Hormones can play a significant role in the development of acne. PCOS or polycystic ovarian syndrome is the most common cause of hormonal acne. It affects one in fifteen Australian women. This form of acne usually requires specialist intervention.
- PCOS can lead to acne, most commonly on the jawline & neck
- This form of acne frequently leads to scarring as cysts are deep
- Topicals creams are rarely effective
- Effective treatments are possible
- Dermatologists employ peels, lasers, & hormonal control to treat PCOS associated acne
PCOS & Acne at a glance
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PCOS or polycystic ovarian syndrome is a common cause of hormonal acne. Skin changes of PCOS include acne, excessive hair growth, hair loss, oily skin, tags, & pigmentation.
PCOS can also lead to weight gain, infertility, period changes, as well as metabolic abnormalities such as glucose intolerance.
PCOS acne falls under the blanket term of ‘hormonal acne’. This type of acne presents differently in comparison to teenage or T zone acne. PCOS acne can affect the jawline and neck area. In many cases it can extend to the trunk. Deep cysts are frequently seen in hormonal acne.
As this type of acne is deep, it often requires specialist treatment to shift. Unlike normal acne, PCOS acne frequently scars– hence the importance of early management.
Try this, it can be helpful in some cases of PCOS acne.
AM: Salicylic acid washes, followed by topical vitamin B
PM: As above with washes, add high strength retinol
Lifestyle choices are super important, including an anti-acne diet, exercise, weight management & good makeup practices. It takes 8 to 12 weeks for DIY skin care to work, so be patient.
Acne in PCOS can be resistant & persistent to normal therapy, including topical skin care. Our dermatologists can prescribe:
- Antihormonal tablets
- Topical retinoids
- Oral retinoids
- Chemical peels including retinoic acid or salicylic acid
- Laser light treatments such as Kleresca, LEDs, & blue light BBL
Perform extractions for deep cysts, most frequently around the jawline area
Mitigation is the key. Treat acne early & effectively. Don’t pick. Use acne patches (see the section on skin care for acne).
Our team employs pico lasers, Tixel resurfacing as well as vascular & fractional lasers to effectively treat scars. Book a FREE consultation with your nurses.
Excess hair is frequently seen in PCOS patients and is due to excess androgens or male hormones. Effective treatments that we employ include laser hair removal using the 1064 hair removal laser by Lumenis.
Antiandrogens can also reduce unwanted hair.
PCOS is a common cause of chronic adult female acne. It is often associated with acne scarring. Our dermatologists can implement a safe & effective treatment regime to reduce outbreaks & promptly repair acne scars.
Hair loss can occur in PCOS. This can be treated with antiandrogens as well as minoxidil topically or systemically. Growth factor injections and light therapy can be useful.
Book an appointment with our dermatologist for effective solutions
Dark patches are frequently seen in PCOS patients and can be located on the neck, underarms, groin and occasional on the face. This condition is termed acanthosis nigricans.
Treatment options include-
- Topical retinoids such as tretinoin (retinol is too weak)
- Lasers such as pico
- Hormonal control
- Exfoliants such as glycolic, salicylic and lactic acids
Metformin is a drug used to modulate IGF or insulin levels. This tablet can treat skin associated with PCOS, in addition to reducing visceral and body fat. It can be prescribed by endocrinologists, GPs & dermatologists.
Though controversial, metformin is also prescribed for longevity and anti-aging, in conjunction with resveratrol & other antioxidants. There is some evidence that it can reduce acne, however it is best used as part of a treatment plan, and not monotherapy.
The biggest gains from DIY treatments include-
- Diet. This improves blood sugar levels and can also significantly improve acne. Consume organic foods, low in sugar, high in complex carbohydrates and protein. Omit all dairy products including milk, yogurt and cheese.
- Skin care includes high strength retinol and azelaic acid. The latter can also improve post-inflammatory hyperpigmentation seen after active acne.
- Makeup choices and best practices. Mineral over oil-based foundations. Remember to have at least two make-up free days to let your skin breathe.
- Supplements include zinc sulphate. This can help reduce acne & inflammation.
Exercise & weight management will improve your skin.
There are strict diagnostic criteria for PCOS. Be guided by your healthcare provider.
PCOS can be labelled if there are two out of three of the following-
- Physical or biochemical signs of androgen excess, namely acne, hair loss, hirsutism.
- Ovulatory problems, such as heavy bleeding or irregular bleeding.
- Polycystic ovaries on ultrasound with cysts less than 9mm but more than 2 mm or total ovarian volume of 10ml or more.
Yes. Remember that blood tests only form one out of the three criteria for PCOS. You may have normal levels of androgens in the blood, however an abnormally high concentration in the skin.
Alternatively, your oil gland & hair follicle may be more sensitive to normal hormones. This is referred to as an intracrine dysfunction.
PCOS is an endocrine & metabolic disorder. You should ideally be under a team of healthcare providers. A PCOS team consists of –
- Dermatologists: manage skin signs of PCOS including acne, hair, oily skin, skin tags and dark patches.
- Endocrinologist: to monitor blood sugar levels & insulin resistance.
- Gynaecologist is useful if you are planning to fall pregnant.
- Dieticians: can guide you with foods for acne management and weight loss.
Exercise physiologists: can help you lose weight & manage your BMI. Do not underestimate the value of exercise as this has a flow on effect on skin health.