Hello all,
I hope you had a lovely week. We are in full autumn mode in the UK. It’s time to get cosy and enjoy the hot drinks and candles. This time of the year makes me more reflective and closed off compared to the adventure vibes spring brings. What does autumn do to you?
Also, whilst on the topic of autumn and the UK, please don’t forget to start taking Vitamin D soon. Vitamin D deficiency is linked to the severity of PCOS (full deep-dive into this topic here).
This week’s question
Why do I get skin issues with my PCOS?
In this newsletter:
Why acne happens?
How do Androgens act on the skin?
Insulin and Acne
Occasional Pimples before my period
Acne
In the case of PCOS, excess androgens express themselves as more than just irregular periods. They affect our skin and, as a result, create acne or pimples. They can also affect our hair follicles and grow hair in unwanted places (you can read more here).
I see a lot of topical solutions for skin problems which will only fix the problem temporarily as the driver is not superficial.
What is the deal with androgens?
Androgens are our male hormones and play a major role in our menstrual cycle, bone mass, libido and muscle mass. The most common androgen you will hear about is testosterone, but there are a few others (DHEA, Androstenedione, DHT, DHT-S).
Interestingly, the ovaries and adrenal glands primarily create androgens, but the skin also contains receptors and enzymes that can metabolise them.
Let’s dive deep into what this means for the skin.
Excess androgens act on the skin by enlarging sebaceous glands and increasing sebum production. This excess sebum production clogs the pores of your skin, so they can't shed dead skin cells and replace them with new ones. The combination of excess sebum and clogged pores creates the ideal environment for a bacteria called Propionibacterium acne. This bacteria leads to inflammation and the creation of papules, pustules, nodules, cysts and scars.
This often leads to pimples and acne.
What about other hormones?
Insulin and insulin growth factors also play a role in acne. These hormones are thought to exacerbate the production of androgens and worsen the whole situation. Some studies found a correlation between the facial sebum excretion rate and serum insulin levels in acne patients. This is where lifestyle change that promotes the regulation of insulin levels can have a big impact on acne.
Occasional Pimples before my period
I often get a few annoying pimples before my period. This is due to the rise in progesterone in the second part of your cycle. The following answer will apply if you tend to have regular cycles.
In short, during the first part of your cycle (follicular), oestrogen dominates the scene. Oestrogen tends to have a beneficial effect on the skin. It helps maintain skin moisture by supporting the production of natural skin oils (sebum) and enhancing the skin's ability to retain water. This is why our skin might be glowing after our period.
Progesterone takes control in the second part of the cycle (luteal phase). Progesterone can lead to increased oil production. This is because it stimulates the sebaceous glands in the skin, causing them to produce more sebum. Higher levels of sebum can make the skin more prone to clogged pores and, as a result, pimples.
It's worth noting that individual responses to hormonal fluctuations can vary. Some people may experience more pronounced changes in their skin during their menstrual cycle, while others may not notice significant differences. Additionally, factors like genetics, diet, stress, and skincare routines can also influence skin health.
I hope you enjoyed this newsletter. If you have any curiosities about PCOS, please don’t hesitate to submit them here.
See you next Sunday,
Francesca