A woman is pictured with hormonal acne around her jawline

PCOS Acne - Why it happens and what you can do about it

PCOS (polycystic ovarian syndrome) creates hormone disruption that affects many aspects of our health, including our skin. One of the most common skin issues associated with PCOS is acne. The underlying hormonal imbalances in PCOS, particularly elevated androgen levels, contribute to the development of acne and other skin problems.

In this post, I’ll share some of the reasons about PCOS acne and what you can try to get your skin back under control. I battled acne for many years due to PCOS so I know the sense of frustration and despair it can bring.

  1. Hormonal Imbalances in PCOS:

PCOS is characterized by hormonal imbalances, including elevated levels of androgens, such as testosterone. Androgens are typically present in both men and women but are usually found in lower amounts in women. In PCOS, the ovaries produce higher levels of androgens, which can disrupt the delicate balance of hormones and lead to various symptoms, including acne. You can find out your androgen levels on a blood test.

  1. Increased Sebum Production:

Androgens stimulate the sebaceous glands in the skin to produce more sebum, an oily substance that helps lubricate the skin. However, when there is an excess of androgens in the body, the sebaceous glands can become overactive, leading to excessive sebum production. This excess sebum, along with dead skin cells, can clog the pores and create an environment favourable for the growth of acne-causing bacteria. Greasy hair is also a common issue. 

  1. Acne Types Associated with PCOS:

PCOS-related acne tends to manifest in specific patterns. It often appears as persistent or recurrent acne on the chin, jawline, and lower face. This is known as "hormonal acne" and is influenced by the androgen-driven hormonal imbalances characteristic of PCOS. The acne may range from mild to severe, with the potential for deep cysts.  I suffered with terrible ‘bacne’ as well and I bear the scars from that time.

Medical options

You can speak to your GP but a dermatologist or endocrinologist have a number of medical drugs they can offer, to develop a personalised treatment plan.

Options tend to be around oral contraceptives, antibiotics and topical creams but also might be androgen blockers such as spironolactone.

I went through loads when I was 16: the pill, topical creams, antibiotics but nothing was working for me and the antibiotics absolutely destroyed my gut.  I ended up being prescribed Roaccutane which is known as an Isotretinoin.  It’s basically vitamin A in a massive dose and comes with hefty side effects.  You need to be under the strict guidance of a medical professional.

I found this was the thing that worked for me at the time but I was left with permanently dry skin which is really difficult to manage. Noone ever mentioned there might be other things I could do from a diet or supplement perspective.

Addressing the underlying cause

Insulin resistance and reducing androgen levels are key to getting PCOS acne under control and you can do a number of things that can really help support your body to get back into balance

  • Manage blood sugar – this is the key thing for most symptoms of PCOS but super important for skin health
  • Bring down androgen levels – there’s a number of nutrients that can help do this, zinc especially so choosing zinc rich foods in your diet is really beneficial – pumpkin seeds are a great one to add into smoothies and into salads.
  • Drinking spearmint tea has been shown in a number of studies to help bring down androgen levels – 2 cups a day.
  • Supplement with key nutrients that have been shown to reduce androgens and support insulin resistance: Myo Inositol and D-Chiro Inositol are key ones to look for and are found in daily balance. Omegas 3s can also be really beneficial to bring down inflammation.

Ensure you have a good skincare routine

If you’re covering up acne with make up ensure you’re washing it off everyday. Don’t sleep in your make up!

Focus on gentle cleansing to remove impurities and excess oil without stripping the skin of its natural moisture. Incorporate products that contain ingredients like salicylic acid or benzoyl peroxide to address acne breakouts.

Hydrate your skin with a suitable moisturiser that won't clog your pores. 

Acne due to PCOS is a common skin issue symptom that can be incredibly distressing. 

By addressing the underlying hormonal imbalances, managing inflammation, and supporting blood sugar balance, you are giving your body a great opportunity to get back into balance, but do also speak to your GP about options of medication that might help you.  Be sure to weigh up the side effects but if acne is preventing you from getting out there and enjoying life then go and advocate for yourself and see what choices you have available.