Polycystic Ovary Syndrome & Acne: How to Clear Hormonal Acne and Reverse PCOS
Are you experiencing jawline, neck, and cheek acne breakouts? Perhaps also with male-patterned hair growth on the face, around the nipples, and on the abdomen, or in combination with irregular menstrual cycles pre- or post-pill? Experiencing reoccurring acne even after stronger treatment like hormonal birth control or Accutane? Are you struggling with weight gain, despite doing all the right things? These may be signs of a hormonal condition known as polycystic ovary syndrome (PCOS).
Women who have significant acne that persists into their twenties and thirties often have some hormonal imbalance or PCOS lurking in the background. Women with PCOS often don’t respond to conventional acne treatments, because the acne is hormonal in nature. Even something like Accutane may deliver results initially, but the acne returns because the root hormonal imbalance or condition was not properly addressed.
So what can people with PCOS do about chronic symptoms like acne? Here’s the good news: There are so many lifestyle and nutritional rituals that can help reverse PCOS symptoms, and clear acne for good.
UNDERSTANDING PCOS.
PCOS affects up to 10 percent of women; it’s best defined as a group of symptoms related to anovulation (lack of ovulation), and elevated androgens or male hormones. One of the main symptoms of PCOS is irregular periods—specifically, longer menstrual cycles, meaning you may have a period a couple of times a year or have cycles that are commonly longer than 40 days. PCOS typically stems from a variety of underlying drivers, which makes addressing and reversing symptoms a multi-factor endeavour. The main drivers that affect the skin are insulin resistance, inflammation, adrenal androgens, and post-pill surge in androgens. (Briden, 2018).
Please note: Hormonal symptoms are unique to each person, so please reach out to a practitioner you trust to fully understand your experience. Other great resources to help people better understand natural menstrual cycles, navigate coming off the pill, and reverse unwanted hormonal symptoms like acne and PMS include Period Repair Manual by Dr. Lara Briden and 8 Steps to Reverse your PCOS by Dr. Fiona McCulloch.
HOW PCOS CONTRIBUTES TO ACNE
Inflammation
Acne put simply, is an inflammatory response in the skin. Not so simple, however, is trying to turn off this inflammatory response, which is why acne can be so troublesome to get rid of. This inflammatory response signals the body to increase inflammation, which ultimately creates more acne and feeds the vicious cycle; Acne leads to inflammation and inflammation is the perfect environment for acne. The key to clearing acne is to break the cycle of inflammation.
Excess Androgens
Acne is a persistent skin condition that is often related to excess androgens, and as we just discussed, women with PCOS tend to have elevated or excess androgens. As one of the most common causes of acne, androgens are stereotypically known as “male” hormones like testosterone, DHT, and DHEA-s; women have these hormones too, but an imbalance related to them can lead to acne. It’s thought that the level of androgens and androgen receptors in the skin are the greatest contributors to acne, rather than the overall level in the bloodstream. Elevated androgens are common with PCOS and can sometimes be associated with a temporary post-pill androgen surge. In the skin, 5-alpha reductase converts testosterone into the more acne-causing androgen DHT (McCulloch, 2016). And it’s these androgens that increase sebum production, which creates the perfect storm for acne to thrive.
Insulin Resistance
Insulin resistance is another factor contributing to acne breakouts that’s common for women with PCOS. When we have the chronic low-grade inflammation that goes along with PCOS, our cells become insulin resistant. Insulin resistance leads to more insulin being sent out, which aggravates the ovaries, causing them to produce more androgens like testosterone—contributing to the androgen-acne cycle previously mentioned. Insulin resistance also contributes to overall oxidative stress on the body, which ultimately feeds back into that inflammatory cycle where acne flourishes.
CLEARING PCOS-RELATED BREAKOUTS
Reduce Inflammation
Reducing inflammation is foundational for clear skin. Finding ways to support reducing inflammation is key when mitigating post-pill breakouts. Fill up your plate with anti-inflammatory foods, like antioxidant-rich berries, organic leafy greens, grass-fed beef, pasture-raised eggs, and food that is grown locally with intention. Lean into real whole foods and start to think about what you can add to your diet to nourish the skin and body from the inside out. Consider reducing refined foods and inflammatory oils and look at restoring a healthy metabolism by nourishing your body and eating every three to four hours. Many of us love bedtime snacks, but consider a snack that balances all three macros: protein, fat, and carbs; try experimenting with eating breakfast within an hour of waking as well. Don’t forget to prioritize quality sleep during this healing time. Sleep balances your hormones and blood sugar, reduces stress, regenerates the skin cells, allows the body to feel safe, and gives the body opportunity and space to heal.
Tea Time—My favourite tea to reduce inflammation and support glowing skin is green tea. This is rich in antioxidants and bioflavonoids. Green tea is great in protecting against toxins, overactive immune responses, and inflammation.
Address Insulin Resistance
Balancing blood sugar is key to reducing and repairing insulin resistance, and truly the foundation for hormone health. Blood sugar runs the show when it comes to hormone and skin health; when blood sugar levels are balanced, mood is stabilized, sugar cravings are kept at bay, hormones can be balanced, and inflammation will decrease. This can be achieved by balancing all three macros in each meal—protein, fat, and carbs.
Prioritizing daily movement is another key way to address insulin resistance and balance blood sugar. The great news is, it also reduces future breakouts and heals current ones. If you wake up one morning with an inflamed spot, instead of picking and over-analyzing, I invite you to consider these steps to heal that breakout fast!
Choose a movement you love to get the blood pumping and deliver fresh calming oxygen to your body’s cells.
Find an enjoyable way to break a sweat to give the body extra detox pathway support. My favourite way is a hot Epsom salt bath or sauna.
Light up your lymph with body dry brushing and facial gua sha massage. These feel amazing, and heal and reduce breakouts.
By supporting stable blood sugar and reducing insulin resistance you’re supporting happy hormones, helping to reverse PCOS, and clearing acne for good.
Reduce Excess Androgens
Addressing excess androgens means addressing the root cause. A great place to start is by reducing inflammation and addressing insulin resistance. Think of it as turning off a hose from the tap compared to trying to deal with gushing water at the end of the hose. Once inflammation and insulin resistance are under control, there are specific ways to address excess androgens. For women with PCOS and acne, this means focusing on promoting ovulation to support regular healthy cycles. Ovulation is how women produce progesterone, and progesterone is a women's superpower hormone for clear and glowing skin. Progesterone reduces androgens by inhibiting the enzyme 5-alpha reductase. This means less opportunity for testosterone to be converted into acne-causing androgen DHT. The result is less sebum production and fewer breakouts. By supporting ovulation and all phases of the menstrual cycle, women with PCOS can begin to find a natural balance in their hormones to help reduce acne breakouts.
Tea Time: My favourite tea to reduce androgens is spearmint. Research shows that two cups per day can decrease androgen levels in people with PCOS. Finding simple and sustainable lifestyle rituals when reversing PCOS-related breakouts, is key for long-term results. Spearmint tea is great to help reduce androgen-related breakouts—especially ones along the jawline and congestion (pore blockage) on the lower cheeks.
Thriving with PCOS and clearing PCOS-related hormonal acne is possible; this article outlined a great foundational starting point. During this time, be kind and gentle with yourself and look for small wins along your journey. Acne didn’t just pop up overnight, and it will likely take time to clear and fade. It’s about making small sustainable changes that work for you and your lifestyle—that’s the secret to clear skin. Celebrate when your mood improves with more balanced blood sugar habits, get excited when you ovulate, and be proud of yourself for showing up every day with love and gratitude for your amazing beautiful body.
Need immediate support? Reverse PCOS + Clear Acne with the Acne Reset.
Big love,
Caralyn