4 Step PCOS Acne Treatment Guide (Fix your Skin from the Inside & Out)

4 Step PCOS Acne Treatment Guide (Fix your Skin from the Inside & Out)

If you suffer from PCOS you are probably intimately familiar with acne.

But what causes acne in patients with PCOS?

The answer might surprise you because it's not one single thing.

Acne in PCOS is multi-factorial, meaning it is often caused by more than one problem.

This is important because it means in order to treat your acne you'll have to employ several different treatment strategies.

In this post we will discuss these acne treatment therapies in detail:


What causes Acne in PCOS?

The solution to acne often has to do with how you approach treatment.

The problem is that most people focus on the wrong treatment!

Acne is often evaluated as if it is a skin disease with little attention given to what is happening on the inside of your skin.

But, if you have PCOS, you've probably noticed a link between your hormones and the type and pattern of acne that you suffer from.

And this link shouldn't be ignored.

effect of hormones on the skin

By understanding your hormones you are already 5 steps ahead of the curve in understanding how to treat your acne.

Because the solution has to do with achieving hormone balance.

So why do patients with PCOS often suffer from acne?

Because of the following hormone imbalances:

These 4 factors create "the perfect acne storm" in women who suffer from PCOS

The good news is that targeting these imbalances is definitely possible and may lead to an improvement in your symptoms.

The bad news is that the generic acne treatments which include copious use of antibiotics and facial products are not likely to work.


Because if your acne is caused by hormone imbalances then the only way to treat the issue is by addressing the imbalances!

Hopefully, this makes sense...

Acne Distribution and Hormonal Patterns

Believe it or not you can learn a lot about acne just by paying attention to when it starts, the distribution of your face and other qualities of your pimples.

And understanding what is causing your acne is critical because it determines how you need to approach treatment.

This is one of the reasons that treating acne is so difficult and why so many people get it wrong.

The standard approach to acne treatment is to focus SOLELY on therapies that you place on the skin.

But you have to realize that many of the causes of acne are actually internal.

This means that no matter how many different creams, lotions or gels you put on your face, you won't be able to treat the problem if it's caused by something INSIDE your body.

The following guide below can help you determine what is causing your acne (but realize it should be accompanied by lab tests to confirm).

This will give you a helpful starting point when determining how to target your treatment. 

Common patterns and distribution of acne:

  • Testosterone-induced acne = Acne on the chin or around the mouth, often accompanied by hair growth on the face (hirsutism) and darkened skin on the back of the neck or on the underarms
  • Estrogen-induced acne = Acne that flares with your menstrual cycle or appears on a "timetable". Often accompanied by breast tenderness, abdominal cramping, and mood changes (depression/anxiety). Estrogen 
  • Thyroid induced acne = Cystic acne which is deep in the skin, often accompanied by other symptoms such as fatigue, weight gain, hair loss and so on. Patients with PCOS should be evaluated for the presence of thyroid antibodies such as TPOab and TGab
  • Other causes of acne = General distribution of acne with whiteheads, blackheads and so on. This type of acne does not seem to follow a pattern (not associated with your cycle or other hormones, comes and goes randomly, not associated with other symptoms, etc.). 

Treating Acne in PCOS without Birth Control

#1. Fixing Acne from the INSIDE (with supplements)

This is #1 for a reason.

Most people, by the time they will have read this information, will have already spent thousands of dollars and hundreds of hours obsessing over what to put ON their skin.

You need to shift gears and start focusing on what you put INSIDE your body.

What do I mean?

I'm talking specifically about the use of certain supplements, vitamins, and minerals to help treat hormonal and PCOS acne.

Believe it or not, these strategies are very effective and may help to kickstart the healing process.

But in order to be effective, they must be accompanied with other therapies (remember you want to "layer" therapies) such as changes to your diet, management of your stress and of course hormone balancing.

I've broken down some of the most common supplements used to treat acne based on the hormonal problem you are facing...

When taking supplements do your best to target your supplementation to the specific issues that you are dealing with.

Also, try to avoid taking more than 3-5 supplements at once as this might be counterproductive and lead to decreased absorption.

If you don't know where to start then you might find the best success taking the combination of Zinc, Indole-3-Carbinol, and Selenium.

This combination hits the major hormone imbalances common among women with PCOS.  

#2. Fixing acne from the OUTSIDE

While treating acne from the inside is important (and necessary), you don't want to neglect the value of using high-quality products directly on your skin.

Just make sure to use these therapies in combination with the supplements we discussed previously.

You don't need to go overboard with your skin care regimen, but you should make sure you hit the basics:

#3. Diet

Diet is another way that you can influence and treat acne.

Your diet, whether you realize it or not, has a powerful impact on your hormones and we already know the powerful impact that hormone balance has on your skin.

With this in mind, you can think about your diet as a tool you can use to alter hormone balance and therefore treat acne.

While there are many diets to choose from (and the one that fits your body will take some effort on your part to find) there are some general rules that you should be following when it comes to your diet:

  • ​Eat only organic foods- Eat plenty of fruits and vegetables (organic when possible)
  • Focus on the consumption of brassica vegetables which are naturally rich in indole-3-carbinol
  • Cut back or eliminate dairy products (milk, cheese, etc.)
  • Cut back or eliminate wheat, grains, and gluten
  • Eliminate sugar and excess refined carbohydratee
  • Eliminate the intake of inflammatory fats such as soybean oil, canola oil, corn oil and so on
  • Drink up to 1 gallon of water per day

As long as you stick to these guidelines it doesn't matter if you opt for a diet like Whole30 or the ketogenic diet, you should still be in a great spot.

#4. Medications

Can medications help treat acne if the other options don't work?

The answer is maybe.

Pharmaceutical medications may be helpful for managing acne but they often don't address the underlying cause.

This approach may be helpful in some situations, especially if you have failed less invasive therapies or if your acne is causing significant distress with your self-esteem.

If you opt to use medications just realize that they may not be a great long-term solution.

Medications that may be helpful:

Medications to avoid:

  • Birth control pills - Birth control medication may be helpful at reducing acne (but be careful because it can also make acne worse), but it often comes at the risk of shutting down normal hormone regulation in your body. It is often better to try and naturally balance your hormones before taking this option.
  • Oral antibiotics - Oral antibiotics may do more harm than good in the treatment of acne as they may lead to damage of your microbiome. Topical antibiotics may be preferred over oral antibiotics, but even then it's probably better to opt for the use of topical probiotics and oral probiotics.
  • Topical antibiotics - Acne, in PCOS, is generally not caused by bacterial overgrowth. Topical antibiotics tend to be effective in the treatment of acne vulgaris caused by the bacteria p. acnes.

Treating Existing Acne Scars from PCOS

What about treating existing acne scars?

Many of the therapies that we have touched on above address the root cause of acne and their purpose is to stop acne, but they don't necessarily target existing acne scars.

Treating acne scars is another topic, but we can briefly go over some of the best therapies available to treat them:

Final Thoughts

The bottom line?

It is possible to treat acne even if you have PCOS.

Make no mistake, though, it may be difficult and may take some time, but it is certainly possible.

The key to success is to use multiple therapies including oral supplements, topical therapies, dietary changes and maybe medications (if necessary).

When considering whether or not to use medications just realize that the best approach is to balance the underlying hormone imbalances that cause acne instead of covering them up.

Now I want to hear from you:

Are you suffering from PCOS acne?

If so, what kind of therapies have worked for you? Which haven't?

Are you familiar with the therapies listed in this guide?

Leave your comments below so that we can add to the existing knowledge here.

Westin Childs

I'm Dr. Childs and I write these posts. I'm a physician that specializes helping patients lose weight, have more energy and FEEL better. My practice focuses on hormone imbalances, thyroid issues and weight loss resistance. My goal is to provide the BEST information out there on the internet that is both actionable and trustworthy. Get my free 3 day meal plan here. You can also find more about my personal journey back to health here.

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