PCOS Acne: Everything You Need to Know

Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age. In fact, PCOS affects up to 20 percent of women in this age group and is one of the main reasons for female infertility.

Sounds daunting, eh?

Honestly, it can be. On top of the struggle to get pregnant, PCOS symptoms include ovarian cysts, heavy periods, no ovulation, irregular or absent periods, pelvic pain, obesity, rogue hairs in undesirable places and patches of dark, thick and velvety skin.

Symptoms tend to vary though –– some find it difficult to lose weight while others are lean. But a symptom I see in all women with PCOS in my program, The Clear Skin Solution, is PCOS acne. The statistics show it too because one in three women with PCOS have acne.

Most doctors give women with PCOS acne antibiotics, Accutane, the birth control pill or spironolactone. However, those medications have a boatload of side effects and don’t address the root causes of PCOS acne.

What Contributes to PCOS Acne?

In order to get rid of the acne and other symptoms associated with PCOS, you need to understand how this hormone condition can arise. The exact cause of PCOS is unclear. But there are three main factors that play a major role in its development.

1. High Androgens

Fifty to 82 percent of women with PCOS have high androgens (male hormones that are usually found in small amounts in women). Excess androgen hormones such as testosterone, DHEA and DHT can stimulate the sebaceous glands to overproduce sebum (oil). This results in clogged pores because the oil is stuck inside of them. Then, bacteria grows in these pores. This sparks an immune response because the bacteria are viewed as foreign invaders. Ultimately, this leads to swelling, redness and inflammatory acne.

2. Insulin Resistance

Similarly to women with PCOS having high androgens, 50 to 80 percent also have insulin resistance. Simply put, insulin resistance occurs when the insulin receptors on cell walls prevent insulin from effectively carrying glucose into the cells to be converted to energy. If glucose is not brought into the cells and converted to energy, it stays in the bloodstream creating high blood glucose levels. As a result, the pancreas has to produce higher amounts of insulin. This leads to both high blood insulin and glucose levels. Over time, insulin resistance can result in pre-diabetes and type 2 diabetes.

High insulin levels trigger the ovaries to overproduce testosterone. As I mentioned before, excess androgen hormones promote more sebum (oil), which results in clogged pores and then inflammatory acne.

3. Poor Gut Health and Inflammation

Research also suggests that women with PCOS have chronic low-grade inflammation, which is commonly a result of poor gut health. The gut becomes damaged from things like pro-inflammatory food, chemicals in water, medications (like antibiotics and the pill), pesticides and stress. 

When those irritants enter the gut, they can cause the tight junctions between the cells lining your digestive system to pull apart. This allows tiny undigested food particles and toxins to get into your bloodstream and lymphatic system. These food particles aren’t supposed to be in the bloodstream so your body’s immune system mounts an attack leading to body-wide inflammation. This is called intestinal permeability — more commonly known as leaky gut.

If you’ve been following me for a while, you probably know that inflammation is at the core of acne. Chronic inflammation can also contribute to insulin resistance because it makes your cells rigid. This makes it more difficult for insulin to bring glucose into the cells leading to more insulin production, higher blood insulin and glucose levels and then insulin resistance. Once again, elevated insulin levels stimulate excess androgens resulting in more oil, clogged pores and inflammatory acne.

How to Clear PCOS Acne and Other Symptoms

I want to make it clear that it is possible to get rid of PCOS acne and the other symptoms of this hormone disorder. When I’m working with women who struggle with PCOS acne in my program, The Clear Skin Solution, I follow these four pillars:

• Balance hormones (especially androgens and cortisol)
• Address insulin resistance
• Repair the gut
• Reduce inflammation

Here are some simple practices that can help you achieve these four steps:

1. Eat Low-Glycemic Index Foods

The glycemic index is a measurement of how quickly foods raise your blood glucose after eating them. High glycemic index foods like refined white bread, muffins and pastries tend to spike your blood sugar levels quickly. As I mentioned early, chronically elevated blood glucose levels can worsen PCOS acne. Low glycemic index foods, on the other hand, promote stable blood sugar levels, reduce the risk of developing insulin resistance and decrease androgen hormones by up to 20 percent. Try to focus on low GI foods such as leafy greens, non-starchy vegetables and some fruits.

2. Consume Lots of Fibre

Including low-glycemic and high-fibre foods in the diet is vital for women with PCOS acne. Fibre promotes healthy daily bowel movements and increases the excretion of androgens in the stool. If you don’t eat enough fibre, androgens will be reabsorbed in the gut. This can result in hormonal imbalances and PCOS acne. I encourage my clients in The Clear Skin Solution to aim for 45 grams of fibre per day. Remember that fibre comes from more than just whole grains. It comes from fresh fruits and vegetables too, including avocados, berries and broccoli.

3. Up Your Protein Intake

Consuming meals with good-quality protein (along with healthy fats and fibre) is crucial for lowering androgens and stabilizing blood sugar levels. I recommend eating at least 100 grams of protein per day (or more) depending on your activity levels, body weight and health goals. Remember to choose the best quality of protein if you can, such as organic pasture-raised chicken, grass-fed beef and low-mercury fish.

4. Follow an Anti-Inflammatory Diet

While there is no one “ideal diet” for everyone, an anti-inflammatory diet is the most effective for repairing the gut, reducing inflammation and clearing PCOS acne. This includes whole foods like beets, cacao, pineapple and wild salmon, among others.

5. Avoid Dairy and Sugar

I recommend eliminating dairy and refined sugar from your diet because they increase inflammation, damage the gut and promote insulin resistance. Both dairy and refined sugar raise your amount of insulin-growth factor (IGF-1), which spikes insulin levels. Chronically high insulin levels can lead to insulin resistance, which elevates androgens, increases oil production and then PCOS acne pops up.

6. Work With a Professional

In order to identify deeper underlying factors (like gut dysbiosis, impaired detoxification pathways and further hormonal imbalances), it’s best to work with an experienced practitioner. Consider joining us in The Clear Skin Solution. You’ll have access to myself and my team of acne experts who can create a tailored approach with specific supplements for your issue.