Natural Solutions for PCOS and Acne
Many women with PCOS have a distressing amount of acne. Studies show that lowering levels of androgens by improving insulin sensitivity with medication and/or a low glycemic load diet is effective for treating acne in women with PCOS[i].
Acne is caused by a combination of biochemical factors including excess androgen hormones plus inflammation caused by hormones called prostaglandins. Acne involves the mostly invisible hairs all over your body. An acne lesion forms when one of your hair follicles becomes swollen under the influence of prostaglandins and traps a combination of sebum, the oily secretion we make to protect our skin, production of which is triggered by androgens, with normal skin bacteria.
Sebum + bacteria + inflammation creates a tiny nodule of infection, that is, acne. The more testosterone you have the more sebum you make. Estrogen and progesterone have effects that can also contribute to the skin changes that produce acne lesions. However, insulin is the key hormone contributing to acne, because insulin promotes increased levels of androgen hormone and inflammatory prostaglandin production. And this is actually great news, because you can change your diet and reduce the production of these hormones back to normal, healthy levels and be relieved of excess acne.
Natural Therapies or Conventional Medicine for Acne?
Severe acne can be an emotionally devastating condition, and it is very important for people with acne to have effective help. Conventional dermatology can treat acne effectively with drugs like antibiotics and synthetic retinols.
The problem is that none of these treatments address the underlying cause of the acne. Plus, there are side effects of real concern. Antibiotic therapy is known to create populations of bacteria that become resistant to the drugs used against them, and eventually will stop working for you. Long term use of antibiotics can also cause problems with your intestines, making it difficult for you to properly digest your food. Some of the other drug therapies like isotretinoin (Accutane) have long lists of side effects, including birth defects in fetuses of women using Accutane while pregnant. Liver damage is another significant threat. Some patients who took isotretinoin have developed depression or psychosis, have become violent, have thought about killing or hurting themselves, and have tried or succeeded in doing so. (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000532)
Most importantly, acne is a sign that something deeper than your skin is not working well and there are other conditions even worse than acne- like heart disease and diabetes that can result over time. By treating your acne, your PCOS, with diet, exercise and natural therapies, you can significantly improve your long term health.
What You Need is a Low-glycemic, Anti-inflammatory Diet
High glycemic foods are simple sugars and starchy, refined carbohydrates low in fiber and other nutrients. These types of foods are known to increase testosterone production. My e-book, The Natural Diet Solution to PCOS and Infertility teaches you everything you need to know to get control over your health and safely reduce the symptoms of PCOS, including acne. You will find literally hundreds of pages of guidance for changing your diet including 30 days of meal plans and dozens of recipes you can use (or modify) as you incorporate your new way of eating healthy. Here are some things you can do starting today, to change the hormones that are creating your PCOS-related acne:
1. Limit consumption of cow milk and other dairy foods: milk products contain estrogens, progesterone and androgens as well as other hormones that are known to promote PCOS, as well as acne[ii].
2. Take zinc gluconate or zinc citrate 30 mg daily- zinc helps hormone balance and supports your immune system to overcome infection and promote wound healing. Women using a retinol therapy will get better results if they have enough zinc in their system, Zinc works as well as tetracycline for acne, with fewer side effects
3. Take Vitamin B6 (pyroxidine) 100mg three times daily for the two weeks prior to your period. A 2004 study documents what so many of us see in the mirror- a 25% increase in acne breakout during the pre-menstrual phase of your cycle[iii]. This is probably related to the swelling caused by the premenstrual hormone cycle, which includes an elevation in androgen-effect. B6 decreases the swelling by causing you to metabolize the extra fluid through your kidneys at a faster rate. If you do not have regular enough cycles to know when your premenstrual time is, I recommend a consultation to help you use this therapy safely and effectively.
4. Stop eating bread! Bread is one of our favorite foods- and also one of your biggest sources of starchy carbs- the sort of food that increases your blood sugar, and therefore your insulin, and thus all the other hormone imbalances that follow from that which are the cause of so much of the pathology of PCOS, including your acne. Another recent study compared the effect of a low glycemic load diet to that of a conventional (defined as a carbohydrate-dense) diet.[iv]. Life without bread can seem pretty unappealing to many people. There are lots of resources for helping you learn to avoid bread and other wheat products- start with celiac.com. Even if you are not a person who is gluten-sensitive, and not diagnosed with celiac disease, the recipes and othe tips you’ll find there will help you avoid breads, crackers, cakes etc, made from wheat >Avoid wheat for at least 3 weeks; it takes minimally that long to give the changes in your system time to show up and allow you to judge the value of avoiding wheat flour products like bread.
5. In fact, eat like a cave person! Acne occurs primarily in Western societies, which makes the link between dietary intake and the development of acne more compelling[v]. Investigators studied the prevalence of acne among two non-Westernized populations, one in New Guinea and the other in Paraguay, along with environmental factors such as diet. Many foods found in Western diets, such as alcohol, oils, sugar, salt, dairy products, and processed foods, were essentially nonexistent in the diets of the people studied. These groups naturally consumed a low glycemic load diet composed primarily of fish, nuts, wild game, fresh fruits, and vegetables. No cases of acne were observed among the 1,300 people examined. In addition to a lower prevalence of acne, these groups had much lower rates of insulin resistance, obesity, and hypertension.[vi] You will find all the information and support you need to make sensible diet changes that reward you with clear skin, optimal body weight and elegant hormone balance, in my e-book.
6. There are still more nutritional supplements that help acne tremendously. However to treat acne effectively, some of these nutrients must be used in doses much higher than is what is typically available at your health food store. That is because if they are not used properly, they can be as harmful as any drug. Consider a consultation with me so we can evaluate your situation and I can recommend a nutritional supplement regime that is not only effective but also safe for you.
[i] Farshchi H, Rane A, Love A, Kennedy RL. Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management. J Obstet Gynaecol. 2007;27:762-773
[ii] Kurokawa I, Danby FW, Ju Q, Wang X, Xiang LF, Xia L, Chen W, Nagy I, Picardo M, Suh DH, Ganceviciene R, Schagen S, Tsatsou F, Zouboulis CC. New developments in our understanding of acne pathogenesis and treatment. Exp Dermatol. 2009 Oct;18(10):821-32
[iii] Lucky A, Quantitative Documentation of a Premenstrual Flare of Facial Acne in Adult Women. Arch Dermatol. 2004 Apr;140(4):423-4
[iv] Smith RN, Mann NJ, Braue A, et al. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol. 2007;57:247-256.
[v] Cordain L, Lindeberg S, Hurtado M, et al. Acne vulgaris: a disease of Western civilization. Arch Derm. 2002;138:1584-1590.
[vi] Collier CN, Harper JC, Cafardi JA, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58:56-59.
© 2005 by Nancy Dunne, N.D. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written consent of the author.