Oh PCOS, Why’d You Have to Mess with My Face?
One thing that’s ridiculously frustrating to me about PCOS is that somehow messing with a woman’s weight and hair just isn’t enough, so PCOS (like the cruel little creature it is – do I sound bitter? Ha!) decided to go on and mess with her face too. SO. FREAKING. MEAN! I find this cruel and unusual punishment because as women with PCOS we must fight for our confidence every day, and having skin problems is the LAST thing we should have to think about.
So, what am I blabbering on about? My dear ladies, I’m talking about acne. Those lovely volcanoes that arise on your face and hurt like hell, because guess what? They’re linked to your hormones and therefore, are linked to your PCOS as well. If you’re at all like me, you’re looking at yourself in every possible reflective surface while you’re reading this and just thinking OH DEAR LORD, WHY MY SKIN? As I write this I’m looking at a particularly large bullseye in the center of my forehead that really draws the eye and I would prefer it to be gone, like now.
Anyways, enough self pity for now because I have some fascinating news to share with you about acne! There has been a TON of recent literature published about the gut. Yes, the digestive system. That may seem like it came out of left field and you may be thinking, “Um Morgan, weren’t you just talking about my face and now you’re talking about my intestines?” Indeed, I AM talking about your intestines! Several studies have found a correlation between your gut and your skin. What’s more, there seems to not only be a gut-skin connection, but a gut-brain-skin connection as well (1). Scientists have found that several disorders such as depression, anxiety, etc. actually overlap with skin conditions like acne (1).
Let’s take a little dive into the intestinal tract just to understand how the gut could be so intricately tied with brain and skin health. You may already know that the gut has several different types of healthy bacteria (intestinal microflora) that help you digest food, keep you healthy, and aid in the absorption of nutrients. These good bacteria are normal, but there are also bad bacteria that live in your gut. When you are healthy, you should have higher levels of good bacteria than bad bacteria. We’ve all had a case of digestive distress where we’ve had to run to the bathroom – maybe you were exposed to a bad bacteria that you weren’t used to and it was able to proliferate (grow and multiply) inside your digestive tract. Imagine this happening with the bad bacteria that you are normally exposed to but ALL THE TIME. Clinicians call this SIBO – Small Intestine Bacterial Overgrowth. When SIBO occurs, the bad bacteria outgrow the good bacteria and you are not able to perform all the digestive functions that you need to. In fact, this actually causes inflammation and over a long period of time it can damage the integrity of your intestinal wall (have you heard of leaky gut? Buzzword these days! This is how leaky gut occurs).
I started doing research on intestinal health when I was very young. I’ve been writing down my story to share with you, but it is a LONG one. My health issues started when I was 13 years old, and the reason I’m telling you this now is because my FIRST symptom was not cyst pain, a missed period, or even acne. My first symptom at 13 years old was a problem with my digestion. Had I known then what I know now about the importance of intestinal health on your quality of life and on the rest of your organs’ health (I know, I was 13 – but still!), I feel that I would have lived a very different sequence of events. THAT IS HOW IMPORTANT YOUR INTESTINAL HEALTH IS! I CARE ABOUT YOUR INTESTINES!!!! I bet no one’s told ya that before, huh?
So while you read the next few paragraphs, keep the following in mind. While I’m focusing on the skin-gut connection because skin issues are a significant problem for all of us with PCOS, your gut is tied to your overall health in sooo many ways and is more important than we realize. Also, your skin is your largest organ so it’s going to indicate your state of health!
Here are some interesting takeaways from a few studies that I wanted to share:
-Omega-3 deficient diets increase SIBO (Small Intestine Bacterial Overgrowth)
-Correction of SIBO leads to marked clinical improvements in patients with Rosacea (so it helps with other skin problems too!)
-Oral administration of probiotics has proven beneficial in the reduction of SIBO
-40% of acne patients note constipation as a clinical complaint in one cited study (2)
-54% of acne patients have marked alternations to intestinal microflora (3)
-Psychological and Physiological stressors can impair normal intestinal microflora (most notable reductions in microflora – Lactobacillus and Bifidobacteria species) (4)
-When given a probiotic drink, patients in one study showed significant reductions in total lesion count in association with a marked reduction in sebum production. (5)
-Probiotics may influence both booth and acne via regulation of glycemic control. Gut microbiota contributes to glucose tolerance (6)
-Orally administered Bifidobacterium lactis can improve fasting insulin levels and glucose turnover rates, even in the presence of a high-fat diet (7)
-Enhanced reactivity to E. Coli LPS (an endotoxin that can circulate in the blood when intestinal permeability occurs) is noted in irritable bowel patients with higher anxiety levels; may also be linked to acne specifically (8)
So, now that I’ve exploded your brain with all of that information… what should you do to improve your skin (and overall digestive health)? Based on the science and my personal experiences, these would be my recommendations (Note, affiliate links included below so that I can one day buy an entire beanie baby collection from e-bay… LOL):
- Start taking an omega-3 supplement (ie: These are what I take, they are also vegan)
- I also noticed a HUGE difference in my skin when I started eating Keto. My skin was AMAZING.
- Take a probiotic with many different strains of microflora, especially Lactobacillus and Bifidobacteria species. For improvements in fasting insulin levels, take one with Bifidobacterium lactis. (I take Garden of Life’s probiotics – see my recommendation on the Resources page)
- Drink Kombucha! It’s delicious, generally has low sugar, and will help feed the microflora in your belly
- Eat prebiotic foods (bacteria need to eat too!). While probiotics are the bacteria themselves, prebiotics are essentially the food for the bacteria to grow and live. Good bacteria like fermented foods (think kefir, sauerkraut, etc.) but also thrive off things like acacia fiber. There are actual prebiotic supplements you can purchase if you would prefer to do this instead of solely eating them (I take Acacia fiber from Garden of Life – link on the Resources page).
- Avoid antibiotics, if possible. They will wipe out your intestinal microflora, both good and bad. It’s much more likely that you will have SIBO after taking antibiotics.
- Try Glutamine and Quercetin to restore intestinal integrity
- *Always talk to your doctor before starting a new supplement routine, especially if you are on other medications! It is always better to ask just to make sure the supplements/vitamins don’t interfere with the meds you are on.
- Other Advice/Note: Your diet WILL dictate what your skin looks like on some level. If you know you aren’t eating as healthy as you should be or drinking enough water, it will likely show in your skin.
I hope you find this helpful! Let me know if any of these things clear up your skin! I’d also love to hear any other suggestions that you have for dealing with your PCOS skin problems OR skin issues you’d like me to post about!
[Side/End Note: When I share information with you, I will always back it up with clinical evidence. I will not give you information just because I think it sounds right or cool or trendy. That’s why I leave my references at the bottom so you can follow up and do your own research as well.
(1) Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathog. 2011 Jan 31;3(1):1.
(2) Ketron LW, King JH. Gastrointestinal findings in acne vulgaris. JAMA. 1916;60:671–75.
(3) Volkova LA, Khalif IL, Kabanova IN. Impact of the impaired intestinal microflora on the course of acne vulgaris. Klin Med (Mosk) 2001;79:39–41.
(4) Logan AC, Katzman M. Major depressive disorder: probiotics may be an adjuvant therapy. Med Hypotheses. 2005;64:533–8. doi: 10.1016/j.mehy.2004.08.019.
(5) Kim J, Ko Y, Park YK, Kim NI, Ha WK, Cho Y. Dietary effect of lactoferrin-enriched fermented milk on skin surface lipid and clinical improvement of acne vulgaris. Nutrition. 2010;26:902–9. doi: 10.1016/j.nut.2010.05.011.
(6) Kleerebezem M, Vaughan EE. Probiotic and gut lactobacilli and bifidobacteria: molecular approaches to study diversity and activity. Annu Rev Microbiol. 2009;63:269–90. doi: 10.1146/annurev.micro.091208.073341.
(7) Burcelin R. Abstract 019, Keystone Symposia – Diabetes. Whistler, British Columbia, Canada; 2010. Intestinal microflora, inflammation, and metabolic diseases.
(8) Liebregts T, Adam B, Bredack C, Röth A, Heinzel S, Lester S. et al. Immune activation in patients with irritable bowel syndrome. Gastroenterology. 2007;132:913–20. doi: 10.1053/j.gastro.2007.01.046.
*I did not include this study because it only includes males, however, it is extremely interesting and pertains to insulin resistance so I thought I’d post it in case anyone was interested 😊
Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007;86:107–15.