"Patients with PCOS tend to get acne that involves more tender knots under the skin, rather than fine surface bumps, and will sometimes report that lesions in that area tend to flare before their menstrual period," Schlosser says. "They take time to go away."
Because the underlying causes for acne related to PCOS are imbalances in hormone levels, PCOS-related acne tends to occur in areas that are more sensitive to the effects of hormones. These include the lower portion of the face, including the lower cheeks and jawline. The back and chest can also be affected.
PCOS cystic acne is typical in appearance, presenting as large, red, and deep breakouts on your skin-a a severe form of acne resulting from hormonal imbalance. PCOS-related acne tends to be concentrated in “hormonally sensitive,” areas-especially the lower one-third part of the face.
Women of every race and ethnicity can have PCOS. It's common for women to find out they have PCOS when they have trouble getting pregnant, but it often begins soon after the first menstrual period, as young as age 11 or 12. It can also develop in the 20s or 30s.
If a woman with PCOS has harsh acne problems, the acne will take 1 to 2 years to clear and also leaves acne scars, blemishes on the face. So, it is always recommended for a woman with an acute acne problem in PCOS to see a doctor for the right diagnosis of the acne problem.
The exact cause of PCOS is unknown. There's evidence that genetics play a role. Several other factors, most importantly obesity, also play a role in causing PCOS: Higher levels of male hormones called androgens: High androgen levels prevent your ovaries from releasing eggs, which causes irregular menstrual cycles.
Some oral contraceptive pills can treat acne that results from PCOS. The combination of estrogen and progesterone in these pills reduces levels of testosterone in the body. A reduction in testosterone limits the development of acne and hirsutism.
However, this differs from the hormonal acne many women experience during their menstrual cycles, in that the levels of androgens don't really dip back down again. What this means for those with PCOS is a much more prolonged period of breakouts and blemishes that aren't carried away with the monthly cycle.
Women with PCOS may notice that acne lesions are deeper, larger, and slower to resolve. Acne in PCOS usually worsens around the time of menstrual periods. Dermatologists often recommend the use of oral contraceptive pills or a medication called spironolactone to treat this type of acne.
And while PCOS doesn't have a clear hereditary pattern, per the Genetics Home Reference, there does seem to be some sort of family association—an estimated 20%–40% of those with PCOS have an affected family member, usually a mother or sister.
Acne and unwanted hair may result from too much testosterone. Dark patches of skin may develop from high insulin levels associated with extra weight gain. These often form on the back of the neck (or encircle the neck) and sometimes the underarm area. This rash is called acanthosis (ak an THO sis).
Irregular periods.
Having few menstrual periods or having periods that aren't regular are common signs of PCOS . So is having periods that last for many days or longer than is typical for a period. For example, you might have fewer than nine periods a year. And those periods may occur more than 35 days apart.
Recent studies have shown that women who were diagnosed as having PCOS 30 years ago have a completely normal life expectancy. An inspection of more than 700 death certificates from women with PCOS has shown that there is no excess risk of cancer in any organ or of heart disease.
The group with PCOS had been diagnosed at a mean age of 27 years. The mean follow-up time was 13.1 years in both groups, during which 1,003 controls and 177 women with PCOS died. The mean age at death was 51.4 years for the PCOS group versus 52.6 years for the control women, a significant difference (P < . 001).
To be diagnosed with PCOS women generally need to have two out of three of the following: Irregular or absent periods. Acne, excess facial or body hair growth, scalp hair loss, or high levels of testosterone and similar hormones in the blood. Polycystic (many cysts) visible on an ultrasound.
Common signs and symptoms of PCOS include:
Acne. Oily skin and hair. Excess hair growth on the face and body. Hair thinning or loss on the head.
As previously stated, the shape of a PCOS belly differs from other types of weight gain. It often appears large and bloated but can also be small and round, depending on genetics and other factors. The PCOS belly involves the accumulation of visceral fat in the lower abdomen and typically feels firm to the touch.