11 Reasons for PCOS Oily Skin
PCOS, or polycystic ovarian syndrome, is a hormone-related condition that can affect your cycle and fertility. If untreated, PCOS can eventually develop and increase the risk of developing type 2 diabetes. It is diagnosed by having two out of the following three symptoms listed below. As a syndrome, there are a collection of symptoms that are patient-dependent, one of them includes PCOS oily skin and acne.
In each pore of our skin, we have sebaceous glands that produce sebum, an oil-like liquid, which helps to moisturize and protect our skin. When too many dead skin cells collect on the top of the skin in conjunction with high amounts of sebum, this can create a clog in our sebaceous glands and will result in inflammation. Our body will respond to this inflammation by sending white blood cells to the site of the clog which forms the white-headed pimples called acne.
Polycystic Ovarian Syndrome is diagnosed when you have 2 out of the 3 (or possibly all) of the following:
1. ELEVATED ANDROGENS (TESTOSTERONE / DHEA)
Testosterone (ovarian) can be elevated due to insulin resistance. This is because increased blood insulin signals the ovaries to produce more testosterone
DHEA (adrenal) can be elevated due to stress / inflammation. DHEA is an enzyme that combines with testosterone, and at elevated levels leads to acne and hair loss.
2. POLYCYSTIC OVARIES ON ULTRASOUND
Small cysts due to the follicle trying to produce an egg
DIFFERENT from an ovarian cyst
3. ANOVULATORY CYCLES / IRREGULAR PERIODS
Irregular periods due to lack of or delayed ovulation
Stress, high testosterone levels can affect ovulation
Source: NIH
1. Estrogen Dominance
Balanced estrogen is found to be beneficial for inhibiting the androgen activity with sebaceous glands and additionally can have regulatory effects on the genes that function in negative acne production. Due to this, one of the reasons for PCOS oily skin can be estrogen dominance. When estrogen is produced too much, you can develop overly dry skin, which causes inflammation, irritation and the sebaceous glands will respond by producing an excessive amount of oil to combat it.
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2. Poor Estrogen Detox
Poor estrogen detox can cause estrogen dominance making it a reason for PCOS oily skin. Estrogen gets eliminated through the 3 step detoxification process in the liver and the gut. There are 3 main steps to detoxification. First, the estrogen is converted into another compound, next, that compound is packaged up with the help of a nutrient like amino acid, and finally, that new compound is excreted from the body in the gut. When one of these steps isn’t fulfilled, estrogen will not be eliminated and will recirculate in the body resulting in higher estrogen levels and PCOS oily skin.
Source: 25506579
3. Elevated Testosterone
Elevated testosterone levels can be another reason for PCOS oily skin. In the body, testosterone and dehydroepiandrosterone (DHEA) react together to get converted into another androgen called Dihydrotestosterone (DHT). This DHT is what causes the increase in sebum in the sebaceous glands to further produce acne. Noticing when breakouts occur on your skin is important too. This is because females naturally have an increase in testosterone around ovulation which causes an increase in libido. If you are noticing acne specifically during ovulation this may not be from high testosterone, but if the acne is occurring throughout any time of the cycle then it probably is one of the symptoms of high testosterone.
Source: 28178574
4. Elevated DHEA
Another reason for PCOS oily skin is elevated DHEA levels. DHEA is another androgen that can be high in those with PCOS. As DHEA combines with testosterone to form DHT, this will increase sebum production and can cause PCOS oily skin. Certain acne medications are made to inhibit the DHEA which subsequently will reduce testosterone and sebum production which will cause an overall decrease in hormonal acne.
Source: 28178574
5. Favoring the 5-Alpha Reductase Pathway
Favoring the 5-alpha reductase pathway is one of the reasons for PCOS oily skin. The 5 alpha-reductase pathway is an enzyme that helps to convert testosterone into DHT. This specific pathway is not the only way to produce DHT because the 5-beta pathway can be up to 3x less symptomatic for acne. There are also two forms of the 5 alpha-reductase pathway, type 1 and type 2. A study has found that the inhibition of the type 1 5 alpha-reductase pathway is beneficial to reduce sebum production and hormonal acne.
Source: 7636302
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6. Dehydration
Dehydration is another reason for PCOS oily skin. Water is essential for skin function, and a study has found that increasing the consumption of water has beneficial effects on reducing acne. When we are dehydrated, there is not enough water to circulate the body, the organs will use up the water first to maintain their function, and the skin will receive whatever is left over. This causes the skin to dry up, and as a response, the sebaceous glands will produce more sebum in order to counteract this. This is why dehydration is one of the PCOS oily skin causes because the skin can not properly determine how much sebum is too much in this situation of dehydration, overproduction can occur.
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7. Low Zinc
Another one of the PCOS oily skin causes is low zinc consumption. Zinc is a great mineral that can be used for a lot of health benefits, but it specifically can be beneficial for enhancing skin appearance and decreasing oil production. A mechanism for this is that zinc has anti-inflammatory properties, and it also can effectively reduce cutibacterium acnes which is a bacteria linked to acne production in the skin. Additionally, zinc can inhibit sebum secretion and production by its antiandrogenic property. Since zinc can decrease androgen levels and reduce excessive oil production, this makes it a great mineral for reducing PCOS oily skin.
Source: 25120566
8. Low Healthy Fats
If you don’t eat enough healthy fats, this can be one of the PCOS oily skin causes. Healthy fats are unsaturated which means they have at least one double bond in the fatty acid chain. Polyunsaturated fats are fatty acids that contain at least 2 double bonds in the structure. Two types of polyunsaturated fats are omega 3 and omega 6. Most western diets consume a ratio of 1:20 of omega 3 to omega 6 when it should be 1:3. This evidence is correlated with acne incidence, showing that omega 6’s are pro-inflammatory and cause acne while omega 3’s have protective effects to decrease acne. Omega 6 sources include soybeans corn, safflower, sunflower oils, nuts, meat, poultry, and eggs. Omega 3 sources include oily fish such as salmon, herring, mackerel, and sardines; fish oil and flaxseed oil; flaxseeds, walnuts, and chia seeds.
Source: 20808513
9. Blood Sugar Imbalances
Blood sugar imbalances are very common in those with PCOS oily skin. Insulin is a hormone released from the pancreas when you eat food, and its job is to take sugar into cells for energy. Think of it like the cell accepting the sugar is a lock and insulin is the key. When you are insulin resistant and have blood sugar imbalances the cells deny the insulin with the sugar, so your blood sugar rises along with insulin levels. This would mean that the cell or “lock” changes so that the insulin or “key” no longer fits.
Insulin resistance causes high levels of testosterone because when insulin levels are high in the blood, it will stimulate an enzyme called 17-hydroxylase which will help the ovaries to produce more testosterone. Additionally, this process will inhibit the synthesis of a binding protein to testosterone which increases the abundance of free testosterone in the blood. This process results in an increase in DHT which causes PCOS oily skin.
10. Gut Imbalances
Another reason for PCOS oil skin is gut imbalances. The gut contains a large diversity of bacteria that aids in regular bowel movements and digestion. When this bacteria is reduced or overpopulated, it can cause issues, one of these being PCOS oily skin. Studies have found that the gut microbiota or bacteria have a connection to acne production due to the inflammatory response it results in. In addition, studies have shown that gut flora can transport excess microbiota to the skin directly. This is because when the intestinal wall becomes permeable, the bacteria can enter the bloodstream and collect in the skin which can clog the pores to create acne and more oils.
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11. Stress
Stress can have an effect on acne similar to how the gut affects it, and this is why stress is another reason for PCOS oil skin. Emotions that come with stress are anxiety, anger, and depression, and these have been predicted to change the gut bacteria balance which will increase inflammation and lead to irritation to the acne. Other studies have looked at different mechanisms for why stress correlates positively with acne severity. One is that stress can increase the androgen secretion from the adrenal glands which cause the sebaceous glands to grow larger. Specifically, stress is a precursor for DHEA which combines with testosterone to make DHT. Additionally, the stress response leads to a release of Corticotropin-releasing hormone which is a derivative of cortisol, and this hormone leads to excess lipid production in the sebaceous glands.
