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PCOS/PMOS and Acne - A Hormonal Connection

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PCOS/PMOS is a hormonal disorder in women characterized by irregular periods, acne, infertility, and excess hair growth.

Written byDr. Shanthwani Francis

Medically reviewed byDr. Khushbu Chaudhari

Published At March 16, 2023
Reviewed AtJune 1, 2026

Introduction

Acne is a skin condition in which the pores of the skin get clogged. Pore blockages can cause whiteheads, blackheads, and other forms of pimples. However, getting acne long after the teenage years may indicate something beyond facial blemishes, as it can be the symptom of an underlying hormonal disorder. Polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome (PCOS/PMOS) is one of the most common hormonal disorders in women of reproductive age. Apart from affecting a woman’s fertility, polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome (PCOS/PMOS) can give rise to various hormone-related side effects, including acne.

What Is Polycystic Ovary Syndrome/Polyendocrine Metabolic Ovarian Syndrome (PCOS/PMOS)?

Polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome (PCOS/PMOS) is a health problem seen in women due to the imbalance of reproductive hormones. The hormonal imbalance causes problems in the ovaries, leading to abnormal production of male sex hormones called androgens, which are usually present in small amounts in women. These androgens are responsible for problems like hair loss, skin darkening, hirsutism (a condition in women characterized by excessive growth of coarse hair in the face, back, and chest in a male pattern), and acne. The ovaries normally produce eggs that are released every month during the menstrual cycle. However, with PCOS/PMOS, the eggs are either not developed or released during ovulation as they should be.

How Does Polycystic Ovary Syndrome/Polyendocrine Metabolic Ovarian Syndrome Cause Acne?

Acne is formed when dead skin cells and an oily substance called sebum build up inside the hair follicles, causing bacteria to get trapped beneath the skin. This gives rise to inflammation, leading to the formation of pimples. One of the significant features of PCOS/PMOS is the excess production of male hormones called androgens, which are known as hyperandrogenism. These androgens play an important role in the formation of acne. They make the glands in the skin produce excessive amounts of sebum.

Generally, the body produces the right amounts of progesterone, estrogen, and testosterone, depending on the signals received from the pituitary gland. These signals are disturbed in women with polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome, leading to an increase in the levels of testosterone and a decrease in the levels of estrogen and progesterone. This can lead to anovulation and result in:

  • Irregular periods.

  • Hair growth on the face

  • Acne formation.

Women with PCOS/PMOS can develop acne in the following areas of the body:

  • Face.

  • Neck.

  • Upper back.

  • Chest.

  • Acne is commonly seen in both males and females during their teenage years. But acne seen persistently in women above the age of 25 years can be PCOS/PMOS-related acne.

  • PCOS/PMOS-related acne has usually been noted to flare up in areas considered to be “hormonally sensitive, " mainly the lower third of the face. These areas include

    1. Cheeks.

    2. Chin.

    3. Jawline.

    4. Upper neck.

  • PCOS/PMOS acne is characterized by more tender knots under the skin, unlike the surface bumps seen in regular acne.

  • PCOS/PMOS acne tends to flare up before menstrual periods and takes longer than normal to resolve than normal acne.

  • Acne in the hormone-sensitive regions of the face, accompanied by consistently irregular periods, can be a sign of PCOS/PMOS-related acne.

Polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome-related acne flare-ups are affected by factors like:

  • Diet.

  • Lifestyle.

  • Skin care products.

  • Stress.

  • Certain medications can cause acne to flare up.

However, in people with acne related to hormonal causes like PCOS/PMOS, flare-ups are seen during the premenstrual part of the menstrual cycle. Some studies suggest that products like face serums and certain makeup products can also cause flare-ups. However, these are very rare and less consistent.

Even though dietary factors can affect acne, some research suggests that junk foods cannot lead to acne on their own. Certain foods can cause inflammation in the body, which, when combined with risk factors like PCOS/PMOS, can lead to acne. Red meat, white bread, sugary desserts, and white potatoes are a few examples of foods that cause inflammation.

What Are the Long-Term Health Risks of PCOS/PMOS?

  • Infertility.

  • Diabetes.

  • Cardiovascular risks.

  • Obstructive sleep apnea.

  • Endometrial cancer.

  • Metabolic syndrome.

  • Nonalcoholic fatty liver disease.

  • Mood disorders like depression or anxiety.

How to Diagnose PCOS/PMOS?

The tests to diagnose polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome are as follows:

  • Pelvic Examination: Reproductive organs are checked for any growths, masses, or other changes.

  • Ultrasound: Helps in detecting the enlargement of the ovaries and the presence of cysts (partly developed eggs) in the ovaries. It is also useful in assessing the thickness of the uterine lining. Both transvaginal and abdominal ultrasounds may be performed.

  • Blood Tests: Blood tests are done to measure the levels of hormones. Blood tests for free androgen index (FAI) and testosterone are useful in diagnosing hyperandrogenism (high androgen levels). Levels of other reproductive hormones like estrogen, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) are also assessed.

The criteria for diagnosing PCOS/PMOS is that at least two of the following conditions should be met:

  • Increased levels of androgen in the blood.

  • Irregular or no periods.

  • Polycystic ovaries (ovary enlargement or presence of follicles on the ovaries).

How to Treat Acne Caused by PCOS/PMOS?

The measures to treat PCOS/PMOS-related acne are as follows:

  • Over-The-Counter (OTC) Acne Medications: OTC acne medications like salicylic acid, sulfur, and benzoyl peroxide help in treating acne. However, these medications can only reduce mild breakouts and do not show many results in hormonal acne.

  • Oral Contraceptives: Certain oral contraceptive pills can treat acne caused by PCOS/PMOS. The combination of progesterone and estrogen in these pills help in reducing testosterone levels which in turn limits the formation of acne. Combination pills that contain Cyproterone acetate and Drospirenone are very effective in blocking the effects of androgen.

  • Anti-androgen Drugs: Spironolactone and Flutamide have shown good results in treating hormonal acne caused due to high levels of androgen.

  • Retinoids: OTC retinoids are not of much use in PCOS/PMOS-related acne. Prescription-strength options under the guidance of a dermatologist that can be either consumed or applied as a cream help with PCOS/PMOS-related acne. Accutane is one of the commonly used options.

Conclusion

Often people experience low self-esteem or feel embarrassed due to PCOS/PMOS symptoms like acne, hair loss, and excess facial hair. Apart from the symptoms which affect the external appearance, PCOS/PMOS can lead to a lot of serious health issues. Hence, consulting a doctor and determining the cause of acne at the earliest is important to diagnose PCOS/PMOS and provide effective treatment.

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Frequently Asked Questions

High concentration of androgens can be the most significant symptom of PCOS/PMOS. This increased androgen level can significantly cause PCOS/PMOS-related acne formation. There exists a common belief that acne associated with hormonal conditions such as PCOS/PMOS seems to be more severe than the acne that occurred due to non-hormonal conditions. PCOS/PMOS acne can be cystic and more typical in appearance. It presents as red, large, and deep breakouts.

The following natural ways can help cure acne due to PCOS/PMOS.


- Have an anti-inflammatory diet consisting more of healthy omega-3 fatty acids like mackerel, walnuts, flax seeds, olive oil, and salmon.


- Limit the carbohydrate intake while increasing the quantity of protein consumption.


- Spearmint tea can be a good remedy.


- Regular exercises.

Certain foods can typically trigger acne breakouts in the case of PCOS/PMOS. The food items include:


- Refined carbohydrates like white bread and mass-made pastries.


- Fried foods.


- Solid fats.


- Processed meats like sausages, hot dogs, and luncheon meats.


- Sugary drinks and beverages such as energy drinks and sodas.

Acne formation is familiar with PCOS/PMOS due to increased levels of androgens in the body. The acne can be cystic and typical in appearance. Moreover, acne associated with PCOS/PMOS tends to flare in certain areas that are typically regarded as hormonal ku-sensitive areas, particularly the lower third of the face. So, acne breakouts are more likely to occur in the cheeks, chin, jawline, and upper neck in the case of PCOS/PMOS.

The cystic (puss-filled) acne is typical with PCOS/PMOS. The acne can be presented as red, large, and deep breakouts. Moreover, PCOS/PMOS-associated acne commonly flares on certain hormone-sensitive areas, particularly the lower part of the face, including the cheeks, chin, jawline, and upper region of the neck. These areas are regarded as hormonal patterns for acne.

PCOS/PMOS is a hormonal disorder characterized by enlarged ovaries with small cysts. The common and predominant symptoms of PCOS/PMOS include the following.


- Irregular periods or absence of periods.


- Difficulty getting pregnant due to irregular ovulation.


- Weight gain.


- Excessive harm or growth, particularly on the face, neck, chest, buttocks, and back.


- Thinning of hair or hair loss from the head.


- Oily skin and acne formations.

A high concentration of androgens can be the most typical sign of PCOS/PMOS. PCOS/PMOS can cause cystic acne breakouts because of the overproduction of androgen hormones in the ovaries. The high androgen levels stimulate or precipitate oil production in the skin. Therefore, individuals with (PCOS/PMOS) might have acne, particularly on the hormone-sensitive areas such as the chin, cheeks, neck, back, and chest.

PCOS/PMOS, is a hormonal condition in which the hormones called androgen levels are typically high. This increases the sebum production of the skin, resulting in the worsening of acne breakouts. High levels of androgens can also cause increased facial hair growth. Acne is a common clinical manifestation among females who suffer from PCOS/PMOS. It can cause severe acne at times. So, one should consider professional treatment and medications before it turns into a severe condition.

The doctors prescribe the appropriate medication and treatment options for women suffering from hormonal acne with PCOS/PMOS. The treatment options include the following.


- Acne medications and skin care products contain Sulfur, Benzoyl peroxide, and Salicylic acid.


- Oral contraceptive pills such as Spironolactone and Flutamide could help.


- Hormone therapies that lower androgen levels in the body.


- Lifestyle changes.


- Skincare routine.

Women with PCOS/PMOS are more likely to get acne involving more tender knots underneath the skin than fine surface-related bumps. People with PCOS/PMOS, at times, report that the acne lesions in the hormone-sensitive areas tend to flare before their menstrual cycle. Moreover, the acne lesions take time to get away. PCOS/PMOS causes acne due to the overproduction of androgen hormones in the ovary.

Unfortunately, there is no effective cure for PCOS/PMOS; therefore, there is no complete cure for PCOS/PMOS acne as well. When women with PCOS have harder and more severe acne breakouts, the acne will take about one to two years for complete clearance. But, the acne also leaves acne scars and blemishes in the concerned areas. Treating the underlying significant condition of hormonal imbalance is the only approach to clear PCOS/PMOS-associated acne.

The period or hormonal acne results just before the beginning of the period, when the estrogen and progesterone levels fall. This can significantly trigger the sebaceous glands in the skin to secrete more sebum or oil. Sebum or oil, is a natural substance that helps lubricate the skin. Too much production of oil can cause clogged pores and acne breakouts. The hormones can also induce skin inflammation and acne-causing bacteria production.

PCOS/PMOS can affect menstruation, ovulation, and fertility, causing a raised risk of certain complications and health issues during pregnancy. Unfortunately, PCOS/PMOS acne formation is not entirely cured during pregnancy or at any time until the underlying hormonal problem is treated. The dermatologists recommended certain skin care products and medications for acne treatment.

The common adverse effects of (PCOS/PMOS) include the following.


- Missed (absence) or irregular menstrual periods.


- Excessive facial hair growth.


- Acne breakouts.


- Infertility.


- Weight gain.


Moreover, females with this condition might be at greater risk of certain conditions.


- Type 2 diabetes.


- High blood pressure.


- Heart problems.


- Endometrial cancer.

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Dr. Khushbu Chaudhari from iCliniq
Dr. Khushbu Chaudhari

Obstetrics and Gynecology

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