Polycystic Ovary Syndrome (PCOS) And Acne

If one has acne problems long after teen years are over, the person may need to look beyond the skin for the source of the problem. Sometimes acne is a symptom of an underlying hormone condition that can cause far more than facial blemishes.

Acne affects a large percentage of women with PCOS and is something you simply cannot ignore.

What to know about PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal disorder that causes enlarged ovaries and is common among females of reproductive age. This condition can lead to a number of hormone-induced side effects, and it includes acne.

acne

 

Acne is common, affecting 10–34% of women affecting with PCOS.2

Does PCOS cause acne?

PCOS is mainly characterised by hair loss, acne, hirsutism (hair growth in unwanted areas), weight gain and irregular or heavy periods.3

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 (Propionibacterium acnes), stress and hormonal changes. 1

acne in pcos

Women with PCOS may experience acne because of the release of hormones called androgens. High levels of androgens, also known as; hyperandrogenism, is one of the key features of PCOS.4

Androgens have a significant role in the development of acne: 4

  • They cause the glands in the skin to produce an excess of an oily substance called sebum.
  • Acne occurs when sebum and dead skin cells build up inside hair follicles, trapping bacteria beneath the skin.
  • It leads to inflammation and the formation of pimples.

Someone with PCOS may develop acne in various areas, including the face, neck, chest and upper back.

Signs and symptoms of acne

Acne is a broad term for several types of breakouts that all have different symptoms: 5

Types of acne
  • Whiteheads: It forms a closed pore that becomes impacted with oil and dead skin cells. It appears as a white bump on the skin’s surface.
  • Blackheads:  The pore is only partially clogged and remains open and further turns black when oil and dead skin cells react to oxygen in the air.
  • Papules: Papules are tiny red, hard pimples. They form when bacteria get trapped in a pore.
  • Pustules: Pustules are similar to papules but contain pus that’s made of dead white cells.
  • Nodules: These large inflamed lesions occur when a pimple extends into the deeper layers of the skin.
  • Cystic acne: This type of severe acne is similar to nodules and forms when the deeper layer of skin becomes inflamed. The difference is that cysts contain pus. These red lumps are soft, painful, and difficult to treat and usually require a visit to a dermatologist.

In the same way that acne can take various forms, the severity of acne also varies depending on the type.

Treating acne caused by PCOS1, 2

  • Oral contraceptives

Oral contraceptives are sometimes used to treat hormonal acne. Some oral contraceptive pills can treat acne that results from PCOS. The combination of estrogen and progesterone in these pills reduces testosterone levels in the body.

Not all oral contraceptives are equally able to treat acne caused by PCOS. Combination pills are the only birth control pills that will help stabilise the hormone levels throughout the entire menstrual cycle. They usually contain a mix of Ethinyl estradiol and one or more of the following:

  • progestin norgestimate
  • drospirenone
  • norethindrone acetate

Investigators have found oral contraceptive therapy can cause a 30–60% reduction in inflammatory acne within 3–6 months. They estimate that 50–90% of people who receive this treatment see an improvement in acne lesions.

  • Anti-androgen drugs

Anti-androgen drugs are prescription medications that decrease testosterone levels. Although androgens are classified as “male” hormones, women have naturally occurring androgens, and the difference is that women have lower amounts. Not everyone with hormonal acne has high androgen levels, so your doctor will likely draw a blood sample to test your levels.

  • OTC products

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.

  • Retinoids

OTC retinoids are conventionally used to fill in the occurrence of wrinkles and help with uneven skin tone. If one has PCOS-related acne, try to 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. 

It can make the skin extremely sensitive to the sun’s UV rays, so it is important to use sunscreen liberally throughout the day. If one chooses topical retinoids, they should only apply them in the evening.

  • Lifestyle Changes

To ease PCOS symptoms, it is advisable to change your lifestyle. Include daily exercise, losing weight and being physically active. Just losing a few kilos can regulate periods, thus improving fertility, reducing symptoms such as hirsutism, making women less likely to get diabetes, and lowering cholesterol levels.

It’s important to know that even the best PCOS acne treatment will do little without a good skincare routine. Ensure you wash your face twice a day, follow up each cleansing with an oil-free moisturiser suited for your skin type and avoid picking and scratching blemishes.

Reference:

  1. Polycystic Ovary Syndrome (PCOS) and Acne: Connection, Treatment, and More, Available at: https://www.healthline.com/health/pcos-acne, Last accessed on 1st March, 2021
  2. What to know about PCOS, acne, and acne treatment, Available at: https://www.medicalnewstoday.com/articles/pcos-acne, Last accessed on 1st March, 2021
  3. Polycystic Ovary Syndrome (PCOS), Available at: https://www.verywellhealth.com/pcos-overview-4581906, Last accessed on 1st March, 2021
  4. Gainder S, Sharma B. Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian Dermatol Online J. 2019;10(2):97-105.
  5. Types of Acne and How to Treat Them, Available at: https://www.healthline.com/health/beauty-skin-care/types-of-acne, Last accessed on 1st March, 2021

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