Suffering from big, painful, red, irritated bumps along your chin, jawline, and on your cheeks? Your cystic acne might not only feel unsightly, but it could also point to an underlying medication condition—PCOS. PCOS stands for Polycystic Ovarian Syndrome, which is a hormonal condition that can affect more than just your ovaries and it could be the cause of your cystic acne. By treating your PCOS, you can start to alleviate the hormonal imbalances that are leading to your acne. Let’s dive into how it all works, and what your body could be trying to tell you.
What Is PCOS?
Polycystic Ovarian Syndrome can show up in a few ways:
- Infrequent periods (this usually shows up as not ovulating or sparing ovulating—meaning your cycle lengths get very inconsistent).
- High androgens, aka DHEA, testosterone, and dihydrotestosterone. These high androgens create coarse, dark hair growth typically on the upper lip, sideburns, chin and arms. These androgens will also cause deep, scarring, painful cystic acne on the face, shoulders, chest, and back.
- Polycystic ovaries which is when cysts start to form on your ovaries. The cysts are actually follicles (eggs) that attempted to ovulate, but were unable to. These cysts can be very painful for many women and typically, you’ll notice one-sided pain when one of these cysts is being created. To determine if you have multiple cysts, we’ll do an ultrasound of your pelvis and ovaries.
How We Diagnose PCOS
PCOS is a spectrum disorder. That means that not every woman with PCOS looks exactly the same. You only need two of the three criteria to meet a diagnosis of PCOS, but depending on multiple factors (diet, exercise frequency, birth control usage, and more), the severity of your symptoms may be different than another person with the same diagnosis.
Women with PCOS also often suffer from metabolic issues including insulin resistance, weight gain, and difficulty controlling blood sugars. When you couple hormonal issues with metabolic issues, PCOS can affect your future fertility, and is often diagnosed when you’re having difficulty with conceiving.
How PCOS Might Be Contributing to Your Acne
A huge complaint of many women who have PCOS is the painful, unsightly cystic acne. Usually brought on by high levels of androgens, and exacerbated by metabolic issues, these patients find little success with facials, over the counter cleansers, and even prescription topicals. A common remedy that women will be offered is hormonal birth control, which can help eliminate the acne while you’re on the pill.
The PCOS Acne Solution
We treat acne in PCOS patients a little differently. First, we run lab testing to determine which hormone in the androgen pathway is out of balance. Not all women with cystic acne have high testosterone, and often we see that testosterone is being over converted into its more potent counterpart dihydrotestosterone (DHT). The enzyme that pushes your testosterone into DHT is called 5-alpha reductase and we can figure out how active yours is through both blood and DUTCH testing! Herbs such as saw palmetto, Prunus africanum, and Camellia sinensis (green tea) are all great at stopping that conversion.
We also have to tackle the blood sugar issue by making sure that your food plan is promoting gentle rises and falls in your glucose. Generally speaking, an anti-inflammatory diet that is focused on vegetables, protein, and fat will do the trick—but that’s where working with your personal dietitian who can give you personalized recommendations comes in. Supplements that contain ingredients such as inositol, chromium, Gymnemma sylvestre, and zinc are going to be helpful in both stabilizing blood sugar and helping with any insulin resistance.
As with any medical condition, no two people are alike—and this holds especially true for women with PCOS. If you’re interested in getting a handle on your PCOS, give us a call for a complimentary 15-minute consultation where we can talk about what treatment options we can offer you so you can say goodbye to cystic acne!