What to Know About PCOS Acne

Polycystic ovary syndrome (PCOS) is a condition that affects about five million women in the US.

It comes with a long list of symptoms, but one of the most common is acne.

What’s more, PCOS acne can be easy to identify because it’s quite different from the classical skin conditions you might have experienced as a teenager.

So, what sparks the spots?

What’s the difference between PCOS acne and a regular pimple?

And what PCOS acne treatments can you try—with or without a prescription?

In this article: 📝

What is PCOS?

PCOS stands for polycystic ovary syndrome.

In short, it’s a chronic hormonal condition where the body produces too many androgen hormones (like testosterone).

This hormonal imbalance can lead to a long list of symptoms that appear on a spectrum – sometimes better, sometimes worse, sometimes flaring up, and sometimes almost disappearing.

As well as acne, you might notice these symptoms:

• Insulin resistance (which is a forerunner to type 2 diabetes)
• Weight gain
• Thinning hair on your head
• Excess hair growth on your body and face (hirsutism)
• Irregular ovulation or anovulation, which is where your ovaries don’t release an egg during a cycle
• Irregular periods, which might be longer or heavier when they do come

The name itself comes from the small cysts – fluid-filled sacs – which can develop in your ovaries if you have PCOS, but it is possible to be diagnosed with PCOS without having cysts.

You can read more about the condition here: PCOS 101: Symptoms, Causes, and Treatment

You can develop PCOS at any time in your reproductive life, but many women find out that they have the condition when they have trouble getting pregnant.

PCOS can be linked to infertility because if you aren’t ovulating regularly, it’s much more difficult to conceive.

Does PCOS cause acne?

Acne which continues (or starts) after the age of 25 is one of the most common symptoms of PCOS.

As many as one in three people with the condition will have it.

PCOS acne is hormone-related, but it’s different to the acne you might have had as a hormonal teenager because it’s specifically connected to the excess levels of androgens in your body.

Acne happens for a couple of reasons connected to PCOS:

• First, the excess testosterone in your body makes your skin more oily. This means it’s easier for your pores to become blocked and infected, which leads to acne.
• Second, PCOS can cause generalized inflammation in your body (especially in response to some foods – more on this later). This inflammation also makes spots more likely.

What does PCOS acne look like?

Unlike regular pimples, PCOS acne has a couple of key characteristics, and it often appears in a distinctive ‘PCOS acne pattern’:

• It tends to break out on the bottom third of your face, especially on your jawline, chin, and on your neck. Basically, it appears in the places where a man could grow a beard. Acne on your chest or upper back can also be connected to PCOS.
• The spots are often larger, deeper, or more painful than regular pimples.
• The spots take a long time to heal and disappear.
• Your skin often gets worse around the time you have your period.
• The acne appears for the first time or persists after the age of 25. But by the way, this doesn’t mean that you can’t be diagnosed with PCOS when you’re younger than 25.

Does PCOS acne ever go away?

Unfortunately, PCOS doesn’t have a cure, so PCOS acne also can’t be cured completely.

But the good news is that there are some really effective PCOS acne treatment options.

And, if you have any scarring from the acne, you can also ask a dermatologist about options for reducing their appearance.

The first thing that most doctors will suggest to treat PCOS acne is the contraceptive pill – though, obviously, this isn’t an option if you’re TTC.

The progesterone and estrogen in ‘combined’ birth control pills makes your body less receptive to the excess testosterone it’s producing.

It’s not an instant fix, but studies have shown that many women do notice that their hormonal acne is less painful and easier to manage on the pill.

There are also effective acne medications such as spironolactone and flutamide.

Again, these don’t work overnight, but they are very effective.

Just be aware that these treatments aren’t an option for women who are planning to get pregnant as they can cause birth differences for your baby.

If you’d rather not go down the medical route for controlling PCOS acne, there are some dermatologist-approved approaches you can try at home:

How to treat PCOS acne yourself

• Wash your face twice a day (and after exercise) with lukewarm water and a gentle cleanser.
• Avoid scrubs and exfoliating treatments. These actually remove the protective layer of your skin and encourage it to produce more oil.
• Try not to touch your face, and don’t be tempted to squeeze your spots.
• Protect your skin from the sun. If you find that sunscreen blocks your pores, stay out of the sun as much as you can and treat yourself to a cool new sunhat for the summer months.

There may also be some changes you can make to your diet…

What foods trigger PCOS acne?

PCOS food triggers are different for everyone, so it’s a good idea to keep a diary to figure out if any specific foods are making your PCOS acne worse.

But as a general rule, it can be helpful to avoid foods that cause inflammation in your body. The most common are:

• White carbohydrates (like white bread, pasta, and rice rather than wholemeal options)
• Refined sugars
• Trans fats and saturated fats
• Red meat and processed meats

If you can eat less of these foods, it should help to keep most of your PCOS symptoms under control, and you’ll be less likely to develop type 2 diabetes, which is a common complication of PCOS.

Foods that are more calming for your skin, and can reduce inflammation, include:

• Green leafy veggies
• Tomatoes
• Almonds and walnuts
• Oily fish like salmon
• Olive oil
• Fruits rich in antioxidants – like berries and cherries
• Turmeric
  And remember, whether you want to swap PCOS recipe ideas, share your experiences, or find other women TTC with PCOS, the Peanut Community is always here for you.