Acne is a common symptom of polycystic ovary syndrome
(PCOS). In fact, up to 30 percent of women with PCOS reportedly suffer from acne (1
). In this article, we’ll discuss how PCOS causes acne and review the PCOS acne diet we recommend for best results.
Does PCOS Cause Acne?
In our practice, we recognize acne as a symptom of an imbalance rather than a skin disorder. If we treat the root causes of your PCOS, we can also treat your acne!
Unfortunately, there isn’t just one underlying cause of PCOS, which is why it is called a syndrome. Rather, there can be a variety of reasons why a woman may develop PCOS. Let’s review a few of the common root causes of PCOS that may cause acne:
Insulin resistance occurs when your body does not respond properly to insulin. Insulin is a hormone responsible for moving glucose (a type of sugar) from your blood and into your cells for energy. When your blood sugar levels remain elevated over time, your cells begin to become resistant to insulin. This leads to blood sugar and insulin levels that are higher than normal.
High insulin levels consequently raise testosterone levels which may cause (or worsen) acne. One study found higher insulin and blood sugar levels in women with acne compared to women without acne (2
). Conventional treatments for insulin resistance and PCOS
, like metformin, have shown to lower insulin and testosterone levels and improve acne in some women. This goes to show that by treating insulin resistance as a root cause of PCOS, you can also reduce acne severity (3
An imbalance of gut bacteria, or dysbiosis, can cause PCOS and acne as well (4
). In fact, some studies suggest dysbiosis may be the triggering event that causes PCOS in the first place. While individuals with dysbiosis often suffer from typical digestive symptoms, some people may also have non-GI symptoms like acne. Small intestinal bacterial overgrowth, or SIBO, is one particular form of dysbiosis which may cause acne. SIBO occurs when too many bacteria end up in your small intestine instead of your large intestine. SIBO is fairly common in people with acne. For instance, one study reported SIBO is ten times more prevalent in those with acne versus healthy controls (5
). Clearly, there is a link between these two conditions. Read more about the connection between SIBO and Acne.
The HPA axis is a communication pathway involving your hypothalamus, pituitary gland, and adrenal glands. Your hypothalamus and pituitary gland are located in the brain and your adrenal glands are located on top of each kidney.
HPA axis dysfunction is a major root cause of PCOS and is commonly referred to as adrenal PCOS. Women with adrenal PCOS often do not have the telltale signs of insulin resistance and high testosterone levels. Rather, they may only show high levels of adrenal hormones, like cortisol and DHEA-S. These stress hormones released from the adrenal glands can indirectly cause acne by increasing oil production in your skin glands, converting into potent forms of testosterone, and worsening inflammation (6
PCOS Acne Diet
Acne is a tricky symptom to treat mostly because conventional medicine only aims to treat the acne itself and not the underlying root cause. We developed our meal plan for PCOS acne with treating the shared root causes of PCOS and acne in mind.
The PFC (Protein, Fat, Carb) Balance Method
Our PFC Balance Method is the first essential tool in our PCOS acne diet. PFC is a simple formula that ensures you have protein, fat, and fiber-rich carbohydrates on each plate. Each of these macronutrients play a vital role in treating PCOS and acne, which is why we need a proper balance of all three.
- Protein: beef, pork, seafood, poultry, eggs, tofu, edamame
- Fat: olive oil, avocados, coconut oil, nuts, seeds
- Carbs: fruit, sweet potatoes, brown rice, quinoa, oats, winter squash, beans, lentils, whole-grain bread
- Non-Starchy Vegetables: leafy greens, Brussel’s sprouts, broccoli, cauliflower, tomato, bell peppers, cucumber, zucchini, etc.
Non-starchy vegetables are a crucial component of your acne meal plan because they contain rich sources of fiber to feed healthy gut bacteria, antioxidants to reduce inflammation, and nutrients to nourish your skin from the inside out. Aim to include at least 3 cups of non-starchy vegetables per day.
Phytonutrients are compounds made by plants that provide desirable health benefits. It is these compounds that give plant-based foods their unique color!
Phytochemicals are crucial for women with PCOS and acne because they boost antioxidant levels in the body and provide anti-inflammatory benefits. Since each color generally represents a different type of phytonutrient, aim to make each plate as colorful as possible to consume a wide variety of these antioxidants.
Carotenoids are one class of phytonutrients particularly helpful for enhancing skin health. Include frequent servings of foods rich in carotenoids like oranges, sweet potatoes, carrots, turmeric
, tomatoes, kale, and spinach.
Limit Added Sugar
For best results, we recommend reducing or eliminating foods high in added sugar. Eating too much added sugar can worsen insulin resistance, raise testosterone levels, cause gut dysbiosis, and worsen your PCOS acne. The biggest sources of added sugars in the American diet are sugar-sweetened beverages, baked goods, desserts, and other sweets. Focus on reducing or eliminating these main sources first, and then begin to swap out hidden sources of added sugars, like flavored yogurt, granola bars, and packaged oatmeal.
In PCOS, the case for a dairy-free diet is nuanced and individualized. However, we find many women report worsening acne with dairy consumption. A few studies support these anecdotes and show an increased frequency of acne in individuals consuming more skim or low-fat milk. Low-fat dairy foods have also been associated with higher testosterone levels, which may explain why these foods are linked to worsening acne. The only way to evaluate your skin’s reaction to dairy is to temporarily eliminate it from your diet. If you choose to keep dairy in your diet, choose organic, pasture-raised, and whole-fat dairy products. Alternatively, if you choose to trial a dairy elimination, keep in mind that some dairy-free products contain high amounts of added sugar. Choose unsweetened nut, oat, or coconut milk products and check the ingredient list for hidden sources of sugar or artificial sweeteners.
Foods as Medicine for Acne
There are a few particular foods we highly recommend including in your meals if you suffer from PCOS acne. First of all, seafood is incredibly rich in nutrients known to boost skin health, like omega-3 fats, zinc, selenium, and vitamin D. Aim to consume at least two servings of seafood per week. The best sources of seafood with the lowest amounts of mercury include salmon, mackerel, anchovies, sardines, and herring.
Nuts and seeds are the next food as medicine recommendation in our PCOS acne diet. These small but mighty foods are packed with fiber, magnesium, zinc, and healthy anti-inflammatory fats. Include at least one serving of nuts or seeds each day. Enjoy a dark chocolate chia seed pudding for a satisfying dessert, add pumpkin seeds to your salad, snack on mixed nuts for an afternoon energy boost, or mix ground flaxseed into your smoothie.
PCOS and Acne Takeaways
Three root causes of PCOS that may contribute to acne include insulin resistance, gut dysbiosis, and HPA dysfunction. Our PCOS acne diet includes the PFC Balance Method to control blood sugar levels, feed healthy gut bacteria, and provide your body with the nutrients it needs for glowing skin. We also recommend the following:
- Eat at least 3 cups of colorful non-starchy vegetables per day
- Include 2 servings of fish each week
- Incorporate 1 serving of nuts and seeds at least daily
- Reduce or eliminate added sugar
- Trial a temporary dairy elimination
An anti-inflammatory diet is crucial as a healthy foundation to treat PCOS acne. However, we also recognize targeted supplements may be needed to support your skin goals as well. Our Acne Supplement Bundle
includes omega-3 (great if you cannot eat two servings of fish per week), zinc to decrease oil production in the skin, and a soil-based probiotic to treat dysbiosis.
Want to learn more? We teach how to create easy, PFC balanced meals to treat PCOS-related acne (meal plan included) in our online PCOS Course, The PCOS Symptom Reversal Method