Understanding PCOS Acne: Causes, Patterns, and Treatments

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age. PCOS affects approximately 1 in 10 women of childbearing age globally, as per the Office on Women's Health. It involves irregular menstrual periods, excess androgen levels, and polycystic ovaries. 

PCOS acne is a type of acne caused by the hormonal imbalances associated with PCOS. It is also often called hormonal acne. It is often persistent and can be difficult to treat. 

In PCOS, an imbalance of hormones, particularly elevated levels of androgens, leads to increased oil production in the skin. This excess oil can clog pores and result in acne. 

About 70% of women with PCOS have insulin resistance, which can exacerbate acne, notes Vinmec. Inflammation and insulin resistance are common in PCOS. Inflammation can worsen acne, while insulin resistance increases androgen production, further contributing to acne.

Acne in individuals with PCOS typically appears along the lower part of the face. The common areas affected are the jawline, chin, and lower cheeks.

This pattern is distinct from other types of acne, which may be more prevalent on the forehead, upper cheeks, and nose. The hormonal nature of PCOS acne causes it to cluster in these areas, often forming a U-shaped pattern.

Unlike typical teenage acne which is more spread out, PCOS acne tends to be concentrated and persistent in the lower facial regions.

PCOS acne often appears as large, inflamed cysts and nodules. These lesions are deeper in the skin compared to regular acne and can be painful.

The size of PCOS acne spots tends to be larger, and they are usually red and swollen. Unlike smaller whiteheads and blackheads, PCOS acne is often cystic, meaning it forms deep, pus-filled bumps.

These bumps can leave scars if not treated properly. The inflammation associated with PCOS acne makes it more noticeable and difficult to manage. Compared to other types of acne, PCOS acne is more likely to be persistent and resistant to typical over-the-counter treatments.

Treatment for PCOS acne involves a combination of lifestyle changes, skincare routines, and medical treatments.

Lifestyle changes:

• Manage stress: Practice relaxation techniques like yoga or meditation.
• Healthy diet: Include plenty of fruits, vegetables, and whole grains. Avoid processed foods and sugar.
• Regular exercise: Aim for at least 30 minutes of moderate exercise most days of the week.

Skincare routine:

• Gentle cleansing: Use a mild cleanser to wash your face twice a day.
• Non-comedogenic products: Choose skincare and makeup products that do not clog pores.
• Moisturizing: Keep your skin hydrated with an oil-free moisturizer.

Medical treatments:

• Hormonal therapies: Treatments that help balance hormone levels, which can reduce acne.
• Other treatments: Additional medical treatments may be prescribed by a healthcare provider to reduce acne symptoms.

Addressing hormonal imbalances is crucial for effectively treating PCOS acne. Balancing hormones can significantly improve acne symptoms and overall skin health.

Diet plays a significant role in managing PCOS acne. A balanced diet can help regulate hormones, reduce inflammation, and improve skin health.

Foods that may help improve acne symptoms:

• High-fiber foods: Whole grains, fruits, and vegetables help regulate blood sugar levels.
• Lean proteins: Fish, chicken, and legumes provide essential nutrients without excess fat.
• Healthy fats: Omega-3 fatty acids found in fish, flaxseeds, and walnuts help reduce inflammation.
• Antioxidant-rich foods: Berries, spinach, and nuts help combat oxidative stress and support skin health.

Foods to avoid that could exacerbate PCOS acne:

• Sugary foods and drinks: Excess sugar can lead to insulin spikes, worsening hormonal imbalances.
• Processed foods: High in unhealthy fats and additives that can increase inflammation.
• Dairy products: Some studies suggest dairy can exacerbate acne in some individuals.
• High-glycemic foods: White bread, pasta, and sugary snacks can cause rapid spikes in blood sugar levels.