Acne (PCOS/Hypothyroidism)

[lilly123]

Hello,

Since my early 20's I have suspected I may have PCOS with irregular periods, acne, hair in unwanted places, hair loss around my hair line, weight problems etc but scans have not showed up any cysts. Roll on 15-20yrs and I still have all those symptoms plus I now have hypothyroidism. I am now on Armour thyroid as Levothyroxine made me feel worse. Distinguishing the symptoms between the two is difficult but I still feel I have underlying PCOS. Anyway, im nearing 40's old and my acne is bad. Mainly on my chin and neck. It hurts and even with a face full of make up I am so self conscious about the lumps and bumps. Since teens I have tried everything going to help my acne, everything except roaccutane. The reason I will never try that is that my cousin tried to commit suicide on it and she has suffered with eye problems since. I know its all hormonal therefore, I believe I need an androgen blocker. The contraceptive pills ive tried have not helped in the past and by researching options, it appears that women with PCOS benefit greatly from being on spironolactone. It is mentioned on the NHS pages online but I cant find a doctor who will prescribe it to me as it is marketed for people with heart conditions primarily. I just don't know what to do??!!

[Dr Alison Layton]

Spironolactone can be a useful treatment in some cases in which androgen hormones are causing an increase in hair growth or grease levels. However, Spironolactone is not licensed to treat these conditions and therefore it would be useful for you to see a specialist to establish whether it would be helpful for you.
It would be worth asking your GP to refer you to a dermatologist to assess your acne and to consider the options for treatment as there may be other treatments that would be helpful. The Dermatologist could also help to establish whether you have PCOS.

[banyaikris]

Similar to The above, I always had acne prone skin, rosacae at a time. Was put on combined pill for long time which did help but last year they took me off due to high bp. Was given mini pill and in 6 months my skin erupted like a teenager (now 45). Since then they cannot treat me... I tried all : various antibiotics, now on doxycycline for 3 months, various creams and topical antibiotics and solutions but I developed allergies and my skin even became worse with allergic rashes and itches. Then I developed two big boils and the cysts had to be removed surgically . My acnes are big ie: half or quarter pea size, no middle, can't press it, hard, painful, red.... And stays for weeks or months before reduces.. Of course, the spot remains even longer.
I do take levothyroxine due to hypothyroid, and after doing all test due to the surgeries, there is no underlying health issue. All doctors say my immune system is very week but unknown as why. I was given a three months trial of combined pill and I immediately saw a significant result.. Ie big acnes stay but those tiny daily ones disappeared however they will not renew it due to my age.
I am with the dermatologist specialist who ponders what to do with me. My confidence is below zero, I have panic attacks looking in the mirror which causes stress and I know that does not help.
Can you advise me anything I could take back yo my dermatologist please?

[Dr Alison Layton]

Your description of cysts sounds more like cystic acne than rosacea. If your skin did improve with contraceptives that had hormones in, this might have related to a reduction in grease (sebum) levels. It is worth asking your dermatologists if they think you have increased grease production and if this might be causing your skin to be a problem. If so, there are some treatments that can be used that can reduce the grease and this might avoid you getting new large spots, I hope this helps.