PCOS Acne: Why It’s Stubborn and What Can Actually Work

Acne has a way of getting under your skin—physically and emotionally. If you’re struggling with persistent breakouts, feeling lost, or blaming yourself because nothing seems to work, please know: I see you. I’ve been there.

In my early twenties, acne was one of the hardest parts of having PCOS. I can still remember how hopeless I felt, staring at those angry red bumps along my jawline and cheeks, desperately searching for something—anything—that would make it go away. I tried all the classic tricks: drugstore washes, harsh scrubs, and yes, I even went to bed with blobs of toothpaste on my spots. (Spoiler: it only burned my skin and made things worse.)

If you can relate, you’re not alone—and you’re not doing anything wrong. PCOS acne is stubborn because it’s driven by hormones, not hygiene or willpower.

Why is PCOS Acne So Persistent?

PCOS raises your androgen (testosterone) levels, which send your oil glands into overdrive. That means oilier skin, clogged pores, and more inflammation—often on your jawline, chin, neck, or back. It’s not just a teenage problem. Many women with PCOS find their acne starts in adulthood or flares up before periods or during stress.

Insulin resistance (very common with PCOS) adds another layer—raising IGF-1, a hormone that boosts oil production and inflammation even further.

So if you feel like you’re “doing everything right” but still breaking out: it’s not your fault, and you don’t have to punish your skin (or yourself).

What Actually Helps with PCOS Acne?

Lifestyle first—because clear skin starts from within.

After years of trying to “fix” my skin with more products, more scrubbing, and more desperate tricks, I learned a simple truth: when it comes to acne, less is more—and supporting your whole body is the real game changer.

1. Prioritise Lifestyle Changes

• Balanced, low-glycaemic eating: The single most powerful thing you can do for your skin is to steady your blood sugar. Fill your plate with whole grains, lean protein, healthy fats, and loads of colourful veg. This helps reduce insulin resistance, which calms the hormonal storm that drives acne.

• Support your gut health: There’s a growing link between gut health and clear skin. Try to include a variety of plant foods (think: diversity!) and add in live yoghurt or kefir if you enjoy them.

• Stress less: Easier said than done, I know. But stress spikes hormones that can trigger flares. Even five minutes of gentle movement, deep breathing, or time outside can really help.

• Spearmint tea: Drinking two cups a day may help lower testosterone and calm acne—there’s even research to back it up. Curious about my favourite brands and more on the science? Read my spearmint tea guide.

• Gentle movement: Find something you love—yoga, walking, dancing, swimming. It all supports hormonal balance.

  
  

2. Keep Your Skincare Simple & Gentle

Evening:

• Gently cleanse with a mild, non-stripping cleanser.

• Moisturise—yes, even if your skin is oily!

  
  

  Morning:

• Don’t cleanse! Splash your face with lukewarm water.

• Moisturise and use SPF—protects your skin barrier and helps prevent marks.

Why this works: Over-cleansing can make acne worse by stripping your skin’s natural oils, causing your body to produce more oil to compensate. Simplicity is powerful.

3. Add Evidence-Based Skincare—If Needed

• Topical retinoids (like adapalene or tretinoin) to unclog pores and help cell turnover.

• Benzoyl peroxide or azelaic acid for bacteria and inflammation.

• Introduce new products slowly—one at a time, and give them a chance to work (think weeks, not days).

• Moisturise every night—even acne-prone skin needs hydration.

  
  

4. Medical Support as a Second Step

If your acne is severe, cystic, or not improving, talk to your GP or dermatologist about:

• The birth control pill: Can lower androgens and improve skin over time.

• Spironolactone: Blocks androgens at the skin, a real game-changer for many.

• Oral antibiotics: Sometimes used for short periods to calm big flares.

• Isotretinoin (Accutane): For severe cases only, under specialist care.

  
  

But remember: these are second steps, after building the foundation of lifestyle changes.

What Doesn’t Work (and Can Make Things Worse)

• Over-washing or harsh scrubbing (been there!)

• Toothpaste or home remedies that burn

• Very restrictive diets, detoxes, or “miracle” supplements

• Blaming yourself—acne is not your fault, or a reflection of your worth

  
  

My Final Word (From Someone Who’s Been There)

Acne can impact your mood and confidence more than most people realise. I remember hiding behind my hair, dreading social events, and feeling like my skin was a reflection of my “failures.” It’s not. You deserve so much more compassion and patience—because with the right support, it does get better.

You are not alone. Your acne does not define you. And you absolutely can find relief, confidence, and clearer skin—without punishing yourself or your skin.

If you have questions or just need a bit of encouragement, please reach out. I’m always here (and always happy to chat about skincare, self-esteem, or anything PCOS).