Beauty 101

Skincare Treatments for PCOS-Related Acne

Dr.Ingky Dermatologist
Skincare Treatments for PCOS-Related Acne

 Should you be scared of PCOS?

What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels. Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes their body to skip menstrual periods and makes it harder for them to get pregnant.

PCOS also causes hair growth on the face and body, and baldness. And it can contribute to long-term health problems like diabetes and heart disease. Birth control pills and diabetes drugs (which combat insulin resistance, a PCOS symptom) can help fix the hormone imbalance and improve symptoms. 

Common Symptoms of hormone imbalance (PCOS)

 Women start seeing symptoms around the time of their first period. Others only discover they have PCOS after they’ve gained a lot of weight or they’ve had trouble getting pregnant. The most common PCOS symptoms are:

  • Irregular periods. A lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year or none at all.
  • Heavy bleeding. The uterine lining builds up for a longer period of time, so the periods you do get can be heavier than normal.
  • Hair growth. More than 70 percent of women with this condition grow hair on their face and body. This includes on their back, belly, and chest. Excess hair growth is called hirsutism.
  • Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
  • Weight gain. Up to 80 percent of women with PCOS are overweight or have obesity.
  • Male pattern baldness. Hair on the scalp gets thinner and may fall out.
  • Darkening of the skin. Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
  • Hormone changes can trigger headaches in some women.

Polycystic Ovary Syndrome (PCOS) and Acne (Connection and Treatment)

How does PCOS cause acne?

One of the key features of PCOS is high levels of hormones called androgens. Doctors call this hyperandrogenism. Androgens play an important role in the development of acne. They cause the glands in the skin to produce an excess of an oily substance called sebum.

Acne occurs when sebum and dead skin cells build up inside hair follicles, trapping bacteria beneath the skin. This leads to inflammation and the formation of acnes. Someone with PCOS may develop acne in various areas, including the: 

  • Face
  • Neck
  • Chest
  • upper back

What are the treatment options? 

Over-the-counter (OTC) acne medications typically rely on benzoyl peroxide, salicylic acid, and sulphur to help treat acne. Although these ingredients can help with mild breakouts, they usually aren’t enough to treat hormonal acne.

Treating the underlying hormonal imbalance is the only way to clear PCOS-related acne. If you think your acne is related to PCOS, you might want to refer to your dermatologist. They may prescribe one or more of the following medications.

Oral contraceptives

Oral contraceptives (birth control pills) are sometimes used to treat hormonal acne. However, not just any birth control pill will do. Combination pills are the only birth control pills that will help stabilize your hormone levels throughout your entire menstrual cycle. They usually contain a mix of ethinyl estradiol and one or more of the following:

  • progestin norgestimate
  • drospirenone
  • norethindrone acetate


OTC retinoids are traditionally used to fill in the appearance of wrinkles and help with uneven skin tone. Some formulas are also used for acne, but these are most often geared toward teens.

If you have PCOS-related acne, skip the OTC retinoids and see your dermatologist about prescription-strength options. They can be taken orally or applied as a topical cream or gel. The oral retinoid isotretinoin (Accutane) is the most popular option.

Retinoids make your skin extremely sensitive to the sun’s UV rays, so it’s important to apply sunscreen liberally throughout the day. If your skin is left unprotected, your risk for hyperpigmentation and even skin cancer will increase.

If you opt for topical retinoids, you should only apply them in the evening. Applying them during the day can increase your risk for sun-related side effects. Topical retinoids may also be drying at first. You might need to start by using the gel or cream every other day and gradually working your way up to the recommended dosage. 

Does metformin help to reduce PCOS acne?

Based on a study published by American Journal of Clinical Dermatology, metformin was associated with improvement in acne in patients with polycystic ovary syndrome (PCOS).

The analysis included 51 studies with a total of 2405 patients with PCOS. The researchers found that metformin as adjuvant therapy led to greater improvement of acne scores compared with the same therapy without metformin.

The studies varied regarding grading acne severity or assessing the presence of acne, metformin dosage, and treatment duration. However, researchers noted that further studies with standardized acne grading scales are needed to more precisely assess the effect of metformin on acne in women who have PCOS. As for now, metformin does reduce ovarian hyperandrogenism, leading to clinical improvement of acne in women with PCOS.

How can you prevent acne caused by PCOS?

It’s important to know that even the best PCOS acne treatment will do little without a good skin care routine. Make sure you:

  • Wash your face twice a day
  • Follow up each cleansing with an oil-free moisturizer suited for your skin type
  • Avoid picking and scratching blemishes
  • Use noncomedogenic makeup only

Remember that acne isn’t the only PCOS symptom you may deal with. Keep your doctor informed about any new or unusual symptoms. They may be able to modify your current treatment plan to better suit your needs. 

PCOS is becoming a more prevalent disorder among women of reproductive age with lifelong complications. One of the most challenging aspects of this syndrome is its ambiguous diagnostic criteria and vast complexity of characteristics. In the future, more research in the genetics and pathophysiology of PCOS is needed to determine preventative risk factors as well as successful treatment modalities for this syndrome.

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