Sep 23, 2022 · 10 min read
If you’ve been diagnosed with polycystic ovary syndrome—aka PCOS—you know just how frustrating this chronic condition can be. And you’re not alone: PCOS affects 6% to 12% of reproductive-age women in the United States alone; that’s as many as 5 million people who are familiar with the issues you may be facing.¹ Among other symptoms, like irregular menstrual periods, excess hair growth on the face, chest, abdomen or upper thighs (called hirsutism), obesity, and patches of darker, velvety skin (called acanthosis nigricans), polycystic ovary syndrome can also cause an increase in acne, which can be severe and persistent.²
Here at Curology, we don’t treat or diagnose PCOS—you’ll have to turn to your in-person medical provider for that. But if you are experiencing acne as a side effect of polycystic ovary syndrome, our team of licensed dermatology professionals is here to help! Below, we’ll explore how PCOS can impact your skin, and what you can do to address this frustrating symptom. When it comes to your health (which includes your skin health!), we believe that information is power. So read on to learn more about the relationship between PCOS and acne. If you have any other questions, be sure to turn to your trusted medical provider.
Many women who have PCOS will also deal with facial acne lesions, and up to half of them experience acne on their neck, chest, and upper back, too.³ That’s due to imbalanced hormone levels. Elevated levels of androgens (reproductive hormones including testosterone) are a common feature of PCOS, and high levels of androgens can cause an increase in sebum production; that can lead to oily skin and acne.⁴
Persistent adult acne in women can be the result of hyperandrogenism caused by PCOS.⁵ That said, just because you’re experiencing acne as an adult doesn’t mean that you necessarily have PCOS. Remember, acne is just one of several symptoms of polycystic ovary syndrome, and you’ll need to speak with your healthcare provider to determine whether or not you have the condition. Either way, persistent acne as an adult is something worth speaking to a medical provider about.
Acne with PCOS can look like papules, pustules, nodules, and cysts. Whiteheads and blackheads can also be present. Basically, it looks like normal acne! As PCOS results in a hormonal imbalance, acne from PCOS may show up in a hormonal pattern. Hormonal acne typically appears on the lower face, including the jawline and chin.⁶ PCOS is just one potential cause of hormonal acne—so if you’re dealing with this kind of breakout, PCOS isn’t necessarily the culprit. It can also develop as a result of menstruation, hormone therapy treatments, and certain types of birth control. Even stress can contribute to hormonal acne!
If you want to better understand how hormones affect your skin, we got you! Learn pretty much everything you need to know about hormonal acne on our blog.
A solid skincare routine that’s designed to fight excess oiliness and acne can help to treat PCOS-related acne—but typically, people with PCOS benefit from additional treatment that addresses the underlying hormonal imbalance that causes their acne. For that reason, a doctor, dermatologist, or other skincare professional may recommend one of the following prescription treatments:
Oral contraceptives are a commonly prescribed treatment for the acne, menstrual irregularity, and hirsutism (excess hairiness) that people with PCOS may experience.⁷ They typically contain a combination of estrogen and progesterone, though some (known as the minipill) are progesterone-only.
Spironolactone is another prescription treatment option for people with acne related to PCOS. The medication (which is available at Curology—consult your dermatology provider!) is also used to treat high blood pressure and heart conditions, but it can help to treat hormonal acne and excess hair growth in people assigned female at birth. Doctors sometimes recommend combining spironolactone with oral contraceptive pills to increase effectiveness at fighting hormonal acne.⁸
Isotretinoin, an oral vitamin A derivative (or retinoid) can also treat hormonal acne in those with PCOS.⁹ It can fight persistent and treatment-resistant acne—which is why your doctor may recommend it if you’re facing PCOS-related acne that just won’t go away. It’s important to note that if you’re pregnant or trying to get pregnant, you should avoid isotretinoin, as it can lead to dangerous pregnancy complications. If your doctor prescribes isotrentinoin, they may require you to take an oral contraceptive or use another form or birth control for this reason.¹⁰
It’s important to speak to a doctor if you’re dealing with polycystic ovary syndrome so they can prescribe you the optimal course of treatment. While acne may be a visible side effect of the chronic condition, PCOS has an impact on your overall health, so it’s crucial to take it seriously.
Natural treatments for hormonal acne due to PCOS likely won’t make as much of a difference as an over-the-counter or prescription treatment, but they may be able to help balance your hormone levels and fight pimples. Just remember, there’s no substitute for a doctor’s recommendation.
Zinc has been shown to improve some symptoms of PCOS (although acne was not mentioned in the study).¹¹ It can be found in supplement form, but also in foods like legumes, shellfish, and red meat.
Green tea may help reduce testosterone levels in people with PCOS,¹² so it may help with PCOS-related acne.
Spearmint tea may also help reduce hirsutism and testosterone levels in people with PCOS.¹³
Over-the-counter treatments for acne related to PCOS can treat existing breakouts and help to prevent future breakouts from happening. Here’s what a basic acne-fighting skincare routine should look like.
In the morning:
Wash your face with a gentle cleanser. If your skin can tolerate it, you might try one that contains salicylic acid. This can be a great option for people with oily, acne-prone skin.
Moisturize your skin with a non-comedogenic moisturizer.
Apply SPF—broad spectrum sunscreen with at least SPF 30 is an everyday essential!
Wash your face with your favorite cleanser (and be sure to remove any makeup, too).
Treat your skin with an acne-fighting topical treatment (like Curology’s Custom Formula).
Moisturize to keep your skin hydrated.
Because PCOS is a chronic condition, that means it doesn’t (currently) have a cure; while that might be incredibly frustrating to hear, just know that there are treatments that can help to significantly reduce the symptoms of PCOS—even acne. It’s important to talk to your trusted medical professional about the symptoms you’re experiencing so you can get an accurate diagnosis and treatment plan. If your hormonal acne doesn’t respond to a treatment like birth control pills, for example, your doctor can prescribe a different course of treatment, like spironolactone.
If you have PCOS, it’s important to remember that you’re not alone. Dealing with any kind of chronic condition can be frustrating and isolating—but there are plenty of people out there who can and want to help. While your Curology dermatology provider can’t diagnose or treat PCOS, we’re here to answer and help with your skin concerns. But we also want to stress the importance of taking care of your overall mental health. If you need help right now, consider these resources—the majority of which are free:
National Suicide Prevention Lifeline (988): a 24/7 confidential hotline to support people in emotional distress.
SAMHSA (800-662-4357): a 24/7 confidential hotline to support people in substance abuse recovery.
Crisis Textline (741741): text a crisis counselor to get immediate help, even when you can’t make a call.
Psychology Today: Search online to find a therapist or psychiatrist licensed to practice in your state—many have sliding scales and offer telehealth visits!
Want to learn more about PCOS, or have any other questions? Here are a few FAQs that people want to know about polycystic ovary syndrome. If you think you may have PCOS, remember to talk to your medical provider—they’re the one who can give you a proper diagnosis and treatment plan! (And if you have any additional skin concerns, we’re here to help).
PCOS, or polycystic ovary syndrome, is a condition that is characterized by at least two of the following: irregular menstrual periods, hyperandrogenism, and polycystic ovaries. It can impact ovulation and fertility.
More research is needed to understand the cause of PCOS, but it may be genetic; it also has a correlation with insulin-resistance and obesity. People with PCOS are also at higher risk of developing type 2 diabetes compared to those without PCOS.¹⁴
If you or your medical provider suspect you may have PCOS, they can give you a diagnosis by inquiring about your medical history, conducting a physical, and doing a pelvic exam. They may also do an ultrasound, to look at your ovaries, and blood tests, to check androgen levels. PCOS is a diagnosis of exclusion, so conditions that mimic the symptoms of PCOS must be ruled out.
PCOS has many symptoms, and not everyone with PCOS will experience the same exact symptoms, or the same intensity of their symptoms. These can include:
Irregular menstrual cycle (missed or very light periods)
Excess body hair (aka hirsutism)
Acne and oily skin
Dark, velvety patches of skin called acanthosis nigricans, which may appear on the neck, under the breasts, or in the armpits
While acne may be more common in your teenage years, it can still pop up in adulthood for a number of different reasons—many of which aren’t related to PCOS. If you find yourself battling pimples past your teen years, these are a few other factors that may be to blame.¹⁵
Smoking doesn’t just have an overall negative impact on your health; it may also be a culprit of adult acne.¹⁶,¹⁷
Stress is a part of life that everyone has to deal with, but it can also correlate with acne severity.¹⁸ That’s why it’s important to find self-care tactics that help you to manage your stress levels, whether that means taking walks, meditating, or prioritizing rest.
Lack of sleep and poor quality of sleep may also contribute to acne in adults, in case you needed another reason to get to bed earlier.¹⁹
Diet can play a role in your skin’s health, too; diets rich in dairy and high glycemic foods are associated with acne in some people.²⁰ Remember, everything in moderation!
Comedogenic hair and makeup products, which contain ingredients that are likely to clog pores, can also contribute to the development of acne.
Many factors, including PCOS, can contribute to the development of acne—but preventative acne treatments, like those designed by Curology can help. After all, your personalized prescription formula is made for your unique skin concerns and goals: Once you take a short quiz and submit photos of your skin, you’ll be paired with a dedicated licensed dermatology provider who will help formulate your personalized prescription formula with three powerful active ingredients. Plus, they’ll be there to answer any skin questions you may have and cheer on your progress. And don’t be shy, let your Curology provider know if you think you’re experiencing hormonal acne or have been diagnosed with PCOS—this will help us with your treatment plan.
If you’re new to Curology, you can try it for free*—all you have to do is pay $4.95 for shipping and handling, and you’ll get an easy-to-follow, customized skin care routine delivered right to your door. Skincare is a journey—and it’s one we’re here to guide you through.
Centers for Disease Control and Prevention. PCOS (Polycystic Ovary Syndrome) and Diabetes. Centers for Disease Control and Prevention. (2020, March 24).
The American College of Obstetricians and Gynecologists. Polycystic Ovary Syndrome (PCOS).The American College of Obstetricians and Gynecologists. (January 2022).
Shalini Gainder and Bharti Sharma. Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian Dermatol Online J. (March 2019).
Elsaie M. L. Hormonal treatment of acne vulgaris: an update. Clinical, cosmetic and investigational dermatology. (2016).
Enrico Carmina, et al. Female Adult Acne and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee, Journal of the Endocrine Society. (March 2022).
Elsaie M. L. Hormonal treatment of acne vulgaris: an update. Clinical, cosmetic and investigational dermatology. (2016).
Duru Shah and Madhuri Patil. Consensus Statement on the Use of Oral Contraceptive Pills in Polycystic Ovarian Syndrome Women in India. J Hum Reprod Sci. (April 2018).
American Academy of Dermatology Association. Stubborn Acne? Hormonal Therapy May Help. American Academy of Dermatology Association. (n.d.).
G. Acmaz, et al. The Effects of Oral Isotretinoin in Women with Acne and Polycystic Ovary Syndrome. Biomed Res Int. (2019).
Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Ibid.
Marzenna Nasiadek, et al. The Role of Zinc in Selected Female Reproductive System Disorders. Nutrients. (August 2020).
Hatav Gasemi Tehrani, et al. Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: A clinical trial. J Educ Health Promot. (2017, May 5).
Anubha Khale. Natural Remedies for Polycystic Ovarian Syndrome (PCOS) : A Review. Int. J. Pharm. Phytopharmacol. Res. (2012).
Rasquin Leon, L. I., et al. Polycystic Ovarian Disease. In StatPearls. StatPearls Publishing. (2022)
American Academy of Dermatology Association. Acne: Who Gets and Causes. American Academy of Dermatology Association. (n.d.).
Jing-Zhan Zhang, et al. Association between acne and smoking: systematic review and meta-analysis of observational studies. Chin Med J (Engl). (2021, January 5).
Capitanio, B., et al. Acne and smoking. Dermato-endocrinology. (2009).
Shadi Zari and Dana Alrahmani The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clin Cosmet Investig Dermatol. (2017, December 5).
Kory P. Schrom, et al. Acne Severity and Sleep Quality in Adults.Clocks Sleep. (2019, December 6).
Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016).
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Nicole Hangsterfer, PA-C