Acne and PCOS
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects people with ovaries. It can lead to various symptoms, and one of them is acne. The exact cause of acne in females with PCOS is multifactorial and involves several interconnected factors:
Hormonal Imbalance: PCOS is characterised by an imbalance in sex hormones, particularly elevated levels of androgens (male hormones) such as testosterone. Increased androgen levels can stimulate the sebaceous glands in the skin to produce more sebum (oil), which can contribute to the development of acne.
Insulin Resistance: Many individuals with PCOS also have insulin resistance, which means their body's cells do not respond efficiently to insulin. Insulin resistance can lead to elevated insulin levels, and insulin has been shown to stimulate androgen production. This, in turn, can contribute to the hormonal imbalance associated with PCOS and exacerbate acne.
Inflammation: PCOS is associated with chronic low-grade inflammation, and inflammatory processes are known to play a role in the development of acne. Inflammation can affect the skin's response to the overproduction of sebum, contributing to the formation of acne lesions.
Genetic Factors: There is evidence to suggest a genetic component to PCOS. If there is a family history of PCOS, there may be a higher likelihood of developing the condition, along with associated symptoms such as acne.
Hyperandrogenism: Elevated levels of androgens are often associated with PCOS, and hyperandrogenism (excessive androgen levels) can directly influence the development of acne.
Lifestyle Factors: While not specific to PCOS, certain lifestyle factors such as diet and stress can also contribute to acne. For example, a diet high in refined carbohydrates may exacerbate insulin resistance, and stress can influence hormonal balance. Over-exercising can be harmful, increasing cortisol levels and triggering your adrenal glands to release more hormones and increase PCOS symptoms such as acne and hair changes.
Managing acne in females with PCOS often involves addressing the underlying hormonal and metabolic imbalances. This may include lifestyle modifications such as healthy diet, regular exercise, and stress management. Additionally, hormonal contraceptives or anti-androgen medications may be prescribed to help regulate hormonal levels and improve acne symptoms. Individuals with PCOS need to work with healthcare professionals to develop a personalised treatment plan based on their specific symptoms and needs.
How do I know if my acne is PCOS?
If you suspect that your PCOS is contributing to your acne, here are some signs to consider:
Hormonal Imbalance: PCOS often leads to an imbalance in hormones, including elevated levels of androgens. If you have other symptoms of hormonal imbalance, such as irregular periods, hirsutism (excessive hair growth), or scalp hair thinning, it may suggest PCOS.
Acne Pattern: Acne associated with hormonal imbalances, including PCOS, often appears on the lower part of the face, jawline, and neck. This is known as "hormonal acne."
Medical Diagnosis: A healthcare professional, such as a dermatologist or an endocrinologist, can assess your symptoms, perform relevant tests, and diagnose PCOS. Blood tests measuring hormone levels, ultrasound imaging of the ovaries, and a thorough medical history can aid in the diagnosis.
Other PCOS Symptoms: Look for other symptoms commonly associated with PCOS, such as irregular menstrual cycles, weight gain, insulin resistance, and difficulty conceiving.
But what if your blood testosterone results are normal or on the lower side?
Many women that I work with have received normal or even low testosterone results in their blood work, yet suffer from significant androgen excess symptoms.
There are a few reasons for this. Firstly, testosterone is difficult to measure in your blood. A blood test for testosterone is only able to measure the testosterone that is circulating around your body. This doesn’t let us see how much testosterone is bound up in your tissues – for example, trapped in your hair follicles causing acne, excess hair growth, or thinning of the hair on your head.
Secondly, testosterone is just one of the many androgens that cause the symptoms of PCOS. Testosterone is the most common androgen, which is why it is most frequently measured by your doctor. In your unique type of PCOS, your symptoms may be driven by another kind of androgen (like DHEAS, which is commonly raised when you experience high levels of stress).
This is a much more reliable way of confirming if androgens are an issue in your PCOS symptoms.
The most common symptoms to look out for are:
Acne around your chin, jawline, upper lip, neck, chest, and back
Thinning hair in the crown of your head or a widening part
Receding hairline
Extensive hair growth around your chin, neck, jawline, chest, breasts or back.
If you suspect a connection between your PCOS and acne, consider taking the following steps:
Consult a Healthcare Professional: Schedule an appointment with your healthcare provider, preferably a dermatologist or an endocrinologist, to discuss your concerns. They can conduct tests to assess your hormone levels and evaluate if PCOS is a contributing factor.
Address PCOS: If PCOS is diagnosed, focus on reducing the level of androgens - see my recommended steps to support this.
Skincare Routine: Regardless of the cause of your acne, maintaining a good skincare routine can help manage and prevent breakouts. Use gentle cleansers, non-comedogenic moisturisers, and acne treatments as recommended by your dermatologist.
Remember, it's crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to your individual needs.
The Three Step Anti-Androgen Plan:
If you believe your acne is PCOS or even if not, the three recommended steps below are likely to improve your acne - alongside a healthy lifestyle.
Drink two cup of spearmint tea
Incorporate a PCOS Repair Breakfast
Take an anti-androgen supplement
Daily Ritual One:
Drink Two Cups of Spearmint Tea. Spearmint tea has been shown to naturally lower androgens levels in women with PCOS. In a randomised controlled trial, drinking two cups daily for 30 days resulted in lowered blood testosterone levels, improved LH to FSH ratios, and significantly reduced abnormal hair growth (hirsutism). At this point in time, peppermint tea has not been studied so for best results seek out a spearmint tea (loose leaf or tea bags are both great choices). Your goal is to enjoy two cups of spearmint tea daily to support balanced androgen levels.
Daily Ritual Two:
Your second daily ritual is to enjoy a PCOS-friendly breakfast. Breakfast is the most important meal to control your blood sugar levels and cortisol levels. A PCOS-friendly is essentially a high protein, low starch, and low sugar breakfast. Aim for 30-40 grams of protein, along with lots of non-starchy vegetables and some healthy fats. By incorporating breakfast only, some of my clients have noticed an improvement in their acne.
Daily Ritual Three:
Your final daily ritual is to incorporate a supplement or herbs that helps hormonal acne. This step is optional and only a recommendation as the first two steps will go a long way in providing relief from some of your symptoms. However, I suggest considering one of the following options for faster results. I recommend discussing any new supplement regimes with your GP before beginning to be sure it is the best choice for you. Some herbs and vitamins naturally help your body to balance androgen levels and reduce the conversion of testosterone to DHT, therefore improving your PCOS symptoms.
Here’s some to consider:
Zinc:
Zinc is an important mineral required for many body processes, including modulating testosterone levels. A systematic review and meta-analysis assessing zinc it's relationship to acne showed that people who suffer from acne are more likely to have lower zinc levels, and treatments with zinc can improve acne.
Myo-Insolitol:
Inositols are compounds that our bodies make naturally, and they are also found in fruits, nuts, and grains. Fifty women with PCOS were given myo-inositol for six months. Results showed levels of testosterone and other hormones were significantly reduced after just three months, and acne and other PCOS symptoms improved at the six-month mark. Another study gave 50 women 2 grams of inositol twice per day for six months, and another group of 50 women was given a placebo for six months. Results showed a significant decrease in DHEA levels in the women given inositol, and subsequently, an improvement in acne was seen.
Omega-3:
Omega-3 also helps to reduce acne by lowering inflammation in your skin. You will see the benefits by aiming for three to four times per week to gain the benefits.
Adaptogen for hormonal acne:
Adaptogens are botanicals that can help the body respond properly to stress via their effects on the hormone cortisol, and thus they may aid in the resolution of hormonal acne. Ashwagandha, Astragalus, and Asian Ginseng are all examples of adaptogens that can help modulate cortisol levels.
As we know, PCOS implies there is a problem with our ovaries, but really it’s a whole-body disorder that affects ovulation. When looking to improve your PCOS symptoms, whether it's to regulate your period, reduce acne and hair loss, or even improve energy levels, I recommend taking a holistic approach. Looking at your nutrition, movement, sleep, and stress levels. Believe it or not, they are all connected, and making the smallest of changes in these areas can have a huge impact on our PCOS symptoms.
References:
https://www.rupahealth.com/post/how-to-get-rid-of-hormonal-acne-naturally#:~:text=Results%20showed%20levels%20of%20testosterone,a%20placebo%20for%20six%20months.
