Introduction
This one condition can explain between 19-37% of female acne cases. Albeit not many women even know they have it!
What Is It?
So, what is PCOS? PCOS is abbreviated from Polycystic Ovary Syndrome. It is characterized by:
- Ovaries that have a high number of cysts, the key being a high abnormal number as healthy ovaries will sometimes have cysts
- Irregular ovulation, if your menstrual cycle is on quite an irregular schedule
- High levels of male androgens which would appear as several symptoms
Symptoms
How do these symptoms present themselves, let’s go through the list:
- Acne
- Excessive hair growth which is in a male-like pattern, like on the chest and face
- Irregular periods
- Obesity is also common, but in particular abdominal obesity which is more of a male-type fat distribution pattern
- Insulin resistance, which in short means your body doesn’t respond to insulin in the normal way which can cause issues for your blood sugar levels
How Is It Caused?
In terms of the hormone fluctuations, we are essentially talking about several hormonal factors here:
- The body produces too much luteinizing hormone which causes the ovaries to produce too many androgens or male hormones
- Too little follicle stimulating hormone produced causes the ovulation cycle to be irregular and dysfunctional
- Too much insulin from insulin resistance will lead to an excessive quantity of androgens as well
How Do You Know You Have It?
So, how do we diagnose PCOS? Generally speaking, this condition will first start presenting itself during puberty or adolescence but it isn’t often diagnosed until later as an adult, because some of the symptoms are symptoms which are simply quite common during puberty anyway with fluctuating hormones such as acne and irregular menstrual cycles.
These are better signs of PCOS in adulthood but if you’re a teenager better signs to look out for would be high levels of male hormones, ovaries that have at least 25 cysts (which you would need to get a scan for) and persistent irregular periods that last for at least 2 years after you started your first menstruation.
It's Link to Acne
Let’s talk about how this condition links to its high correlation with acne. As you probably guessed a symptom of this condition which is higher male androgens/hormones often leads to a higher production of skin sebum/oil and that often means more acne.
Studies have shown that PCOS acne tends to appear more in different areas, so pubertal acne tends to appear more often on the face whereas PCOS-related acne is more on the lower face, neck, chest and upper back.
Treatment
So how do we treat PCOS and how do we treat PCOS-related acne? Well for acne as you may know I would recommend running a good quality skincare routine using high-quality non-irritating and non-comedogenic or “non-pore-clogging ingredients”, and Aqneeq’s products are an example of that.
However, PCOS is part of a bigger issue, and you probably would like to treat the other symptoms of that as well but for the purpose of this article, I will stick to treating acne as a symptom of this condition. I would suggest seeing a doctor about this condition to get it treated.
In terms of the medications that are often prescribed for PCOS-related acne are:
- Birth control pill
- Cyproterone acetate
- Spironolactone
- Flutamide
- Finasteride
- Birth Control Pill
Let’s talk about each. Firstly, the birth control pill or combined oral contraceptive is often prescribed. These contain a combination of oestrogen and also progesterone as well. These have been shown in various studies to be quite effective for female acne somewhere between a 50%-87% clearance of acne so they will often need to be combined with effective skincare products for full clearance of acne.
As with any medication, these come with some mild side effects as well, which may be nausea, headaches, breast pain, or more severe ones like heart disease or blood clots.
- Cyproterone Acetate
The second treatment is Cyproterone Acetate which is often prescribed with a combined oral contraceptive. This is an anti-androgen which reduces the levels of male hormones in the body. This again has been shown to help clear acne but studies haven’t been as clear and this can cause a few issues in the female body such as loss of libido, weight gain, mood changes or even more irregular menstruation or no periods at all.
- Spironolactone
The third treatment is Spironolactone which is also an anti-androgen which again works by lowering male androgens/hormones. The side effects are similar to that of the previous anti-androgen such as headaches, irregular periods and breast tenderness. It has been shown in studies to be effective against excessive hair growth when used on its own but not so much for acne.
- Flutamide
The fourth treatment is flutamide, which is another anti-androgen. This is usually prescribed at a lower dose as higher doses can damage the liver. In terms of its effectiveness, there hasn’t been an abundance of studies, particularly being used on its own but has been studied being used with a combined oral contraceptive and this was very effective for clearing acne.
- Finasteride
Our last treatment is finasteride which is also sometimes prescribed for men with hair loss. This isn’t an anti-androgen as such but it does reduce the conversion of testosterone into a more potent form. This hasn’t been as well studied for its effectiveness for PCOS-related acne but it was effective in treating excessive hair growth in women. Its side effects include sweating and hot flushes.
- Others
Other alternative medications for PCOS acne that aren’t hormonal treatments are Metformin which lowers sugar levels in the blood and has been shown to be quite effective in PCOS-related acne and also isotretinoin which as we know is quite a nuclear treatment for acne and although it has been shown to be very effective for permanent clearing of acne it has a host of side effects that can be lifelong.
Conclusion
So overall if you’re a female I would suggest seeing a doctor or dermatologist about this condition for a diagnosis and to review your treatment options. If you also have a family member or partner with this condition it’s well worth doing your reading up also.