Polycystic ovary syndrome (PCOS) is a fairly common condition that affects a woman’s hormone levels and fertility. About 12 to 21% of Australian women of reproductive age have PCOS, but up to 70% of women with the condition remain undiagnosed. Many women who have PCOS may also experience hormonal acne. We dive into the connection between PCOS and acne and treatment options to help manage breakouts.
What is PCOS?
PCOS, or polycystic ovary syndrome, is a hormonal disorder in women of childbearing age (age 15 to 44). As its name suggests, it affects the ovaries. Ovaries are a woman’s reproductive organs that produce estrogen and progesterone, the female hormones that regulate the menstrual cycle. They also produce a small amount of male sex hormones called androgens.
In order to be diagnosed with PCOS, you must have at least two of these three symptoms:
- Irregular periods
- High levels of androgens on blood testing
- Cysts on the ovaries on ultrasound
What causes PCOS?
It’s unclear what actually causes PCOS, but it’s possible that genetics play a role. If there is a family history of PCOS, it could increase your chances of also having it. Other factors that may play a role in causing PCOS include excess insulin, high levels of androgens and low-grade inflammation.
Signs and Symptoms of PCOS
Signs and symptoms of PCOS often begin to appear around the time of the first menstrual period during puberty and adolescence. However, PCOS can also develop later in life. The features and signs will vary by person, but as mentioned above, you must have at least two of the three defined signs of PCOS:
- Irregular periods - whether it’s infrequent, irregular or prolonged cycles, any sort of irregularity with your monthly cycle is the most common sign of PCOS. This could be missing periods when not pregnant or having abnormally long or very short cycles.
- High levels of androgens - while all females naturally have some androgens, having high levels of these male hormones is a common symptom of PCOS. Having elevated levels of androgens can lead to physical signs, such as acne or excess facial and body hair.
- Polycystic ovaries - cysts are fluid-filled sacs or pockets in an ovary or on its surface. Most cysts are generally harmless and go away on their own; however, if you have many cysts on your ovaries or enlarged ovaries, they may not function regularly.
Talk to your doctor if you’re experiencing any of these symptoms.
What’s the connection between PCOS and acne?
Acne is caused by a variety of factors, including changes in androgen hormone levels that lead to an overproduction of sebum, an oily substance your body needs to keep skin and hair moist. Elevated levels of androgens and testosterone is a common cause for hormonal acne, and many women will experience this change during their menstrual cycles. However, women with PCOS commonly have higher levels of androgens in their bodies on a regular basis, which leads to acne.
Because androgens and testosterone are male sex hormones, women with PCOS who develop hormonal acne will most commonly get pimples on their face and jawline where a beard would grow. However, acne can also develop on your neck, chest and back.
Is there PCOS acne treatment?
There are both over-the-counter and prescription acne treatments available to help with acne. However, acne caused by PCOS is typically more severe than an occasional breakout that can be treated with OTC options. There are several prescription acne treatments that can help with PCOS-induced acne, including:
- Oral contraceptives (the birth control pill) - the birth control pill can sometimes be used to treat hormonal acne caused by PCOS. The combined pill contains a mix of estrogen and progestogen and will help stabilise your hormone levels throughout the entire menstrual cycle.
- Retinoids - retinoids promote skin cell turnover, which helps prevent pores from getting clogged and turning into pimples. Retinoids can be taken orally or applied as a topical cream or gel.
- Antibiotics - antibiotics work by killing the bacteria that causes mild acne to turn into red, inflamed and painful acne. Antibiotics are available both as an oral or topical treatment for acne.
- Anti-androgen drugs - if your PCOS acne is caused by high levels of androgens, you can take anti-androgen drugs that work by decreasing testosterone levels.
Talk to your doctor about any prescription acne treatments you’re interested in exploring.
PCOS is a common condition and one of the common symptoms is hormonal acne. If you’ve been diagnosed with PCOS and want to treat hormonal acne, you can sign up for Rosemary’s subscription acne plan and receive clinically proven, prescription acne treatments shipped straight to your door with free delivery.
- Australian Family Physician (October 2012) - Polycystic ovary syndrome: an update
- Australian Family Physician (May 2005) - Polycystic ovary syndrome: a management update
- Australian Family Physician (October 2017) - Oral hormonal contraception in special circumstances