Among the various symptoms of PCOS, acne and oily skin can present a real problem. PCOS is a condition that causes abnormal growths in the ovaries in the forms of cysts, thereby disrupting a woman’s menstrual cycle.
PCOS is also a common cause of infertility in women, presenting a real problem when trying to conceive. When it comes to acne, this is a common symptom among affected women, and it is important to learn the relationship between the two.
What is Acne?
Acne is a trapped skin pore due to excessive oil, skin cells or bacteria. They usually occur in the face, even though any part of the human body can get full of acne. Acne often occurs in the neck, chest or on a human’s back.
Different types of acne can develop, such as:
• Blackheads – in dermatology are classified as comedones. Blackheads develop when oil and bacteria trapped within the pores rise to the top of them. The skin pores are only partially blocked. As these pores are open, the oil and bacteria are in contact with the air and skin melanin, from where they get their black color.
• Whiteheads – develop in the skin when the oil, sebum, bacteria or dead skin cells completely block the skin pores.
• Papules – are just the same as whiteheads, but only more painful due to the fact that they are inflamed. They often tend to be red, with a white or yellow head, small or medium in size.
• Pustules – are just the same as papules, only that due to the inflammation of the skin pore, pus is collected. They are usually larger in size and have a yellowish color due to the collection of pus.
• Nodules and cysts – are a severe form of acne. They are red, inflamed and large in size, lasting for weeks and sometimes even months. Nodules and cysts can cause severe and permanent damage to the skin including acne scars or skin discolorations if they are not treated on time.
The relationship between acne and PCOS
Women with PCOS will often have acne, particularly on the lower third of the face. This leads doctors to believe that the cause of the acne is due to a hormonal imbalance since the lower third of the face is more sensitive to hormones. For example, this is the area where beards grow in men, which is stimulated by hormones. The rest of the face is not as sensitive to hormones.
Although we don’t know exactly what causes PCOS, it is widely believed that the condition develops from an insulin resistance. Since insulin is responsible for triggering other hormones in the body, in this case, androgens, PCOS causes a hormonal imbalance. This imbalance is what causes acne to develop thereafter.
Differences in acne caused by PCOS
The first sign that acne may be a result of PCOS is the age of the woman. We all develop acne during adolescence, but if they continue to persist past the age of 25, then its possible PCOS may be involved. The acne will also flare up in the days leading up to the menstrual period more than the weeks before.
This symptom indicates a hormonal cause, and this also signals PCOS as the cause of the acne. Acne due to PCOS will also present differently, with more tender knots beneath the skin rather than the usual surface bumps. These knots may also cause skin lesions, which would set the symptoms apart from regular acne.
Women with PCOS will also often have diabetes since they are both conditions arising from insulin problems. To be clear, not all acne experienced by diabetic women means that it is caused by PCOS. It is worth checking out in case the woman had never been diagnosed with this condition in the past.
Management and treatment of acne caused by PCOS
For acne caused by PCOS, using regular face creams and gels will not be very effective as it would be treating the symptom. To treat the cause of the symptoms, you will need to address the hormonal imbalance, and this requires hormone therapy. The simplest and effective hormone replacement therapy can be done through the use of birth control pills.
These pills will have estrogen and progesterone hormones, which will help to substitute the decreased levels of these hormones in the body. For this therapy to work, it may take up to 3 months before the acne goes away, and even 6 months in some women. The alternative is spironolactone, which blocks the production of testosterone hormone thereby reducing the symptoms of PCOS including acne.
It is a much more effective treatment compared to birth control pills. It will often be recommended for women who may be at risk of undesirable side-effects from the birth control pills.