PCOS and Acne

Polycystic Ovarian Syndrome (PCOS) affects approximately 5 million women in the US, and world-wide it is estimated that 1 in 15 women are affected. Some of the symptoms of PCOS are infrequent or cessation of menstrual cycles, increased facial or body hair growth, scalp hair loss/thinning, and unexplained weight gain or impaired weight loss. Hormonal acne is also often a symptom of PCOS but you do have choices you have to help you manage your complexion and get your confidence back.

Your HPAO-axis (Hypothalamus-Pituitary-Adrenal-Ovarian) is command central for hormone production, including estrogen, progesterone, and androgens (testosterone, 5-dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), and androstenedione (A4).

It is normal for women to produce some androgens, because you need them for mood, libido, and bone health. In fact, all your hormones work together like a finely tuned orchestra to produce harmony and health. But when your hormones, especially your insulin levels, are out of balance, one of the obvious and upsetting symptoms is acne.

Insulin resistance is one of the root physiological imbalances in most, if not all, PCOS. This is where your pancreas needs to pump out more and more insulin in response to high blood sugar levels. But, higher than normal levels of insulin and Insulin-like Growth Factor (IGF) increase your production of androgens while simultaneously inhibiting your liver’s ability to produce sex hormone-binding globulin (SHBG).

SHBG binds tightly to estrogen, dihydrotestosterone (DHT), and testosterone and carries these three hormones throughout your blood. The critical hormone in the trio is testosterone, and SHBG controls the amount of testosterone your body tissues can use. Low levels of SHBG allow too much testosterone to enter your cells.

The rise in testosterone/androgen levels triggers your body to makes excess sebum, an oil that stops your skin from drying out, and this clumps together with dead skin cells that clog up your pores. When a bacteria known as Propionibacterium acnes (P. acnes), becomes involved, it triggers an inflammatory response from your immune system. All of a sudden, you’ve got pimples that are red, swollen, and sensitive to the touch.

Over-the-counter treatments like benzoyl peroxide and salicylic acid do not address your hormone imbalance and will most likely not work for acne resulting from PCOS.

Doctors often prescribe the birth control pill as a way to provide some hormonal balance, but there are potential health issues associated with it that are a concern. And, only one pill is approved by the Food and Drug Administration for treating acne – Norgestimate/ethinyl estradiol (Ortho Tri-Cyclen). Ortho Tri-Cyclen uses a synthetic hormone called norgestimate that doesn’t encourage the release of acne-causing androgens.

Desogestrel/ethinyl estradiol (Ortho-Cept) is not approved for acne. This oral contraceptive contains a low-androgenic progestin, desogestrel, that may clear up breakouts.

Aldactone is an androgen-suppressing drug used as a prescription medication on its own, and a few birth control pills have a progestin that is a spironolactone type drug (Yasmin and Yaz).  It’s most commonly used to treat high blood pressure and heart failure, and is a diuretic. Aldactone does suppress the production of aldosterone (androgens), but potential side effects include drowsiness, dizziness, stomach upset, diarrhea, nausea, vomiting, and headache.

According to Tori Hudson, N.D., in the book, The Hormone Connection, a more holistic approach that includes natural remedies often works (but may take longer for results). Dr. Hudson recommends:

• Vitamin A (moderates skin cell turnover and production of sebum. Please work closely with your doctor or naturopathic physician)
• Zinc (30 to 45 milligrams daily, but check with your doctor before exceeding 30 milligrams)
• Vitamin E (400 IU)
• Selenium (up to 200 micrograms from diet and supplements combined)
• Vitamin B6 (100 milligrams daily)
• Saw palmetto (160 milligrams twice daily of standardized saw palmetto extract with 85 to 95% fatty acids. Recommended for prostate gland health, this herb checks your production of the enzyme that converts testosterone into sebum-stimulating DHT)
• Tea tree oil (a natural antiseptic)

Femmenessence’s unique mode of action through the HPAO axis does not introduce any hormones, rather it supports your body to produce its own hormones at a level appropriate for optimal wellbeing and for your particular stage of life. Femmenessence has a team of doctors and educators who are able to answer medical questions and, as important, talk to your practitioner in medical terms which they will respect and listen to. (At no charge to you). It’s important to remember that so many variables exist with PCOS that it may take some time to discover your best solution, but the Femmenessence team is known for never giving up! Their Medical Team has worked with thousands of women for positive results and very happy outcomes. Voted “Best Women’s Health Supplement” two years in a row by Delicious Living.

References:

1. Mehta-Ambalal S. Clinical, Biochemical, and Hormonal Associations in Female Patients with Acne: A Study and Literature Review. The Journal of Clinical and Aesthetic Dermatology. 2017;10(10):18-24.
2. Marshall JC, Dunaif A. All Women With PCOS Should Be Treated For Insulin Resistance. Fertility and Sterility. 2012;97(1):18-22. doi:10.1016/j.fertnstert.2011.11.036.
3. [Correlations between acne and polycystic ovary. A study of 60 cases].  Iurassich S, Trotta C, Palagiano A, Pace L. Minerva Ginecol. 2001 Apr;53(2):107-11. Italian.
4. Emiroğlu N, Cengiz FP, Kemeriz F. Insulin resistance in severe acne vulgaris. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2015;32(4):281-285. doi:10.5114/pdia.2015.53047.