Constant Companions of PCOS: Acne and Why it Happens!

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of childbearing age. If you have PCOS, your ovaries produce more than normal amounts of male hormones called androgens, which is usually present in small amounts in females. 

As a result, your ovaries may develop numerous fluid-filled sacs that prevent the regular release of eggs from the ovaries (ovulation). This hormonal imbalance and unpredictable ovulation lead to irregular menstrual cycles and other symptoms like acne, unwanted hair growth, weight gain, etc.

Want to know more about “PCOS pimples”? Read on.

PCOS: Skin Symptoms

So how does PCOS manifest as skin-related symptoms? It can lead to:

Acne

How does PCOS cause acne? PCOS can lead to acne because it causes your ovaries to produce more male hormones called androgens, which stimulate the production of oil in the skin. This excess oil in your skin along with the dead skin blocks the follicles from which your hair grows and causes acne. 

The acne appears in what is known as the “PCOS acne pattern”, usually on the chin, jawline, and upper neck. The acne tends to have larger and deeper lesions than other acne forms and may also resolve more slowly.

Darkened Skin

You may develop thick, dark, velvety patches of skin under your arms or breasts, on the back of your neck, and in your groin area (between the legs) due to insulin resistance. This condition is called acanthosis nigricans.

PCOS: Diagnosis

If you think you are experiencing the symptoms of PCOS, consult your doctor without any further delay. Inform your doctor about your symptoms, medical history, including your menstrual cycle, and if there are any changes in your weight. 

Your doctor will perform a physical examination, a pelvic check, and order blood tests and a pelvic ultrasound to diagnose PCOS.

You need to meet at least 2 of these 3 criteria to be diagnosed with PCOS:

• Irregular or missed periods
• Signs of excess androgens such as acne or excessive hair growth or blood test results confirming high androgen levels.
• Cysts on one or both ovaries.

PCOS: Acne Treatment

Treatment for acne related to PCOS involves treating the root cause, the hormonal imbalance in PCOS. Your doctor may recommend the following treatment options for PCOS-related acne:

Medications

• Combination birth control pills: Medications that contain oestrogen and progestin are used to help regulate menstrual cycles and reduce the risk of endometrial cancer in women with irregular periods associated with PCOS. This combination of medicine decreases androgen production and normalises the level of oestrogen. 
• Spironolactone: This medication blocks the effects of androgens on your skin. It is recommended to use this medicine only if you are not planning to become pregnant as it can cause birth defects in the infant in your womb. It is ideal to use effective contraception during treatment with this medication.
• Acne Medications Your doctor may prescribe medications that are typically used to reduce acne. These include:
• Topical antibiotics such as clindamycin and erythromycin 
• Dapsone, an anti-bacterial gel
• Benzoyl peroxide, which targets surface bacteria
• Salicylic acid, which breaks down excess oil and dead skin and prevents them from clogging the pores 
• Azelaic acid, which has an anti-inflammatory property and reduces swelling and redness of the skin.
• Retinoids reduce acne breakouts and prevent clogging of pores. It also reduces the formation of scars.

All these medications should be used only in consultation with your doctor.

Lifestyle Changes

Insulin resistance and weight gain in PCOS may make your acne symptoms worse. You can effectively manage PCOS by modifying your lifestyle with healthy food habits, and regular

PCOS Acne: Diet

Your diet plays an important role in the management of PCOS and its symptoms. The food you consume is broken down into carbohydrates (sugars), which cannot be taken up by your cells and converted into energy due to insulin resistance caused by PCOS. 

This elevates your blood glucose (sugar) levels, which can disturb the balance of hormones in your body and aggravate the symptoms of PCOS. A diet that helps you manage PCOS and can help manage PCOS acne as well. 

You need to adopt a balanced diet plan based on whole grains, pulses, lean protein sources, fruits, vegetables, nuts, and seeds in order to manage PCOS and its symptoms. 

Avoid foods such as sweets, fruit juices, processed foods with refined carbohydrates, fried food, and red and processed meat as they make it difficult to manage PCOS. 

PCOS Acne: Home Remedies

While your hormonal levels in PCOS may be stabilised with medications, diet, and exercise, you can soothe your irritated skin with a few home remedies.

• Aloe vera: Applying fresh aloe vera gel can soothe your skin. It has anti-inflammatory, antiseptic, and astringent properties.
• Honey: Honey (especially Manuka honey) has an antibacterial property. It is a great moisturiser to soothe red, inflamed, acne-ridden skin.
• Turmeric: Turmeric has antibacterial and antiseptic properties. It is very effective in treating acne and its scars.

PCOS Acne Skin Care Routine

Skincare should be a part of your daily routine. Developing acne with PCOS may be exaggerated due to poor skin care. Here are a few ways by which you can keep your skin healthy:

• Discuss with a dermatologist to buy skincare products that are suitable for your skin. 
• Wash your face at least twice or thrice a day with a gentle cleanser, but not more than that.
• Moisturise your skin regularly.
• Apply sunscreen during the day while going out in the sun. Avoid direct sunlight if you are using medications that cause photosensitivity.
• Use non-comedogenic (a product that does not block your pores) makeup and skin products that are gentle on your skin. 
• Always use makeup remover at the end of the day.
• Avoid touching your face unnecessarily.
• Do not try to pop your acne.

When to See a Doctor?

Consult a doctor if you observe any symptoms of PCOS such as irregular or missed periods, darkened skin, skin tags, anxiety, and infertility issues along with oily and acne-prone skin. You can consult a dermatologist if the acne is not responding to any treatment or lifestyle changes.