Acne is a common concern as we go through puberty. The hormonal changes in the body during puberty are regarded as one of the primary reasons for acne. However, women might also experience persistent acne long after puberty because of hormonal imbalances in the body.
Polycystic ovary syndrome or PCOS is a lifestyle and hormonal disorder that affects 1 out of 5 women in India and is the most common reason for acne in women of reproductive age.
However, with the right approach, PCOS acne can be managed to an extent that it doesn’t affect your daily life.Start PCOS Treatment
Cystic acne refers to inflammatory acne that causes pus-filled pimples to form deep under the skin and can vary in degrees of discomfort, often being quite painful. One of the causes of acne can be skin pores that are clogged with oil and dead skin cells. However, the presence of male hormones called androgens in a woman’s body can cause severe acne too, and this is the case in most women with PCOS.
PCOS cystic acne is the most severe type of acne because acne cysts are extremely painful and are likely to cause scarring. There is also a high chance of bacteria getting into the pores of the skin and causing inflammation and swelling.
Since PCOS is a lifestyle and hormonal disorder, it brings about many changes in the body that can cause and worsen acne. Let’s explore those further.
- Excess sebum production
Acne from PCOS can be a result of increased levels of androgens in the body, which in turn promote sebum production by the oil glands of the skin. High levels of sebum and chronic inflammation increase the chances of pore blockages that can develop into blackheads or whiteheads and eventually acne.
Furthermore, pores blocked with oil, dirt, and grime create favourable conditions for the growth of the acne-causing bacteria Propionibacterium acnes, which in turn can make PCOS acne worse.
- High levels of blood sugar
PCOS acne can be a result of hyperinsulinemia, a common condition affecting around 70% of women with PCOS. It is a condition in which the body is not as responsive as it should be to insulin, leading to high blood glucose levels. This triggers the ovaries to produce more androgens, which thus aggravate acne by encouraging the production of excess sebum.
One of the most ignored causes of PCOS acne is emotional stress. Physical appearance is of great importance to many people, and having acne can easily induce depression and spike stress levels. Stress causes havoc in the body, especially with hormones, which can thus intensify both PCOS and acne.
Some studies suggest that certain areas of the face can be more hormonally sensitive than others. PCOS acne mostly occurs in the lower third of the face, which generally includes the cheeks, jawline, chin, and sometimes the upper neck. In some cases, women might also experience acne in the upper thoracic region and the back. These regions are considered a hormonal pattern in women with PCOS.
PCOS acne is generally larger, pus-filled, aggravated, and much slower to resolve than typical acne. It is also accompanied by pain and inflammation. The acne might come with a cluster of cysts that can be painful to the touch.
Acne is one of the most common skin problems, and it affects women of all ages, even those who do not have PCOS.
While the main causes of acne are blocked pores and hair follicles, there are other factors that affect skin texture, spots, and pimples, including:
The sebaceous glands (skin glands that secrete sebum into the hair follicles to lubricate the skin and hair) have receptors that respond to sex hormones. These glands are strongly affected by androgens. When more androgens are binding to these receptors, more sebum (an oily, waxy substance that coats, moisturizes, and protects your skin) is produced. This can lead to noticeably oily skin and may progress to acne. Since PCOS causes high levels of androgens, it can cause an increase in oil production and hence worse acne.
Women with PCOS acne are advised to take care of their skin and health to manage PCOS acne naturally. Every case of acne is different, so your treatment should be customised to your skin type and acne severity.
There are several skincare tips women with PCOS acne can follow:
Even after severe acne clears, acne scars often appear. These scars can cause damage to the surface of your skin and in some cases also cause raised acne scars. Depending on the type and the extent of the scarring, there are various treatments for reducing or eliminating scarring.
Laser treatment may further help treat hyperpigmentation and flatten acne scars. Treatments like micro-needling can also be extremely beneficial but should only be considered after consulting with your healthcare provider.
Acne can look different in different women. PCOS acne often shows a hormonal pattern, meaning the acne usually flares around the jawline, chin, and upper neck area. When diagnosing PCOS — along with symptoms such as facial hair, hirsutism, unusual fatigue, and irregular periods, your doctor will also check for the following to diagnose PCOS acne.
A balanced diet and regular exercise are the key to managing most PCOS symptoms. However, PCOS hormonal acne treatment can involve therapies that address visible symptoms while also focusing on the underlying causes. PCOS acne treatment can include anti-androgen drugs, over-the-counter medications, retinoids, oral contraceptive pills, and laser therapy. However, appropriate treatment can only be devised once your doctor has evaluated the severity of your acne along with other PCOS symptoms.
One or more of the following PCOS acne treatments may be prescribed.
If the acne is not too severe, a chemical peel may be prescribed to exfoliate the skin and unclog pores. Alpha and beta hydroxy acids, generally used in chemical peels, are derived from natural sources and are considered to be safe for the skin when used in certain concentrations under medical supervision. This kind of treatment can be of great help to manage PCOS acne in the initial stages.
Oral contraceptive pills (OCPs) are generally prescribed to help stabilize hormone levels and thus help manage PCOS acne. OCPs work by lowering the level of androgens in the body and thus improving symptoms such as acne.
Increased levels of androgens are the major cause of PCOS acne, but they can be brought under control with prescribed anti-androgen medicines. These drugs are usually prescribed after other medications, such as OCPs, haven’t worked. Moreover, since anti-androgens pose the risk of causing birth defects in an unborn child, they are always used in combination with a form of contraception.
Benzoyl peroxide, salicylic acid, and niacinamide can be helpful in treating PCOS acne, and they can be bought with a prescription. However, these may only work in cases of mild acne and may not be quite as effective for severe acne. In severe cases, your doctor may recommend antibiotics to help fight the acne-causing bacteria.
Both oral and topical retinoids can be used for treating PCOS acne. Topical retinoids should be used as directed, as they have the tendency to make the skin sensitive when exposed to sunlight. Ideally, they should be applied to the affected areas in the evening followed by using sunscreen the next day. Oral retinoids such as isotretinoin are prescribed for treating all types of acne, including PCOS hormonal acne.
Lasers use beams of light to target the infected area and exfoliate it. This helps unclog pores and eliminate infection-causing bacteria. This treatment can also cause a decrease in the production of natural oils to help reduce acne and prevent breakouts and scarring.
Although not backed by solid scientific evidence, some people report that the following natural remedies are effective in treating their PCOS acne.
Aloe vera contains antiseptic, anti-inflammatory, and astringent properties that can help treat acne naturally without irritating the skin or causing dryness.
Tea tree oil can be very effective, as it dries up cystic acne and does not clog pores. It can also help in diminishing acne scarring over time.
Honey, especially manuka honey, has amazing benefits for the skin, as it has several antibacterial properties and is a great natural moisturizer to soothe inflamed, red, acne-prone skin.
Acne can flare up for a number of different reasons. It can be a reaction to a skincare product, eating processed foods, stress, lack of sleep, or certain medications.
In such cases of flare-ups, following a simple skincare routine can help calm the skin. If your skin is irritated and inflamed, using a gentle cleanser followed by a light serum and moisturizer can restore the skin barrier and give your skin time to heal. You can also consult a dermatologist, who can help you understand what could have triggered your acne and what you can do to prevent future flare-ups.
PCOS acne can be hard to cope with, especially when it is combined with inflammation and pain. The best way to treat your acne and prevent possible scarring is to speak to a PCOS professional who can address the visible symptoms while also helping treat the underlying causes to prevent prolonged acne.
When it comes to acne, especially the cystic acne that can come with PCOS, attempting to treat it on your own could potentially damage your skin permanently. It is best to let a PCOS expert take care of your condition.
PCOS acne can often be stubborn, but the doctors at Veera Health are determined! Our expert dermatologists work with other professionals to treat the root cause of PCOS acne.
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