The sad thing is that there are many dermatologists who believe they have the magic pill in the form of Isotretinoin (Accutane), a drug originally formulated as a chemotherapeutic agent. I must issue a serious warning concerning this medication for PCOS women. The success rate in this group is much lower than for others; only about one in three has long term benefit. Some see short-term improvement, followed by the acne’s return with a vengeance a short time later. Isotretinoin also has many side-effects such as headaches, dry eyes, cracked lips, bleeding gums, and fatigue. Among the more serious ones are birth defects, increased suicidal feelings and suicides, liver injury, elevation of blood lipids (fats), and permanent irritable bowel syndrome.
In PCOS women, the bacteria on the skin have been demonstrated to be different from that of “normal” women. Additionally, the sebum, or oily material which protects our skin, is also unique in PCOS women; its constituent fatty acid components are not the same and have reduced capability to fight off infection, hence the development of cystic, recalcitrant acne.
So what shall we do? We must douse those fires! We first must measure your inflammatory status and then must lower it. Your acne will dramatically improve once the flames are out. Start by getting your inflammatory lab tests performed. Contact me if you need help on this. Over the past few months, I’ve worked out a system to help all get these important tests performed at a network of draw sites. Next, we must get that inflammation down. As this is a short article on a very complex problem, I can only provide an overview of my program. If desired, I am happy to help you individually, simply contact me.
The treatment of PCOS related acne starts with your food choices. You must eat an anti-inflammatory diet. Avoid all dairy, in all forms! Dairy increases levels of IGF-1, which increases testosterone, increasing acne! Also, avoid all wheat and gluten, all sugars and sweeteners, alcohol, white rice and corn, and all chemical and processed foods.
There is no diet which is perfect for all PCOS women, so please feel free to do some experimentation to discover what works best for you. We are all unique in our immune systems, our toxic load, and genetics. The unifying theme must, however, be a diet to reduce inflammation! For those who enjoy it and can handle it, I suggest trying initially, for three to six months only, an organic vegan diet consisting of 10 servings (1/2 cup each) of vegetables, including at least 4 servings of a variety of root vegetables such as beet roots, turnips, rutabagas, parsnips, and carrots. Add in 2 fruits, particularly tart apples and berries. The other vegetables should consist of many different varieties of vegetables – all the colors of the rainbow! The phytonutrients and anti-oxidants in these foods fight inflammation and the resistant starch fibers in the vegetables, particularly in the root vegetables, provide nourishment to those critically important bacteria living in your intestinal tract. Add in organic beans, lentils, a handful of organic raw seeds and nuts, small amounts of whole grains such as millet, buckwheat, quinoa, and brown rice, along with lots of green and spearmint tea. This diet is high in nutrients, anti-oxidants, and gut-nourishing fiber. A healthy gut lowers generalized inflammation, which in turn lowers circulating testosterone and DHEA levels, which then reduces inflammation in the skin and improves acne! But if not eating animal products is more than you can handle, go ahead and add in some organic eggs, chicken, red meat, and fish.
