PCOS and Acne: What’s the Connection?
By Jake Admire
March 13, 2025
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If your breakouts feel more hormonal than usual—especially deep, painful ones around your chin or jawline—it might be time to look beyond your skincare routine. For many people assigned female at birth, persistent cystic acne is one of the more visible signs of an internal imbalance: PCOS.
Here’s what you need to know about polycystic ovary syndrome, how it contributes to hormonal acne, and what steps you can take to care for your skin and your body.
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What Is PCOS?
PCOS, or polycystic ovary syndrome, is a common hormonal condition that affects as many as 1 in 10 people with ovaries. Despite how common it is, it often goes undiagnosed for years.
Core symptoms of PCOS include:
- Irregular or missing periods
- Elevated androgen levels (like excess testosterone)
- Ovarian cysts (though not always present)
-
Signs of insulin resistance or metabolic issues
And while these are the clinical markers, PCOS also shows up in more visible ways—especially on your skin.
How PCOS Can Trigger Acne
The root cause of PCOS-related acne? Underlying hormonal imbalance.
When your body produces high androgen levels (male hormones), your sebaceous glands respond by going into overdrive. This leads to:
- Increased oil production by the sebaceous glands
- Clogged pores and inflammation
- Deep, painful cystic acne that’s hard to treat topically
PCOS-related breakouts are a type of hormonal acne that typically shows up around the jawline, chin, and cheeks—and may not respond to your usual over-the-counter treatments.
More Than Acne: Other PCOS-Related Skin Signs
If you’re dealing with PCOS, you may also notice:
- Oily skin from excess oil or oil production
- Hirsutism (excess hair growth on the face, chest or back)
- Skin tags
- Acanthosis nigricans (dark, velvety patches, often on the neck or underarms)
These are all signs your hormones may be out of balance—and that your skin is asking for a more holistic approach.
When to See a Doctor
If you're experiencing:
- Persistent, hormonal acne
- Irregular periods
- Sudden hair growth or hair loss
- Unexplained weight gain
- Skin changes mentioned above
—it’s worth having a conversation with your healthcare provider.
A gynecologist, primary care physician, or endocrinologist can help diagnose PCOS through:
- Your medical history
- Blood tests (to check hormone levels)
- A pelvic ultrasound
-
A discussion of your symptoms and menstrual cycles
From there, they may recommend lifestyle shifts, medications (like spironolactone or metformin), hormone regulation through oral contraceptives, or other treatment options to manage both PCOS and acne.
How to Manage Acne with PCOS
Managing PCOS-related acne takes a twofold approach: topical skincare and internal hormone support as part of a thoughtful treatment plan with multiple treatment options.
1. Build an Acne-Safe Routine
Use non-comedogenic, topical treatments that support your skin’s barrier. Gentle actives like salicylic acid, azelaic acid, and niacinamide can help reduce inflammation and prevent new breakouts—without compromising your skin barrier.
2. Consider Lifestyle Shifts
Because PCOS often affects insulin and inflammation, consider these lifestyle changes to support your skin and hormones. Think:
- A balanced diet of low-glycemic, anti-inflammatory meals
- Daily movement or resistance training
- Prioritizing stress management
- Getting enough sleep and hydration
3. Be Consistent (and Kind to Yourself)
Hormonal acne doesn’t clear overnight. But with the right products and lifestyle shifts, you can absolutely make progress. This is a long game—and your body deserves patience.
The Takeaway: Listen to Your Body & Seek Support If Needed
PCOS is more common than most people realize. If you feel like your breakouts are tied to something deeper—especially when paired with other signs like irregular cycles or unwanted hair growth—trust your gut.
You know your body better than anyone else. And you don’t need to go through it alone.
Getting clarity on PCOS can be a powerful first step—not just toward clearer skin, but toward feeling more at home in your body. So, if something feels off, reach out to a medical practitioner. Support is out there, and so are solutions that meet you where you are.
