PCOS & Acne – The Connection and Practical Solutions

By Amy Medling, founder of PCOS Diva

For many, the word acne, evokes memories of your teenage days, awkward adolescence, and skin insecurities. However, women with hormonal issues like Polycystic Ovary Syndrome (PCOS) often don’t have this luxury. PCOS and acne are certainly linked, but there is good news. There are specific foods you can eat (and avoid) and supplements you can take to help with your PCOS acne.

The Link Between PCOS and Acne

Before we dive in to the foods and supplements that can help with acne, it’s helpful to understand the connection between PCOS and acne problems.

Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine disorders found in women, affecting approximately 5-10% of women worldwide, with less than 50% of them diagnosed. The syndrome is present throughout a woman’s life from puberty through post-menopause and affects women of all races and ethnic groups. Women with PCOS wrestle with an array of possible symptoms including obesity, irregular menstrual cycles, infertility, depression, acne, hair loss, and more.

While the bulk of the discussions around PCOS is focused on infertility and its link with diabetes, it should be noted that hormonal imbalances are at the root. Having PCOS can cause serious disruptions when it comes to your body’s estrogen, progesterone, and testosterone production.

For more about PCOS & acne, listen to (or read the transcript) Practical Tips for Healing PCOS Acne [Podcast] 

Is PCOS to blame for your acne?

Having PCOS can definitely impact your skin, but it’s not the only cause of acne.

Generally speaking, acne can be caused by excessive oil production, trapped dead skin cells in pores, bacteria, and high hormone activity. Acne is also known to be caused by stress, pregnancy-related hormonal changes, and some drugs like corticosteroids.

More than physiological causes, people who don’t wash their faces regularly, don’t drink enough water, or use poor quality makeup and skincare products are also at an increased risk of getting acne.

Acne is also a sign of inflammation which can be caused by many things including specific foods in your diet.

Common acne treatments

Being a common skin condition that every person can experience is both the worst and best thing about acne. It’s bad because, well, who likes to have acne? It’s good because it’s so common there are various ways to treat it.

• OTC medications. Over-the-counter acne treatments are advertised on TV and social media. They appear in various shapes and sizes, but the bulk of them rely on four common active ingredients: Benzoyl peroxide, salicylic acid, mandelic acid, and Note that while these medications work for breakouts, they’re not considered “preventative” especially in the case of hormonal acne.
• Oral contraceptives. Women with PCOS are often prescribed oral contraceptives. While they do not heal the root of PCOS, in the short-term, they help women with PCOS regulate menstrual periods (though a pill period is not a “real” bleed), and may offer some relief of hormonal acne. The ingredients to look out for are a mix of progestin norgestimate, drospirenone, and norethindrone acetate. However, using these pills isn’t for everyone, especially for women over 35 or those with a history of breast cancer, blood clotting, hypertension, or smoking. When women stop taking the pill, PCOS symptoms return and must be managed for the long-term.
• Anti-androgen drugs. Women with PCOS have abnormally high levels of testosterone. This spike in testosterone is linked to acne problems as too much testosterone can produce too much sebum and skin cells. Metformin is a drug often prescribed to people with high levels of blood sugar. It is not without side effects and is not a long-term solution, it may be useful in the short-term. Flutamide and Finasteride are also sometimes prescribed, but are have high risk of side effects.

Dietary adjustments

It’s no secret that our diet plays a major role in what happens to our body, acne and other external skin conditions included. Some studies note that eating junk food, sugar, or anything oily and processed doesn’t lead to acne per se, but these foods do contribute to inflammation. Inflammation can be a factor when it comes to acne breakouts, especially when you have PCOS. Common inflammatory foods for women with PCOS include gluten and dairy.

Foods that contribute to inflammation vary by person, but often include red meats, white potatoes, sugary desserts and pastries, and white bread. Other foods to avoid include fast food, frozen meals, meal bars, chips, microwave meals, table sugar, energy drinks, sweetened juices, and sports drinks.

Foods that have anti-inflammatory properties include kale, almonds, spinach, walnuts, olive oil, berries, salmon, and turmeric. Other foods that are good for you include vegetables like broccoli, cauliflower, and beets, fruits like berries, oranges, apples, and bananas (in limited amounts), whole grains (quinoa, etc.) and starchy vegetables (also in limited amounts), healthy fats from whole eggs, avocados, and coconut oil, plant-based dairy like almond milk, coconut milk, and cashew milk, high quality protein such as chicken and salmon, herbs and spices like cinnamon, black pepper, and garlic, and unsweetened drinks like plain water, green tea, and lemon water.

It’s important to note that dietary changes alone may not be enough to suppress acne breakouts, but they do help with the overall acne treatment.

Apart from specific foods, changing eating habits and overall dietary preferences can also help with acne problems. The PCOS Diva protocol serves this purpose well. It is an anti-inflammatory diet, packed with a wide variety of foods that nourish instead of inflame. That is good for your acne, but also your overall PCOS symptoms.

For more about the link between diet, PCOS, and acne listen (or read the transcript) PCOS & Acne: Tips From a Pro [Podcast] 

Low Glycemic Index foods

Reducing blood sugar fluctuations can help control acne. Foods with a high glycemic index score such as white bread, soda, candy, sugary cereals and beverages, and other sweets and pastries can cause dramatic fluctuations in blood sugar levels which can worsen acne problems.

How does sugar affect acne? In a complicated process, sugar promotes insulin release. Elevated levels of insulin can promote the release of other hormones and can lead to excess sebum. Excess sebum then worsens acne.

Cutting dairy and whey protein

Some scientists believe milk and dairy products contributes to acne problems by way of insulin production not unlike sugary foods. In a review that included 14 studies and over 78,000 subjects, it was found that a greater risk of acne was found in those who consumed any type of dairy products (milk, cheese, yogurt, etc.) regardless of amount or frequency.

Supplements to treat acne

Eating specific foods can help reduce acne problems. However, access to these foods can be limited or just not practical. The next best thing, therefore, is to supplement the compounds found in these anti-acne foods.

• Vitamin D. Low vitamin D levels have been associated with acne problems. Scientists think the anti-inflammatory properties of Vitamin D help keep acne at bay, so a deficiency gives the undesirable, opposite effect. Some studies suggest taking 1,000 IU of Vitamin D per day for at least two months can improve acne lesions, especially for those who were found to be deficient in Vitamin D.
• Green tea. When it comes to antioxidants, tea is often at the top of the list and plenty of studies agree. Green tea, especially, contains a lot of antioxidant potential that has benefits ranging from weight loss and anti-ageing to anticarcinogenic properties. Some studies report that taking green tea supplements (often as green tea extract) for a period of four weeks can lead to reduced acne lesions. While tea extract supplements are generally safe for consumption, you can overdose on it and potentially damage your liver. Be sure to check with your doctor especially about your liver health before taking any green tea supplements.
• Fish oil. Eating fish is generally healthy. Outside of heavy metal contamination, fish is a staple in an optimal diet. The bulk of what makes fish healthy is in its fat, aptly called fish oil. There is some evidence that suggests taking fish oil supplements may reduce acne. Scientists think this is due to how fish oil has anti-inflammatory properties.
• B-Vitamins. Some studies show B-vitamin supplementation (usually in doses above 100% daily value) can benefit those with acne problems.
• Zinc. Zinc plays a critical role in skin health which can greatly influence the severity of acne breakouts. Zinc has been found to help reduce oil production and even offer protection against bacterial infections and inflammation. You can take zinc orally or topically. If orally, be careful not to overdose as it can lead to copper deficiency.
• Vitamin A. Not orally, but topical application of vitamin A helps with acne. Experts don’t recommend oral ingestion of Vitamin A for acne because it’s fat-soluble, and fat-soluble vitamins can build up and cause toxicity if left unchecked. Do note that topical vitamin A can weaken your skin’s natural ability to protect itself from UV rays. If you use topical vitamin A, stay away from direct sunlight or apply sunscreen.
• Resveratrol. Studies show this powerful anti-oxidant inhibits acne, especially when combined with benzoyl peroxide
• Berberine. Berberine is a natural antibiotic, improves insulin sensitivity (as well as Metformin), and reduces testosterone and inflammation. All of this combines to make it a powerful anti-acne supplement.

Apart from following an anti-acne diet, women with PCOS should also prioritize habits that prevent their skin from becoming a home for acne. They should practice washing their face twice a day, cleansing with an oil-free moisturizer, avoid picking or popping acne blemishes, stop using cheap or poor-quality makeup, quit smoking, and reduce alcohol intake.

It’s also critical to consult with a dermatologist as well as a PCOS expert before trying out any sort of medication or supplement. Often, treating hormonal acne may not require any form of medication at all for some women with PCOS. Many of us are able to control it with a combination of diet, skin hygiene, and supplements.

For more about PCOS & Acne, check out:

• Control Your Hormones, Fix Your Acne? [Podcast] 
• Practical Tips for Healing PCOS Acne [Podcast] 
• PCOS & Acne: Tips From a Pro [Podcast] 
• Acne and PCOS
• Does Dairy Cause Acne?
• 6 Natural Skincare Tips to Heal Your PCOS Acne

 

Amy Medling, best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health, and happiness. 

References:

• Tanghetti EA. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol. 2013;6(9):27–35.
• Vaughn AR, Branum A, Sivamani RK. Effects of Turmeric (Curcuma longa) on Skin Health: A Systematic Review of the Clinical Evidence. Phytother Res. 2016;30(8):1243-64.
• Cervantes J, Eber AE, Perper M, Nascimento VM, Nouri K, Keri JE. The role of zinc in the treatment of acne: A review of the literature. Dermatol Ther. 2018;31(1)
• Gainder S, Sharma B. Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian Dermatol Online J. 2019;10(2):97–105. doi:10.4103/idoj.IDOJ_249_17
• Sharma S, Mathur DK, Paliwal V, Bhargava P. Efficacy of Metformin in the Treatment of Acne in Women with Polycystic Ovarian Syndrome: A Newer Approach to Acne Therapy. J Clin Aesthet Dermatol. 2019;12(5):34–38.
• Taylor EJ, Yu Y, Champer J, Kim J. Dermatol Ther (Heidelb). 2014 Sep 17