PCOS and Acne

Polycystic ovarian Syndrome is a collection of signs and symptoms that has multiple possible causes. A common cause is the overproduction of testosterone in the ovaries, which typically results from insulin resistance. When blood sugar levels are high, the ovaries are forced to absorb sugar and use the extra energy to make both estrogen and testosterone.

These fluctuations in hormones can cause ovarian cysts, infertility, and menstrual irregularity, as well as hirsutism (unwanted hair growth) and acne! Hirsutism is present in 60-80% of women with PCOS, with unwanted hair potentially forming on the top lip, chin, lower back, stomach, hands and feet etc.(1)

New onset acne as a female adult can be highly predictive of PCOS. Acne connected with PCOS is due to high levels of your androgen or “male” hormones – testosterone and DHEA, in the body. Acne caused by PCOS tends to flare up in ‘hormonal sensitive’ areas around the lower third of the face. Typically under the skin, angry inflammation through the cheeks, jawline, chin, and upper neck.  

Common treatment via conventional medicine for these symptoms includes the oral contraceptive pills (OCP), androgen-blocking medications or diabetes medications such as metformin.  

What bothers me about the above treatment plan however, is that the OCP is not a cure for PCOS. It simply masks some of the symptoms while the syndrome continues unhindered in the body. Would you not want to know the root cause of your insulin sensitivity, your irregular periods, your excess hair growth or your adult onset acne? Not just mask the symptoms? 

When being treated by a Functional Practitioner, finding the root cause of the issue can take quite a bit of testing. They will typically consider gut health testing, comprehensive blood panel and heavy metal burden, in order to search for anything that could be contributing to hormonal disruption, immune imbalance or chronic inflammation.

PCOS can put intense stress on the body, however often the external factors like the acne, abnormal hair growth or weight retention can be a woman's number one focus. They will willingly spend hundreds if not thousands of dollars trying to treat these symptoms topically, however treating the root cause is where the focus needs to lie for long term results!

My best recommendation is to have thorough testing to know your individual diagnosis and reasoning for developing PCOS. This will allow you to know exactly what treatment plan will be a success for you. For instance, if your adrenal glands are over-stimulated by continual sugar highs and lows, they will produce too much adrenaline and testosterone, preventing ovulation altogether. If your primary issue is insulin resistance and metabolic dysfunction, then a low-carb/ketogenic diet or intermittent fasting to regulate blood sugar, may be your answer. Whereas somebody else may find through testing, that they have Small Intestinal Bacterial Overgrowth and this inflammation has led to disruption of the female hormones and caused the overproduction of testosterone. Therefore the SIBO would need to be addressed.

Here are some of my internal focused, more holistic tips I recommend to my PCOS clients suffering from acne;

Eat less carbs and more fat:

Many studies support that a higher fat and lower carb diet can help alleviate the symptoms of PCOS. When consuming high intakes of carbohydrates, especially refined carbohydrates (ie. refined sugar, white bread, white rice, etc.) they will quickly turn to sugar and cause spikes in insulin. Diets like the ketogenic diet and Paleo diet can be more effective when treating PCOS over the conventional, low fat high carb diets. (2)


Berberine is a herb that can be as effective as metformin in treating hyperinsulinemia. It up regulates insulin receptors and stimulates glucose uptake into the cells. This can help reduce the intensity of your acne breakouts. Studies do show however, that pre and probiotic support should be taken along side long term use of Berberine, to ensure good gut health due to Berberines antimicrobial properties.(3)

Flax Seeds:

Flax seeds are high in fiber, high in omega 3 fatty acids, and contain essential amino acids that are great for the skin. They also contain lignans that increase sex-hormone binding globulin levels and reduce androgen and insulin levels. This can help to alleviate some of the symptoms of PCOS


Cinnamon can help reduce insulin resistance and restore ovarian function in women. This powerful spice is very easily added to our daily intake and gives a serious glow to the skin from inside out!

Reducing plastics and toxins in your daily life:

Certain chemicals in plastic can mimic hormones or bind to hormone receptor sites, disrupting the body’s hormone balance. These toxins can affect the endocrine system, reeking havoc for the already imbalanced hormones. Try replacing your daily water bottle or tupperware with glass to reduce your daily chemical intake.


The Functional Skin online store stocks a range of hormone friendly skin care to help reduce your toxic load and calm your hormonal skin. 

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