Does PCOS Cause Acne?
Acne can indeed be a sign of polycystic ovary syndrome (PCOS) but not everyone with PCOS will be suffering from acne. About 70% of the patients with PCOS will suffer from some form of acne. Acne seen in the context of PCOS can be more resistant to the conventional acne treatments, especially if there is evidence of an underlying hormonal imbalance. Classically testosterone is elevated (but can be normal in PCOS!) however other hormones such as LH, FSH, estrone and progesterone can also show abnormal values. The excess of male hormones, also known as hyperandrogenism, is what often drives the acne and hair problems in patients with PCOS.
What should someone do if they think this might be the case for them?
PCOS is a complex disease as the signs and symptoms can vary a lot from one person to another person and the management can require the input of more than one doctor (GP, gynaecologist, dermatologist). A diagnosis of PCOS is considered when you experience at least two of the following: 1) irregular periods, 2) polycystic ovaries seen on pelvic ultrasound and/or 3) symptoms of excess male hormones. If you are suffering from skin problems triggered by excess male hormones such as resistant acne, hair loss and/or excessive hair growth in unusual places (known as hirsutism), then a visit to a dermatologist can be useful. Your treating doctor might ask you to do a female hormone profile (usually blood test but sometimes a saliva test can be done too) as well as a pelvic ultrasound to help make the diagnosis. If PCOS is suspected or confirmed, additional investigations such as blood sugar levels, cholesterol and/or blood pressure might be required too.
What are the treatment options for acne related PCOS
Acne in women with underlying PCOS can be more resistant to the conventional treatments used for acne (creams, antibiotics) and might require hormonal treatment options (eg the pill, spironolactone) or treatment with a drug called Isotretinoin (Roaccutane) which requires regular monitoring. The doctor will tailor your treatment depending on your symptoms and investigations.
Lifestyle measures do play an important role in all patients with PCOS and should include regular (cardio-vascular) exercise and nutritional intervention (low glycemic index diet and reduced sugar). It is vital to balance blood sugar levels and sometimes the drug metformin will be considered to help regulate the sugar uptake.