I haven't had time to read through all of these posts but I read through quite a few and I wan to share my experience with PCOS and acne.
From ages 12-17 I always had irregular periods. I was a normal weight, healthy and athletic. My diet, I admit, wasn't the best but I wasn't malnourished or anything. I went to an OB/GYN to see what I could do about the irregular periods when I was 16 and the Dr. shamed me and acted like all I wanted was birth control... in front of my mom... it was pretty horrible. She didn't bother to do any tests or anything else.
When I went to college a friend of mine was on birth control for anemia and she recommended another doctor to me. I went and had blood tests done and they confirmed that I had PCOS. My LH/FSH ratio was really high. My levels of testosterone, estrogen, thyroid levels, glucose levels etc. were all normal. Since none of my indicators were too off my doctor prescribed Yaz to regulate my hormones and that was it. She explained that once I got to a point in my life when I wanted kids, I might have trouble conceiving, but we could focus on that when the time came. The birth control would help protect my ovaries and I had nothing to worry about in the meantime.
Before birth control my acne was moderate/mild and mostly on my forehead and chin. It slightly improved once I started taking birth control but to be honest, I didn't really think it had anything to do with PCOS or my hormones. I thought I was just growing out of it.
About a year and a half ago I moved across the country for grad school and soon after decided to get the Mirena IUD for various reasons. My skin started to get worse. I tried various things to get it under control. I cut out dairy, I tried the OCM, I used Proactiv, all with minor success at best. I don't want to blame Mirena. Plenty of my friends also have it and none of them have issues with acne. Since Mirena is a lower dose of hormones, and they are localized, I suspect that the hormonal imbalance that is triggered by PCOS is now able to dominate and therefore, I breakout. The low dose of hormones isn't enough to mask the symptoms of PCOS.
After 1 year of struggling (last October) I was at the end of my line. I made an appointment with my OB/GYN for my annual exam and nearly broke down in tears as I explained how frustrated I was with my skin. So we decided to order another set of blood work and I got a referral to see an Endocrinologist. If you have been diagnosed with PCOS and decide to go the medical route for treatment, PLEASE SEE AN ENDOCRINOLOGIST. They specialize in hormonal/endocrine disorders, whereas OB/GYNs just know how to treat them.
Again, I was mostly healthy with the exception of my LH/FSH hormone. Everything else was normal. She prescribed 100mg of Spironolactone and told me to see an dermatologists after a few months of being on the medication. SInce then it has been a rough road. I didn't see ANY improvement for 2 months and things actually got worse for the first month or so. I had to be patient. With hormonal acne, you have to be patient. You can not expect to see results after 1 day. You also can't expect to see results if you're just treating your acne topically. You will never fix the underlying problem.
Spironolactone is amazing. I saw some posts in this forum about Saw Palmetto, and it has similar properties as Spironolactone but the efficacy of Spiro is well documented and much better understood. Spiro blocks testosterone receptors that stimulate oil production and who knows what else. If you are overweight it is likely that an endocrinologist will also prescribe Metformin and/or birth control to help regulate your blood sugar and in turn other hormones. These medications are not just beneficial to your skin but will help keep your reproductive organs healthy and cyst-free.
Diet is also very important. Many women with PCOS are prediabetic and have insulin resistance. It is important to cut back on sugar and refined carbohydrates that spike insulin production. Moderate exercise like walking also helps balance blood sugar.
I hesitated a lot to see a doctor about my PCOS and acne and I don't want to push anyone to go a route they're not comfortable. There are definitely things you can do to manage your hormones without prescription medication. This is what I would recommend that is safe to use without the guidance of a doctor or naturopathic doctor:
- Chrommium (regulates blood sugar)
- Cinnamon in diet and capsule form (regulates blood sugar)
- B vitamins
- Vitamin D3
- Moderate exercise, at an active lifestyle
- A diet high in protein and fiber
- No refined sugars or carbohydrates
- Drink plenty of water (half your weight in ounces is a good estimate)
- CeraVe products are good
Through my search for a "cure" I tired some of the herbal supplements i.e. Saw Palmetto and Vitex (chasteberry). I didn't really see any effect. Some women say they do. If you want to go this route I strongly recommend you do so with the guidance of a Naturopathic doctor to monitor you. If you don't know what your underlying hormone imbalance is you are at risk of just further setting it off. The endocrine system is complex and it is much safer and effective if you have someone who understands it guiding you.
Best of luck and health to all of you.
Edited by shawnabowbawna, 14 March 2013 - 10:00 AM.
150 mg Spironolactone - Split into 2 doses per day
Aczone - Morning and Night
0.025% Tretinoin Gel - Night
Cleansers of choice:
Glytone (4.2% Glycolic Acid Gel Cleanser)
CeraVe Foaming Cleanser
Neutrogena Stress Control (Glycolic Acid and Salicylic Acid)
Moisturizers of choice:
Neutrogena Oil-Free SPF 15
Treatments of choice:
Acure Organics Aragn Oil (100% pure and organic)
Betonite Clay + ACV + Tea Tree Oil Masks
Queene Helene Mint Julep Mask