Women
with PCOS have been finding ways to deal with Acne. Acne goes hand in hand with
PCOs. In more than 20% of PCOS women, Acne is the first symptom that leads to
the diagnosis. Acne is embarrassing and painful with distress and low
self-esteem afmong younger women with PCOS. Acne is a skin condition with
eruptions on the skin. They look like cysts and in extreme conditions may be
inflamed and appear like skin rashes. It normally forms in parts of the skin
abundant in sebaceous glands. Sebaceous glands are present within hair
follicles and secrete sebum, a lubricant that moisturises the skin. Skin areas
of the face, back and upper part of the chest with more sebaceous glands are
prone for Acne. In PCOS, Acne is more common in areas of the skin on jaw line,cheeks, chin and neck that are more sensitive to hormones. Unlike Acne in other
conditions which open up on the skin, Acne in PCOS form as tender knots under
the skin that take longer to disappear.
Factors
that contribute towards the formation of acne are :
-
pores can get blocked by dirt and dead skin cells that
accumulate and fail to shed away.
-
Skin infection by certain bacteria that block the pores can
cause Acne.
-
High Testosterone levels in PCOS can trigger hyperactivity of
sebaceous glands to produce excess sebum and Acne.
-
General inflammation as a secondary symptom of another
underlying medical condition or medicines can also be the source of Acne in
PCOS.
-
Behavioural habits such as not having a wash regularly, not
drinking enough water and using cosmetics.
-
Consuming excess of junk food, fried food, sweets and
chocolates are also known to increase sebum secretion and Acne.
It
is important to note that though Acne is a worrying symptom, it is not the only
symptom of PCOS. Best therapy to get rid of acne may include treatments for
other symptoms as well. Treatment
options for Acne in women with PCOS are to be discussed with a
Gynaecologist to seek best quality health care. To prioritise what is most
important to be treated has to be communicated to the doctor. The
gynaecologist, after complete examination will recommend the best suitable
treatment. There are tried and tested ways to deal with Acne in PCOS. Treating
the underlying hormonal imbalance has been the most effective. One or more
medications, depending on the symptoms may be prescribed by the gynaecologist.
Managing Hormonal Levels
- Hormonal Contraceptive pill combinations taken
throughout the menstrual cycle can help maintaining hormonal balance to
control Acne. The mode of action is that they reduce Testosterone and
other Androgens produced by Ovaries and increase the body's production of sex
hormone binding globulin (SHBG). SHBG is a protein usually present
in very low amounts in PCOS. This SHBG functions in binding with
Testosterone and reduces free circulating Testosterone. Growth of Acne is
associated with the levels of free Testosterone in the body and not those
that bind to proteins. By increasing SHBG levels, the pill reduces the activity of free Testosterone and thus reduces the symptoms of androgen excess causing Acne in PCOS.
- In severe cases of Acne, Antiandrogen drugs in
short specified courses, in addition to the hormonal contraceptive pills
may be suggested. These drugs, either bring down the level of Androgens
being produced, blocks androgen activity or reduces the binding of
Testosterone to target tissues prone to Acne.
- High levels of Insulin are known to increase
Androgen levels in the body. There are Insulin sensitising drugs that can
help with reducing symptoms of Acne. They have similar effects as hormonal
contraceptive pills but with less side effects and comparatively safe on
prolonged use.
Dermatological treatments
Face
creams, gels or lotions that reduce pore blocking, oil production by the skin
and inflammation can be used to treat Acne. Severe Acne can also be treated by
Dermatologist prescribed medications that shrink sebaceous glands and prevent
sebum production in the skin. These drugs are only for women who do not wish to
conceive and are strictly prescribed alongside effective contraceptive pills.
They are popularly known as Retinoids and can be taken orally or applied as a
topical cream or gel. For PCOS-related Acne, Retinoids that are available over
the counter (OTC) are not recommended. Dermatologist prescribed Retinoid
dosages need to be progressed gradually depending on how the skin reacts to the
medication. Retinoids make the skin extremely sensitive to sun’s UV rays, so it’s
important to apply sunscreen liberally throughout the day. Unprotected skin is
high risk for hyperpigmentation and skin cancer. This medication is more popular
among teens with PCOS.
Diet & Lifestyle
Diet
may not be the only cure for Acne in PCOS but incorporating a PCOS diet is avital part of an overall treatment plan in PCOS. Inclusion of anti-inflammatory
foods in everyday diet can be a good modification that supports clearance of
Acne. Anti-inflammatory foods include spinach, tomatoes, walnuts, almonds,
olive oil, salmon, turmeric and berries. Foods such as red meat, refined
products, potatoes & tubers and sugary foods like beverages and sweets, have
an inflammatory tendency and so can be better avoided in regular diet. Dairy
foods are also known to exacerbate Acne, hence can be avoided.
Exercise and physical
activity
with the objective of loosing weight can bring down Insulin levels in the bodyand thereby reduce Acne in PCOS. Aerobic exercises contribute towards better
skin care by opening pores and allowing the skin to breathe better. Overall
health improves with look good, feel good attitude.
Supplements
To
manage inflammation and Acne, supplements may be considered. Zinc, Bromelain,copper, Vitamin A, Vitamin C and Vitamin B6 are commonly recommended as
additional antioxidants to defend against Reactive Oxygen Species (ROS) in
stress conditions of PCOS. They control inflammation and skin eruptions in a
more passive and sustained mode.
Skin Care Tips
A
skin care routine involving simple care and effort can be very useful in
maintaining skin health. Following are some skin care tips:
-
Washing the face twice daily with a mild soap.
-
Gentle scrubs with natural ingredients can help exfoliate
dead skin.
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An oil-free moisturizer suitable for the skin type is
recommended.
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Avoid picking and scratching blemishes.
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Use noncomedogenic cosmetic makeup only.
Acne
is not the only PCOS symptom to deal with. Doctor needs to be informed about
any new or unusual symptoms to facilitate change in treatment plan and better
suit timely needs. It is recommended to follow a step by step follow up
treatment to better overcome PCOS as per required symptom relief and reduce suffering
from Acne. Women who are highly disturbed by their Acne affected appearance,
may need counselling along with family and social support to protect from
emotional break down and depression.
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