Acne
Acne in women with PCOS is not only linked to excess androgens. Other factors like insulin resistance, gut dysbiosis, and adrenal dysfunction can also exacerbate hormonal imbalances, leading to acne.
Insulin Resistance
Many women with PCOS experience insulin resistance, where the body’s cells don’t respond effectively to insulin, leading to increased blood sugar levels. This causes the body to produce more insulin, which prompts the ovaries to produce more androgens.
The increased androgen levels drive more oil production in the skin, clogging pores and causing acne. Insulin resistance also increases inflammation, making acne worse and more resistant to treatment.
Gut Dysbiosis
Gut health and hormone balance are closely connected. Gut dysbiosis, or an imbalance in the gut microbiome, can lead to systemic inflammation and impair the body’s ability to detoxify and regulate hormones. Poor gut health can contribute to higher circulating levels of androgens and exacerbate skin inflammation, making acne more difficult to control.
Adrenal Dysfunction
Adrenal dysfunction occurs when the adrenal glands produce excessive hormones, particularly androgens like DHEA-S. In women with PCOS, this overproduction of androgens can worsen acne by increasing oil production in the skin.
Chronic stress can also trigger adrenal dysfunction by raising cortisol levels, which drives androgen production and increases inflammation in the body. This combination of excess oil and inflammation leads to more severe and persistent acne.
What Are the Treatment Options?
For women with PCOS, treating acne requires addressing both the skin condition and the underlying hormonal imbalances. Treatment options include hormonal treatments, topical treatments, oral medications, or a combination. They offer comprehensive treatment for acne in women with PCOS.
Hormonal Treatments
Oral Contraceptives (Birth Control Pills)
Combination birth control pills containing estrogen and progestin help to regulate the menstrual cycle and lower androgen levels. The pills regulate your hormones and reduce oil production, preventing acne.
It is important to note that birth control pills are not for everyone. Consult your doctor before taking any drugs.
Anti-Androgens
Anti-androgen medications such as spironolactone block androgen receptors. By preventing androgens from binding to these receptors, spironolactone reduces the impact of these hormones on oil glands, thus lowering sebum production.
Anti-androgens can be used to treat acne, hirsutism, and alopecia in women with PCOS and other hormonal disorders.
Topical Treatments
Retinoids
Topical retinoids, such as tretinoin, are vitamin A derivatives that promote skin cell turnover and prevent the clogging of pores. By speeding up the shedding of dead skin cells, retinoids help keep pores clear, preventing blackheads and whiteheads from forming. They help treat non-inflammatory acne but also help reduce inflammatory lesions. Retinoids can improve skin texture and reduce the appearance of acne scars.
Benzoyl Peroxide
Benzoyl peroxide is an antibacterial agent that targets Propionibacterium acnes, the bacteria that causes acne. It also has anti-inflammatory properties and helps dry out excess oil.
Oral Medications
Oral medications are used for more severe cases of acne, especially when topical treatments aren’t enough.
Isotretinoin is a powerful oral retinoid that shrinks the sebaceous glands, dramatically reducing sebum production and preventing clogged pores. It’s highly effective for severe, cystic, or treatment-resistant acne.
Oral antibiotics like doxycycline help reduce acne by targeting bacterial infections in the skin and reducing inflammation. These antibiotics are especially effective for treating moderate to severe inflammatory acne.
How Does Diet Impact Your Skin When You Have PCOS?
Diet can play a significant role when managing acne and PCOS symptoms. Dietary strategies to consider to control hormonal imbalances in PCOS-related acne include:
Cut Down on Dairy Consumption
High dairy intake has been linked to insulin resistance in women. Excess insulin production can contribute to acne by stimulating oil production and inflammation. Dairy may also contain hormones that further disrupt androgen balance, worsening PCOS symptoms.
If you notice a connection between dairy consumption and your acne, consider reducing or eliminating milk, cheese, and other dairy products from your diet. Try plant-based alternatives such as almond, oat, or coconut milk, and opt for dairy-free yogurt or cheese options.
The PFC (Protein, Fat, Carb) Balance Method
Maintaining a balance of protein, fats, and complex carbohydrates at every meal can help regulate blood sugar and insulin levels, which is vital for managing PCOS.
Include a source of lean protein (chicken, fish, eggs, legumes), fats (avocado, nuts, olive oil), and carbohydrates (whole grains, fruits, vegetables) in each meal. This balance helps manage hunger, regulate hormones, and reduce the likelihood of acne flare-ups.
Reduce Added Sugars
Excess sugar intake, especially from processed and refined foods, can cause blood sugar levels to spike, leading to an overproduction of insulin. Elevated insulin levels can increase androgen production, worsening acne in women with PCOS.
Minimize foods high in added sugars like sodas, candy, pastries, and sugary cereals. Instead, satisfy sweet cravings with naturally sweet options such as fruit, which also provides fiber to help regulate blood sugar.
Incorporate Phytonutrients
Phytonutrients are natural compounds found in plants that have anti-inflammatory and antioxidant properties. They help reduce oxidative stress and inflammation, common contributors to acne.
Load up on colorful vegetables and fruits like berries, spinach, carrots, and tomatoes, rich in phytonutrients like flavonoids, carotenoids, and polyphenols. These compounds help support skin health by reducing inflammation and promoting skin repair.
Foods as Medicine For Acne
Certain foods can reduce inflammation, regulate hormones, and impact the body’s ability to fight PCOS acne. Food can be used as medicine to clear and heal acne from the inside out.
Omega-3 fatty acids found in fish like salmon, mackerel, and sardine have high anti-inflammatory properties that can reduce the severity of the swelling and redness accompanying acne.
Nuts and vegetables, like spinach and kale, are rich in anti-inflammatory and antioxidant compounds that can help repair skin damage. Oysters, chickpeas, and pumpkin seeds are rich in zinc, which helps regulate the immune system.
Other Recommendations
Aside from tailoring your diet to incorporate anti-inflammatory foods and prebiotics, there are other ways to manage acne. While improving what you eat can make a difference, lifestyle habits and certain supplements can further enhance your skin and reduce breakouts.
We also suggest the following to achieve clearer skin:.
- Drink enough water to keep the skin hydrated and flush out toxins.
- Avoid processed foods, especially those high in refined sugar and unhealthy fats.
- Cleanse your face using a gentle cleanser and lukewarm water, moisturize using oil-free products, and use sunscreen daily.
- Avoid smoking and excessive alcohol consumption.
- Use supplements that help balance your hormones.
Frequently Asked Questions
Preventing acne in PCOS involves addressing the root causes of hormonal imbalance, inflammation, and excess oil production. You can prevent acne by maintaining a low glycemic diet, balancing your hormones, managing stress, and exercising regularly.
Clearing skin affected by PCOS-related acne requires a holistic approach that addresses hormonal imbalances, dietary choices, and lifestyle habits. One of the first steps is to consult a dermatologist or healthcare provider. A professional can provide personalized treatment options tailored to your specific needs, including medications or skincare regimens that can effectively target acne.
Maintaining a skincare journal can also be beneficial. By tracking the products you use and any changes in your skin, you can identify what works best for you and what may trigger breakouts. This self-awareness is essential for developing an effective skincare routine.
No, eggs are a healthy protein source and a valuable addition to the diet of women with PCOS. However, as with any food, moderation is key. Individual dietary preferences should also be taken into account.
