PCOS and Medical Acne Treatment

Acne is a common and troubling symptom of PCOS.

It is an inflammatory skin disorder that involves interactions between hormones, hair, sebaceous (oil-secreting) glands and bacteria.

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If you have PCOS or insulin resistance, here are some treatment options to consider.

Retin-A - Accutane

Oral or topical tretinoin or isotretinoin (retinoic acid, Retin-A, Accutane). Oral tretinoin should only be prescribed by a physician who thoroughly understands its adverse effects.

Pregnancy testing is important prior to beginning tretinoin therapy and at monthly intervals, due to the risk of severe fetal abnormalities that can occur if pregnancy results while taking this drug.

It acts by unplugging hair follicles and bringing pimples (comedones) to the surface. This is why tretinoin makes your skin look worse in the first few weeks of treatment.

Over the Counter Meds

Over-the-counter topical preparations containing benzoyl peroxide (Benoxyl), which is an anti-bacterial agent.

Over-the-counter topical preparations containing sulfur (Clearasil, Acnederm), which is a keratolytic (peeling agent) and also helps suppress the growth of bacteria.

Topical agents containing azelaic acid (Skinoren Cream, Azelex, Finevin). Azelaic acid exerts an antibacterial effect. It is also keratolytic and has a therapeutically positive effect on the formation of comedones (blackheads, whiteheads).

In severe cases, the antibiotics tetracycline or minocycline may be used. Antibiotics are anti-bacterial agents.

Light Therapy

Increased exposure to sunlight or ultraviolet light (such as tanning beds).

The ClearLight system, which uses a narrow-band, high-intensity light known as blue light to attack the bacteria in pimples. Available from some dermatologists.

In the case of women with PCOS and pimples, physicians will typically prescribe spironolactone (Aldactone) and birth control pills. Some birth control pills (e.g., Orthotricyclen, Orthocyclen, Desogen, and Demulen) contain lower levels of androgens and should, at least theoretically, provide better control.

What about Laser Treatment?

Conventional treatment for pimples isn't much fun. Is there another way?

There appears to be some good news from the Department of Dermatology at the University of Missouri. They tried laser treatment on 28 people aged 25-45 years old who had mild-to-moderate acne. Treatment was given twice a day for eight weeks.

They used a new, hand-held, light-emitting diode blue light device in conjunction with a foam cleanser containing 5% glycolic acid and 2% salicylic acid, plus a skin rebuilding serum containing 1.25% salicylic acid, 0.5% niacinamide, 0.08% liposomal-based azelaic acid and superoxide dismutase.

Both the amount and severity of the skin problems significantly diminished.

By the end of the study, 90% reported improvements in their skin's overall appearance, clarity, radiance, tone, texture and smoothness.

In addition, 82% said they were satisfied or very satisfied with the blue light treatment system and 86% said the treatment system was much gentler than traditional treatments.

You might ask your dermatologist about it.

Source: Wheeland RG eet al, Evaluation of self-treatment of mild-to-moderate facial acne with a blue light treatment system, J Drugs Dermatol. 2011 Jun 1;10(6):596-602.