28 Apr Food & Lifestyle Considerations for PCOS Acne
Acne & I had big beef throughout my teens and well into my early 20s; I spent years wishing everyone would just wear brown paper bags over our heads when out in public.
So I fully get the struggle.
I get the confidence knocks. I get the social impact. I get not wanting to put your face on a pillow because of the pain.
I get it all.
I also get that when we’re already dealing with periods that are MIA; excess hair that’s sprouting out our chins, chests & bellies; fatigue; insulin resistance (for some) and all the other delightful PCOS symptoms? Then having a face that feels as though it’s a fire engine siren can sometimes be a bit too much.
And, because I didn’t know better (and quite frankly, was desperate) at the time, I used everything from the Accutane, to the Pill, to the endless antibiotics to whatever topical creams would burn the most – because that means they’re really working, right?
While these sometimes helped short-term, nothing lasted. That, coupled with becoming acutely aware of the side effects of some of them (and the fact that I hadn’t had a proper period for more than a decade), got me exploring all other options.
(Side note: there’s absolutely zero shame in taking meds. In fact, many of my 1:1 clients are on meds when we start working together; all I ask is that you’re always fully informed about them, and all your options, beforehand – especially when it comes to something like Accutane.)
It wasn’t long before I fully appreciated the impact of what I ate & how I lived. And what was happening externally on my face was simply a reflection of what was going on within all the different systems inside my body. Because, as we always come back to: everything is connected.
And even though I have a BSc in Dietetics (and am pretty much always neck deep in continuous education), with all that was going on for me physically, I couldn’t tell my elbow from a chicken’s knee let alone what the next best step for me was when it came to using food & lifestyle factors to do something about my PCOS acne.
So I invested in my very own nutritionist to help me figure it out.
And when pushed far enough upstream? Over time, my skin cleared up in a way I’d never believed possible. (And yes – I got that period back too.)
Thankfully though, I’m no snowflake.
I see this to be true time and time again with my 1:1 clients. Because we follow the research, we listen to your body, we meet you where you’re at, we implement and track and adjust accordingly. And we harness the fullness of using food & lifestyle factors to reverse your PCOS symptoms – acne and all.
But before we dive into what we can do?
Let’s first understand what’s actually going on with PCOS Acne
We have glands on our skin called sebaceous glands and these produce something called sebum (oil). Sebaceous glands are connected to hair follicles with the purpose of keeping our skin & hair lush and lubricated. But excess (or a greater sensitivity to) androgens (testosterone, DHEA-s) can cause an overproduction in sebum.
All this excess oil then mixes with dead skin cells (yum) and in doing so, clog up our pores. Bacteria (naturally found on our skin) then overgrows as a result. The overgrowth then activates our immune system, triggering an inflammatory reaction to deal with the ‘invaders’ and this is what causes the tenderness, irritation, redness and pustules.
High androgens > overproduction of sebum > blocked up pores > overgrowth of bacteria > inflammation.
It’s also important to appreciate that other factors can further exacerbate matters; these include inadequate water intake; poor quality make up & skincare products; certain medications and stress.
So, while it’s great to know that high androgens are behind PCOS Acne, the question you should be asking right about now is:
What’s causing the high androgens to begin with?
Insulin Resistance and PCOS Acne
We already know that insulin resistance is one of the main drivers behind PCOS in general. But let’s take a two second stop to remind ourselves about insulin:
Insulin is a hormone that helps the cells in our body bring in something called glucose, which they then use to make energy. Insulin resistance is when this process happens less efficiently (and can be because of a number of reasons). As a result, we end up with a whole heap of excess insulin which then causes those androgens to increase, that sebum to be overproduced and ultimately, that acne to rage.
And given that approximately 80% of women with PCOS have insulin resistance, getting this sorted is très important, especially if you want to do something meaningful about your PCOS acne.
(Side note: please remember that having a ‘normal’ HbA1C level – the marker often used by Drs to test insulin resistance – is not enough. We want to be using markers that detect early insulin resistance. Ideally we’d be after an Insulin Assay but where that’s not possible, then using fasting insulin & fasting glucose levels, can be really helpful in guiding us with what’s going on for you. Essentially, what I always come back to when working with 1:1 clients is identifying signs & symptoms of blood sugar dysregulation, and using that information, combined with blood test results to make personalised recommendations.)
It’s also worthwhile to mention here, something called IGLF-1, or Insulin Growth-like Factor 1. This has a very similar structure to insulin, and all of us make it. But, in women with PCOS, we’ve been shown to have twice the amount of IGLF-1, our ovaries are way more sensitive to it and it stimulates the production of an enzyme called 5-alpha-reductase; 5-alpha-reductase converts testosterone to its more potent form: dihydrotestosterone (DHT) which then can translate into angry acne.
Digestive Health, Inflammation and PCOS Acne
For the last century, skin conditions have been linked to digestive health. The thinking behind this is that when there’s an imbalance in our gut bacteria (otherwise known as ‘dysbiosis’), this can trigger an inflammatory response, worsen insulin resistance, increase androgen production and lead to acne.
According to the research, we also know that PCOS in and of itself is associated with longterm low-grade inflammation (that might not show up in blood test results). So, we always want to come back to understanding what’s causing that inflammation in the first place; and if you have digestive symptoms, this is also a great place to start.
What can we do for PCOS Acne?
Below, I’m going to chat through some food & lifestyle considerations for PCOS acne, but as always, consult your trusted healthcare provider before making any changes 🙂
First and foremost, be patient.
It often takes time to see a shift in acne – six months or longer – a if we know this from the get go, we won’t place huge pressure on our body to respond like YESTERDAY ALREADY. Nor will we fall down the “I’m a failure” rabbit hole.
Also, remember that if you’ve stopped the pill, post-pill acne is a very real thing.
Secondly, make sure that you have a solid foundation in place to address both Insulin Resistance & Inflammation.
So often, I’ll be asked “… but what about this supplement, or this one, or these ones? Will they help my acne?!”
And while there’s certainly a time and place for including specific nutrients (which I outline below), we can’t turn to them for silver-bullet solutions.
So when it comes to improving insulin resistance, and lessening inflammation, so as to reverse PCOS acne? Although there are a number of factors can cause both the inflammation and insulin resistance, there are certain considerations that are going to be so beneficial regardless.
I often refer to these as the “foundational factors”, and when working with 1:1 clients, these get personalised to where they are in their individual PCOS journey.
- Optimising sleep (I wrote a whole other blog post about this here.)
- Having aligned ways of understanding & addressing stress.
- Appropriate movement (We don’t want exercise to contribute to or exacerbate inflammation.)
- Adjusting macronutrients in meals to ensure stable blood sugar throughout the day (This would include ensuring that there’s an adequate intake of protein in each meal; that healthy fats are included in each meal; and that carbohydrate quality & quantity is adjusted based on your individual situation as guided by blood-work & symptoms. Also aim for about 4 hours between each meal, unless you get irritable & shaky – in which case, begin by eating smaller meals more often and work your way up from there.)
- Optimising intake (Include a variety of colourful vegetables; bringing in plenty of foods with anti-inflammatory & anti-oxidant properties such as turmeric, oily fish, berries, green tea; taking a step back from more processed foods; being very aware of sugar intake even in its ‘natural’ forms as they often still contain a lot of fructose which can exacerbate insulin resistance when consumed in excess; be very mindful of cow’s dairy intake especially given the link with this and IGLF-1 discussed above.)
Deeper Digestive Support
Digestion plays such an integral role not just in PCOS Acne but in overall health too, and I see this to be true with many of my 1:1 clients. If you’re dealing with digestive concerns that you can’t get to the bottom of, please get some support; this could come down to things such as food sensitivities, high stress and overgrowths that can all contribute to increased intestinal permeability (otherwise known as ‘leaky gut’). Having systematic, multi-pronged approach to addressing these, is key.
You can however start with these two simple but absolutely essential considerations that are so supportive of optimising digestion, regardless of the above:
- Chewing your food well
- Taking three deep breaths before, during and after your meal
As already highlighted above, I’m not interested in turning to supplements as silver-bullet solutions for PCOS Acne (or reversing PCOS symptoms in general). After all, if you’re stressed out your brain; you’re eating foods that are triggering an inflammatory response; your blood sugar is like being on a wild rollercoaster ride; you’re exercising more than what your body can cope with at the moment; you’re not prioritising sleeping; you have digestive or thyroid concerns? Although supplements and specific nutrients can be (and often are) extremely beneficial, it’s highly unlikely that they’re going to be your only answer to your PCOS Acne with any of the above going on at the same time. The sooner we can make peace with that, the sooner you’ll be ready to address your PCOS concerns in a multifactorial, meaningful way using all the incredible food & lifestyle factors we have at hand.
My go-to nutrient when it comes to PCOS Acne is zinc. Zinc helps to keep pores open, helps to kill bacteria associated with acne, reduces inflammation and lowers the production of androgens.
Start including it in your intake through food sources such as pumpkin seeds, egg yolks, grass-fed red meat, legumes & well-sourced shellfish. Initially, high quality supplementation will likely also be necessary to obtain the required amounts for therapeutic benefit. However don’t supplement long term given the antagonistic relationship between copper and zinc.
Other nutrients that I’ll consider for PCOS Acne include vitamin A, vitamin E and vitamin D. In addition to getting these through food sources, a good quality multivitamin may be necessary for some time too.
Consider what you’re putting on your skin
What we put on our body is just as NB as what we put in our body when it comes to PCOS Acne because certain substances food in commercial products can cause huge irritation to the skin. Sourcing good quality cosmetics & toiletries is one of the key areas that I focus on with my 1:1 clients. Here’s a great blog post I wrote to underscore just how important this is.
In Conclusion, are food & lifestyle considerations beneficial when it comes to reversing PCOS Acne?
Hands down yes! I know I was continuously told throughout my teens and early 20s that they didn’t have much impact. And truth be told, I kinda loved that at the time because it meant that I didn’t have to change what I was doing, and neither did I have to take any responsibility either. But in the end that just kept me caught in a bit of a victim-mentality mindset rather than stepping up and realising how much of a huge say I did (and still do!) have in using food & lifestyle factors to reverse my PCOS Acne. And the best bit about this? It’s not just about the clear skin, but the confidence that comes with, and spills into, showing up fully in every other area of my life. What an actual gift. What big possibility!
If you’re keen to find out how this could be true for you? Get in touch. We’ll set up a discovery call, I’ll hear where you’re at on your PCOS journey and share how I can help.
You’ve got this x