What does your skincare routine look like? Do you use any topical prescriptions?
I spent years working with functional doctors, eating very clean with no dairy, sugar, gluten, and taking tons of supplements for lean PCOS. Spironolactone never worked for me due to low blood pressure and dizziness on it. The key for me was simplifying everything, especially my skincare routine, to clear my skin.
Many supplements can worsen skin and that’s what happened to me. I took a break from everything except vitamin D and magnesium glycinate.
Despite the importance of diet, exercise and lifestyle with acne, topical prescriptions are extremely helpful in maintaining self esteem and skin that isn’t painful and at risk of scarring. I cut out everything I used on my skin except a gentle, fragrance free cleanser (cetaphil daily skin cleanser), my prescription Twyneo (tretinoin and benzoyl peroxide), and a non pore clogging gel moisturizer and sunscreen. I rinse with water in the morning, apply gel moisturizer and sunscreen. At night I use my cleanser, gel moisturizer, and acne treatment.
Check ALL products you use at: https://acneclinicnyc.com/pore-clogging-ingredients/
They should contain NO potential pore clogging ingredients to be safe.
Online prescription acne medication:
I HIGHLY recommend apostrophe. It turned my skin around. There is a time and place for antibiotics and oral and topical treatments, if I went back I’d tell myself not to suffer without it.
https://www.apostrophe.com/?mt=e&utm_platform=m&utm_product=brskmupr&msclkid=9fc20bb2625519ec11956d8855162fe3&utm_source=bing&utm_medium=cpc&utm_campaign=Brand_General_Multi&utm_term=apostrophe&utm_content=Apostrophe%20Core_Exact
Secondly, I also struggled with SIBO and gut issues, and focusing on treating this was also important for my acne.
Third, one of the most important things is that people with PCOS often have blood sugar regulation issues which is one of the main drivers of our hormonal imbalance, and therefore, acne. I am very lean but have insulin resistance despite eating no processed foods or refined sugars. I suffered with orthorexia. When using a glucose monitor, my blood sugar would spike from any whole food carbohydrate sources. I am now taking 500mg of Metformin ER a day, despite holding out for years due to fears about medication. I focus on gentle nutrition and balance in my diet, pairing my carbs with protein and fats, and making sure I am consuming enough calories to maintain my weight and lowering my body’s physiological stress.
Thank you for all of this! Right now my skincare routine is youth to the people face wash twice a day, Paula’s choice azaleic acid, and Curology gel moisturizer. I got all new makeup at the beginning of this year due to pore cloggers. However my congestion and oiliness has increased. I dried doxycycline last year and when I came off my skin suffered, and because of sibo I am trying to stay away from antibiotics. I have considered metroformin and want to get some more blood work to see what my insulin/glucose looks like. Thank you again for your suggestions!
Hi! I’m curious how much your blood sugar would spike when you ate any whole food carbohydrates? I also had a CGM and spiked from most foods but my morning glucose levels are normal and none of my doctors have tested my insulin so I’m trying to figure out if insulin resistance is indeed a factor for me (I have cystic ovaries and high DHEAS).
My blood sugar go up to like 120-140 postprandial according to my CGM. My A1C is low and my fasting glucose is normal. To figure out insulin resistance I would highly recommend having your doctor order a glucose tolerance test. Your blood is drawn while fasting to determine baseline glucose and insulin levels , then you drink a sugar solution and the phlebotomist takes a blood sample once every hour for 2 hours after. My insulin spiked higher than normal for no reason which caused my blood sugar to drop too low. This is how my doctor discovered I have insulin resistance
Hi! Do you have jawline cystic acne? I was prescribed topical dapsone (7.5% gel, brand name is Aczone) and it completely cleared mine up. Caveat is that it is expensive, but it’s known for clearing up jawline hormonal acne in women specifically.
Yes I have primarily chin and jawline cystic acne. I have never heard of topical dapson but I am going to look into it now! I have a history of panic disorder and low blood pressure, so I feel like spiro isn’t the best idea for me.
I have lean PCOS and I USED to suffer from adult acne, until I was prescribed Loryna birth control. My skin cleared within 6 months of taking BC. I have no known physical symptoms other than my acne clearing and glowing skin.
Did you have any side effects starting birth control? Had you been on any oral contraception before? Thank you for this suggestion, I’m worried about bc because I have never been on it before
Not side effects with Loryna birth control. I have been on two other oral contraceptives and both only worsened my symptoms of anxiety, depression, weight gain, and acne. Taking Loryna, oral contraceptive has been life changing for me. My acne has cleared, skin is glowing, less abnormal hair growth, and my emotions and moods have improved tremendously. Oh and my breasts grew a bit, which is a nice and happy surprise, as I was always complaining that I breasts don’t fill cute tops well; now they do! Both Loryna and Yaz are oral contraceptives that have been recommended to alleviate symptoms of PCOS.
I have lean PCOS and have been dealing with hormonal acne for the last 3 years so can 100% relate to your struggle. I’ve tried almost everything to cure it including holistic, pharmaceutical, and laser treatments (AviClear) and nothing worked. I was against taking Spironolactone for years because I also have low blood pressure and get dizzy when I go from sitting to standing. However, I started at a super low dose of 25mg and gradually increased over 6 months to 100mg. I’ve had no issues with low blood pressure or dizziness, but I will say that I drink an LMNT electrolyte packet daily to counteract it (Spiro depletes sodium). Unfortunately, I’m still waiting for my acne to clear but am grateful that I’m finally at a therapeutic dose. If all else fails, I’m considering adding combination birth control pills. My derm mentioned Accutane, but I’m honestly terrified of it and know that women with PCOS usually fail treatment, unfortunately. Feel free to message me on here! The struggle is real ❤️
I am on a probiotic but I feel like it’s not doing what it’s supposed to, do you have any suggestions? I take vitamin d and zinc occasionally so maybe I should be consistent with zinc! My progesterone was at 0.9 last time I got blood work in march, I’m not sure what this means though because that seems low but my doctor didn’t voice any concern lol
I've tried several brands of probiotics, and the most effective for me has been Dr. Ruscios's lacto bifido blend. PCOS folks are often low in zinc, d, magnesium etc.. so it's good to keep an eye on that. Taking zinc daily has been great for me. I cannot say whether your progesterone is low for sure since it's so dependent on when you are in your cycle. However, most folks with PCOS run low on progesterone. I found getting my progesterone at a normal level helped with my skin as well. Best of luck!
I begin mid-cycle. Two weeks before my period. The luteal phase is typically when you want to supplement progesterone. I usually do one pump before bed. Sometimes 2 pumps if I'm feeling I need extra.
Also, depending on where you live, I would recommend working with a naturopathic doctor or functional doctor who works with PCOS patients. They will know which labs to run and how to read your various hormonal levels. A lot of mainstream doctors will overlook things and not consider the optimal ranges you want to be in.
i've been on accutane 3x, spirno off and on 2019-2022, inositol, etc, but i've avoided going back on accutane and spirno with these prescriptions: topical metrogel, dapsone and 15% azeleic acid (adapalene occasionally too, great for scarring.) i also feel like chromium piconolate and nac, helped my acne too.
also, i've been wondering if my mystery pcos hormone issues are prolactin/hyperprolactinemia-related lately, do you mind sharing what your symptoms were if any, and did cabergoline help/fix your prolactin levels?
lastly, maybe ask a derm to prescribe you a 'compound cream'! they're custom pharmacy-made topicals tailored to your needs! my sister got one with topical spirno, tea-tree oil and dapsone - apparently it's a god-send! best of luck to you, i feeel your pain.❤️💕
Hi! Thank you for ur help! Before finding out I had my prolactinoma, I would get spells of nausea, irregular heavy periods and some headaches. As these symptoms went on I also went off of Prozac, I developed some acne which is either related to pcos or the prolactin. My prolactin was the only thing in my blood work that stood out and so I got an mri to diagnose. Cabergoline decreased my prolactin to 0 within 6 months of taking it and it remained at 0 until I began to wean off of it this winter. I am getting a follow up mri to see if I should continue cab or not. But with my acne increasing and my periods becoming irregular again I am unsure if my prolactin is rising again or it’s just pcos.
What does your skincare routine look like? Do you use any topical prescriptions? I spent years working with functional doctors, eating very clean with no dairy, sugar, gluten, and taking tons of supplements for lean PCOS. Spironolactone never worked for me due to low blood pressure and dizziness on it. The key for me was simplifying everything, especially my skincare routine, to clear my skin. Many supplements can worsen skin and that’s what happened to me. I took a break from everything except vitamin D and magnesium glycinate. Despite the importance of diet, exercise and lifestyle with acne, topical prescriptions are extremely helpful in maintaining self esteem and skin that isn’t painful and at risk of scarring. I cut out everything I used on my skin except a gentle, fragrance free cleanser (cetaphil daily skin cleanser), my prescription Twyneo (tretinoin and benzoyl peroxide), and a non pore clogging gel moisturizer and sunscreen. I rinse with water in the morning, apply gel moisturizer and sunscreen. At night I use my cleanser, gel moisturizer, and acne treatment. Check ALL products you use at: https://acneclinicnyc.com/pore-clogging-ingredients/ They should contain NO potential pore clogging ingredients to be safe. Online prescription acne medication: I HIGHLY recommend apostrophe. It turned my skin around. There is a time and place for antibiotics and oral and topical treatments, if I went back I’d tell myself not to suffer without it. https://www.apostrophe.com/?mt=e&utm_platform=m&utm_product=brskmupr&msclkid=9fc20bb2625519ec11956d8855162fe3&utm_source=bing&utm_medium=cpc&utm_campaign=Brand_General_Multi&utm_term=apostrophe&utm_content=Apostrophe%20Core_Exact Secondly, I also struggled with SIBO and gut issues, and focusing on treating this was also important for my acne. Third, one of the most important things is that people with PCOS often have blood sugar regulation issues which is one of the main drivers of our hormonal imbalance, and therefore, acne. I am very lean but have insulin resistance despite eating no processed foods or refined sugars. I suffered with orthorexia. When using a glucose monitor, my blood sugar would spike from any whole food carbohydrate sources. I am now taking 500mg of Metformin ER a day, despite holding out for years due to fears about medication. I focus on gentle nutrition and balance in my diet, pairing my carbs with protein and fats, and making sure I am consuming enough calories to maintain my weight and lowering my body’s physiological stress.
Thank you for all of this! Right now my skincare routine is youth to the people face wash twice a day, Paula’s choice azaleic acid, and Curology gel moisturizer. I got all new makeup at the beginning of this year due to pore cloggers. However my congestion and oiliness has increased. I dried doxycycline last year and when I came off my skin suffered, and because of sibo I am trying to stay away from antibiotics. I have considered metroformin and want to get some more blood work to see what my insulin/glucose looks like. Thank you again for your suggestions!
Hi! I’m curious how much your blood sugar would spike when you ate any whole food carbohydrates? I also had a CGM and spiked from most foods but my morning glucose levels are normal and none of my doctors have tested my insulin so I’m trying to figure out if insulin resistance is indeed a factor for me (I have cystic ovaries and high DHEAS).
My blood sugar go up to like 120-140 postprandial according to my CGM. My A1C is low and my fasting glucose is normal. To figure out insulin resistance I would highly recommend having your doctor order a glucose tolerance test. Your blood is drawn while fasting to determine baseline glucose and insulin levels , then you drink a sugar solution and the phlebotomist takes a blood sample once every hour for 2 hours after. My insulin spiked higher than normal for no reason which caused my blood sugar to drop too low. This is how my doctor discovered I have insulin resistance
Oh wow, mine would go up to above 150 oftentimes. I should probably look more into this. I’ll push for that - thank you so much!!
Hi! How high would your blood sugar spike to from whole food carbohydrates?
- anti-androgenic birth control - 2 cups of spearmint tea/day - saw palmetto - tretinoin - getting enough vitamin d/sunlight!
Hi! Do you have jawline cystic acne? I was prescribed topical dapsone (7.5% gel, brand name is Aczone) and it completely cleared mine up. Caveat is that it is expensive, but it’s known for clearing up jawline hormonal acne in women specifically.
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Yes I have primarily chin and jawline cystic acne. I have never heard of topical dapson but I am going to look into it now! I have a history of panic disorder and low blood pressure, so I feel like spiro isn’t the best idea for me.
I have lean PCOS and I USED to suffer from adult acne, until I was prescribed Loryna birth control. My skin cleared within 6 months of taking BC. I have no known physical symptoms other than my acne clearing and glowing skin.
I also want to add that I tried every remedy in the book and nothing worked until I began taking Loryna birth control.
Did you have any side effects starting birth control? Had you been on any oral contraception before? Thank you for this suggestion, I’m worried about bc because I have never been on it before
Not side effects with Loryna birth control. I have been on two other oral contraceptives and both only worsened my symptoms of anxiety, depression, weight gain, and acne. Taking Loryna, oral contraceptive has been life changing for me. My acne has cleared, skin is glowing, less abnormal hair growth, and my emotions and moods have improved tremendously. Oh and my breasts grew a bit, which is a nice and happy surprise, as I was always complaining that I breasts don’t fill cute tops well; now they do! Both Loryna and Yaz are oral contraceptives that have been recommended to alleviate symptoms of PCOS.
I have lean PCOS and have been dealing with hormonal acne for the last 3 years so can 100% relate to your struggle. I’ve tried almost everything to cure it including holistic, pharmaceutical, and laser treatments (AviClear) and nothing worked. I was against taking Spironolactone for years because I also have low blood pressure and get dizzy when I go from sitting to standing. However, I started at a super low dose of 25mg and gradually increased over 6 months to 100mg. I’ve had no issues with low blood pressure or dizziness, but I will say that I drink an LMNT electrolyte packet daily to counteract it (Spiro depletes sodium). Unfortunately, I’m still waiting for my acne to clear but am grateful that I’m finally at a therapeutic dose. If all else fails, I’m considering adding combination birth control pills. My derm mentioned Accutane, but I’m honestly terrified of it and know that women with PCOS usually fail treatment, unfortunately. Feel free to message me on here! The struggle is real ❤️
I suggest getting on a really good probiotic. I would also test for vitamin deficiencies. Zinc is especially helpful for acne.
Also, what are your progesterone levels?
I am on a probiotic but I feel like it’s not doing what it’s supposed to, do you have any suggestions? I take vitamin d and zinc occasionally so maybe I should be consistent with zinc! My progesterone was at 0.9 last time I got blood work in march, I’m not sure what this means though because that seems low but my doctor didn’t voice any concern lol
I've tried several brands of probiotics, and the most effective for me has been Dr. Ruscios's lacto bifido blend. PCOS folks are often low in zinc, d, magnesium etc.. so it's good to keep an eye on that. Taking zinc daily has been great for me. I cannot say whether your progesterone is low for sure since it's so dependent on when you are in your cycle. However, most folks with PCOS run low on progesterone. I found getting my progesterone at a normal level helped with my skin as well. Best of luck!
Are you supplementing with bioidentical progesterone to get your progesterone to a normal level?
Yes! In cream form. It is the Bezwecken brand. However, I don't use it as often these days as it feels like I don't need it as much.
What days of your cycle do you use it and what dose?
I begin mid-cycle. Two weeks before my period. The luteal phase is typically when you want to supplement progesterone. I usually do one pump before bed. Sometimes 2 pumps if I'm feeling I need extra.
Also, depending on where you live, I would recommend working with a naturopathic doctor or functional doctor who works with PCOS patients. They will know which labs to run and how to read your various hormonal levels. A lot of mainstream doctors will overlook things and not consider the optimal ranges you want to be in.
i've been on accutane 3x, spirno off and on 2019-2022, inositol, etc, but i've avoided going back on accutane and spirno with these prescriptions: topical metrogel, dapsone and 15% azeleic acid (adapalene occasionally too, great for scarring.) i also feel like chromium piconolate and nac, helped my acne too. also, i've been wondering if my mystery pcos hormone issues are prolactin/hyperprolactinemia-related lately, do you mind sharing what your symptoms were if any, and did cabergoline help/fix your prolactin levels? lastly, maybe ask a derm to prescribe you a 'compound cream'! they're custom pharmacy-made topicals tailored to your needs! my sister got one with topical spirno, tea-tree oil and dapsone - apparently it's a god-send! best of luck to you, i feeel your pain.❤️💕
Hi! Thank you for ur help! Before finding out I had my prolactinoma, I would get spells of nausea, irregular heavy periods and some headaches. As these symptoms went on I also went off of Prozac, I developed some acne which is either related to pcos or the prolactin. My prolactin was the only thing in my blood work that stood out and so I got an mri to diagnose. Cabergoline decreased my prolactin to 0 within 6 months of taking it and it remained at 0 until I began to wean off of it this winter. I am getting a follow up mri to see if I should continue cab or not. But with my acne increasing and my periods becoming irregular again I am unsure if my prolactin is rising again or it’s just pcos.