Oily Skin with PCOS: Managing DHT Levels

If you have PCOS and struggle with oily skin, you're not alone. Hormonal imbalances, particularly elevated DHT (dihydrotestosterone), can overstimulate oil glands, leading to persistent skin issues like acne and excess oil production. Here's what you need to know:

• DHT's Role: High DHT levels trigger sebaceous glands, causing overproduction of oil, especially in areas like the T-zone, jawline, and chin.
• Contributing Factors: Insulin resistance, common in PCOS, increases androgen levels, worsening oily skin and acne.
• Lifestyle Adjustments: An anti-inflammatory diet, regular exercise, stress management, and quality sleep can help regulate hormones and lower DHT.
• Skincare Tips: Use gentle cleansers, lightweight moisturizers, and non-greasy sunscreen. Ingredients like salicylic acid, benzoyl peroxide, and azelaic acid can help manage oil and acne.
• Medical Options: Treatments like spironolactone, oral contraceptives, or metformin can address hormonal imbalances and insulin resistance. Telehealth services offer convenient access to these treatments.

Managing oily skin with PCOS requires addressing the root hormonal causes alongside a consistent skincare routine. Lifestyle changes, targeted treatments, and professional support can make a noticeable difference.

How to lower DHT and why it matters

How DHT Causes Oily Skin in PCOS

Dihydrotestosterone (DHT), a powerful androgen, plays a major role in the overproduction of sebum that leads to oily skin in individuals with PCOS. Elevated DHT levels activate oil glands, causing clogged pores and acne.

DHT and Sebum Production

When DHT levels increase, sebaceous glands go into overdrive, producing excessive amounts of sebum. This is especially evident in PCOS, where heightened testosterone levels are converted into DHT. Once formed, DHT binds to androgen receptors in the sebaceous glands, triggering them to ramp up oil production.

"Women with elevated testosterone, which is very commonly seen with PCOS cases, typically have a higher conversion rate to dihydrotestosterone (DHT). DHT is a more potent androgen that will ultimately cause increased sebum production, clogged pores, and acne." - Pollie Team

In adults, about 10% of testosterone is converted to DHT through the action of the enzyme 5-alpha reductase.

"Androgens stimulate the activity of oil glands in the skin. When your oil glands are more active, they release more sebum, resulting in oily skin."

These effects lay the groundwork for understanding what drives elevated DHT levels in PCOS.

What Increases DHT Levels in PCOS

To grasp why DHT levels rise in PCOS, it's important to look at the underlying triggers. Insulin resistance is a key factor - elevated insulin levels encourage the ovaries to produce more androgens, including testosterone, which is then converted into DHT. Ovarian dysfunction also plays a role, as increased GnRH pulsatility leads to higher LH secretion, stimulating androgen production in ovarian theca cells. Additionally, fat tissue in women with obesity and androgen output from the adrenal glands further contribute to elevated androgen levels.

PCOS Skin Symptoms

The surge in sebum production caused by increased DHT results in a range of skin issues. Persistent oily skin is often the first noticeable symptom, especially in areas rich in androgen receptors, like the T-zone, jawline, and chin. Acne breakouts can be more pronounced and harder to manage in PCOS. Another common symptom is hirsutism, or excessive hair growth, which is linked to high androgen levels.

"When androgens are high and out of balance, they contribute to hormonal, metabolic, reproductive, and psychological issues, affecting all facets of life." - TārāMD

Tackling the hormonal imbalance at its root is key to managing these skin concerns and improving overall skin health in the long term.

Lifestyle Changes to Lower DHT Levels

Making thoughtful adjustments to your lifestyle can significantly help regulate hormones and lower DHT levels, which in turn can alleviate oily skin associated with PCOS. Since insulin resistance affects between 50% and 75% of women with PCOS, addressing it through diet, exercise, and stress management can create a solid foundation for hormonal balance.

Anti-inflammatory Diet

An anti-inflammatory diet can be a game-changer for managing PCOS symptoms and reducing inflammation. Certain foods can inhibit 5-alpha reductase, the enzyme responsible for converting testosterone into DHT. Additionally, managing insulin resistance through smart dietary choices can help lower overall testosterone levels.

To stabilize blood sugar, aim for meals that include a balanced mix of protein, healthy fats, fiber, and complex carbohydrates. Lean proteins, whole grains, and healthy fats are especially effective in promoting stable blood sugar levels and reducing inflammation. Healthy fats - like those found in fish, nuts, seeds, olive oil, and avocados - also play a role in supporting hormone production and reducing inflammation.

The Mediterranean diet is particularly helpful for PCOS. It emphasizes anti-inflammatory foods while steering clear of saturated fats, processed meats, and refined sugars. Include omega-3–rich fish, olive oil, and plenty of colorful fruits and vegetables in your meals. At the same time, cut back on sweetened drinks and highly processed foods.

Two specific dietary additions might also help: drinking two cups of spearmint tea daily has been shown to lower androgen levels, and adding ground flaxseed to your diet may help reduce testosterone levels.

"If you are diagnosed with polycystic ovary syndrome, it doesn't mean that you are destined to have poor health. There is a lot you can do to take charge, minimize symptoms and keep yourself healthy." - Amanda Stathos, M.S., R.D., L.D.N.

Pairing these dietary changes with regular physical activity can further enhance insulin sensitivity and hormonal balance.

Regular Exercise

Exercise is another powerful tool for improving insulin sensitivity, which helps lower androgen production and DHT levels. Both aerobic and strength training exercises are effective in supporting hormonal balance and reducing androgens. Cardio workouts, such as brisk walking or swimming, can improve glucose metabolism and prevent insulin spikes that trigger androgen production.

Try to engage in 30 minutes of moderate exercise most days of the week, focusing on activities you enjoy - whether that’s dancing, cycling, or yoga. Strength training and yoga are particularly beneficial for lowering androgen levels. Research suggests that vigorous aerobic exercise improves insulin measures, while resistance training and yoga offer specific benefits for women with PCOS.

Consistency is key. Regular exercise not only helps with weight management and cardiovascular health but also boosts mood, all of which contribute to better hormonal balance and healthier skin.

Alongside exercise, managing stress and prioritizing quality sleep are essential for controlling DHT levels.

Stress Management and Sleep

Chronic stress can elevate cortisol levels, worsening hormonal imbalances and insulin resistance - both of which can drive up DHT production in PCOS. Women with PCOS are three times more likely to experience heightened emotional stress compared to those without the condition.

Incorporating mindfulness practices such as meditation or deep breathing exercises can be highly effective in managing stress. The 4-7-8 breathing technique - inhaling for four counts, holding for seven, and exhaling for eight - is a quick way to reduce stress. Mindfulness-based stress reduction (MBSR) has been shown to lower anxiety, depression, and stress, improving overall quality of life for women with PCOS.

Getting enough quality sleep is equally important for hormonal balance. Aim for 7–9 hours of restful sleep each night. Create a sleep-friendly environment by keeping your bedroom cool, dark, and quiet, and avoid screens before bedtime. Poor sleep can disrupt cortisol patterns and worsen insulin resistance.

Additional stress management strategies include progressive muscle relaxation, guided imagery, and listening to calming music to improve mood. Cognitive Behavioral Therapy (CBT) can also help reframe negative thought patterns linked to chronic stress. Building a strong support system - whether through family, friends, or PCOS support groups - and practicing self-compassion can further promote hormonal balance and overall well-being.

Skincare for PCOS Oily Skin

Managing PCOS-related oily skin often starts with lifestyle changes, but a well-thought-out skincare routine can provide extra help in controlling excess oil and preventing breakouts. PCOS often leads to persistent acne due to increased sebum production, particularly around the lower face, jawline, and neck.

PCOS Skincare Routine

A gentle yet effective skincare routine is key to maintaining your skin's health without overactivating oil glands.

• Cleanse twice a day with a mild, oil-free cleanser. Look for products labeled "oil-free" to avoid clogging pores. Stay away from harsh scrubs or over-washing, as these can actually stimulate more oil production.
• Hydrate your skin with a lightweight, non-comedogenic moisturizer. Even oily skin needs hydration to maintain its balance.
• Protect your skin daily with a broad-spectrum sunscreen of at least SPF 30. Choose a non-greasy formula, especially since some acne treatments can make your skin more sensitive to UV rays.

Sticking to a consistent routine lays the groundwork for incorporating targeted treatments to further manage oil and acne.

Topical Treatments for Oily Skin

Certain ingredients are particularly effective in tackling excess oil and acne caused by PCOS. Here are some of the most commonly recommended:

• Salicylic Acid: Helps dissolve dead skin cells and unclog pores.
• Benzoyl Peroxide: Targets acne-causing bacteria.
• Retinoids: Promote skin renewal by breaking up blackheads and whiteheads while preventing clogged pores. These should only be used under the guidance of a dermatologist.
• Azelaic Acid: Reduces microorganisms on the skin and calms inflammation.

When introducing new products, it’s best to add one at a time. This approach helps you identify what works for your skin while minimizing irritation.

If these over-the-counter options don’t provide enough relief, prescription treatments might be necessary.

Prescription Skincare Options

For more stubborn cases, a healthcare provider may recommend stronger, prescription-grade topical treatments. Prescription retinoids, for instance, can further enhance skin renewal and help manage persistent acne, but they should always be used under medical supervision.

For a personalized skincare plan, consulting a specialist is highly recommended. Services like Oana Health connect you with licensed medical professionals who specialize in PCOS. They can provide tailored skincare advice and even deliver prescription treatments directly to your home, ensuring comprehensive and convenient care.

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Medical Treatments for DHT Control

When lifestyle adjustments and skincare routines fall short in managing oily skin linked to elevated DHT levels, medical treatments can step in to provide more targeted solutions. These prescription options focus on addressing the hormonal imbalances that drive excess oil production, particularly in women with PCOS. Below, we explore specific treatments designed to tackle these imbalances.

Prescription Medications for Androgen Control

Several prescription medications are available to help lower DHT levels and manage androgen-driven skin issues. Spironolactone is a commonly prescribed option that effectively addresses hormonal imbalances associated with PCOS. Another approach involves oral contraceptives with anti-androgenic properties, which can regulate hormone production and reduce oiliness when prescribed and monitored by a healthcare provider.

For more severe cases, medications like finasteride or dutasteride might be considered. Finasteride can block around 70% of DHT production, while dutasteride can inhibit up to 90%. However, these medications are typically not first-line treatments for women due to potential risks during pregnancy. Additionally, topical DHT blockers, such as topical finasteride, have been studied for their ability to reduce scalp DHT levels without significantly impacting systemic levels.

Treating Insulin Resistance to Lower Androgens

Addressing insulin resistance plays a crucial role in managing DHT levels over the long term. Insulin resistance affects 65–70% of women with PCOS, and elevated insulin levels can exacerbate symptoms by increasing testosterone production. This, in turn, raises androgen levels, worsening skin issues.

Metformin, a commonly used medication for insulin resistance, and inositol supplements are effective in improving insulin sensitivity and reducing androgen levels. These treatments are particularly helpful for women who experience acne breakouts around the jawline, chin, and upper neck.

High insulin levels can also elevate insulin-like growth factor-1 (IGF-1), which promotes skin cell growth and may lead to skin tags or discoloration. By treating insulin resistance, women can achieve better skin health and improved control over oil production.

Telehealth Treatment Options

For women seeking convenient and personalized care, Oana Health provides comprehensive telehealth services tailored to those with PCOS and hormonal imbalances. Their licensed medical professionals offer science-backed treatments that address the root causes of oily skin and other PCOS-related symptoms.

Through Oana Health’s platform, women can access treatments like spironolactone starting at $14 per month or topical spironolactone for localized treatment at $43 per month. For managing insulin resistance, they offer oral metformin starting at $22 per month, or a combination of metformin and spironolactone for $32 per month.

Telehealth adds a layer of convenience by delivering medications directly to your doorstep with free shipping, eliminating the hassle of pharmacy visits. Each treatment is prescribed by licensed professionals who review your health history to ensure safety and effectiveness. This personalized approach is key to managing the complex hormonal dynamics of PCOS and maintaining skin health. The telehealth model also allows for continuous monitoring, ensuring that your care plan evolves as needed for optimal results.

Tracking Progress and Getting Professional Help

Managing oily skin and DHT levels effectively requires consistent monitoring and knowing when to turn to experts for help. Keeping track of your progress can reveal patterns, measure how well treatments are working, and signal when professional intervention might be needed.

How to Track Skin and Hormone Changes

Start by documenting daily changes in your skin - like oiliness, blemishes, and specific areas affected. For women, tracking your menstrual cycle can also provide valuable insights into hormonal fluctuations. Many women with PCOS notice their skin becomes oilier during certain phases of their cycle, and understanding these patterns can guide treatment decisions.

There are tools that make tracking easier and more precise. The Mira Hormone Monitor helps track hormonal changes and offers insights that can shape your treatment plan. Another option is DERMSCORE™, which uses AI-powered mobile technology to analyze skin issues like pimples, blackheads, and discoloration caused by hyperpigmentation.

It’s also helpful to note other factors, such as weight changes, energy levels, mood shifts, and hair growth patterns. These details can reveal connections between symptoms and the effectiveness of treatments. If you notice no improvement or worsening symptoms after consistent tracking, it’s time to consult a professional.

When to See a Healthcare Provider

Tracking your progress is an essential part of evaluating how well your lifestyle changes and treatments are working. If you’re dealing with persistent hormonal symptoms - like irregular periods, excessive hair growth, oily skin, or acne - that don’t improve after 3–4 months of treatment, or if symptoms worsen significantly, it’s crucial to reach out to a healthcare provider.

PCOS affects up to 15% of females of reproductive age. Skin and hair issues are often the most visible signs of PCOS and are frequently what prompt people to seek medical advice. These are not just cosmetic concerns - they signal underlying hormonal imbalances that require professional care.

Telehealth Support Benefits

For those who find it challenging to visit a doctor’s office, telehealth provides a convenient and efficient alternative. Services like Oana Health offer personalized care through regular virtual check-ins and home delivery of medications, ensuring consistent treatment and timely adjustments.

Telehealth is particularly useful for monitoring progress over time. With regular virtual appointments, healthcare providers can review your symptom journals, assess how well treatments are working, and make necessary adjustments - all without requiring an in-person visit. This approach makes it easier to stay on top of your care while accommodating a busy schedule.

One of the key advantages of telehealth is its flexibility. As your symptoms evolve - whether your skin improves or new concerns arise - providers can adjust your prescriptions, recommend additional treatments, or modify your care plan to suit your current needs. This dynamic approach ensures your treatment stays aligned with your progress.

Additionally, telehealth services often include educational support to help you understand how lifestyle factors, stress, and other variables impact your DHT levels and skin condition. This knowledge empowers you to make informed decisions while benefiting from professional guidance to achieve the best possible results.

Conclusion: Managing DHT for Better Skin Health

Taking control of oily skin and elevated DHT levels in PCOS requires a thoughtful mix of lifestyle changes, proper skincare, and medical treatments. This comprehensive approach ties back to earlier strategies for managing PCOS, emphasizing that with the right plan, healthier skin and improved overall well-being are achievable.

Start with the basics: a balanced, anti-inflammatory diet, consistent exercise, and stress management through mindfulness practices and adequate sleep. Pair these with a gentle, non-comedogenic skincare routine to help regulate oil production and reduce inflammation. It's worth noting that 30 to 40 percent of women with PCOS deal with acne, so if you're facing this challenge, you're far from alone.

When lifestyle adjustments aren't enough, medical treatments can provide targeted solutions. Options like prescription medications to manage androgen levels or therapies addressing insulin resistance can make a significant difference.

"If you are diagnosed with polycystic ovary syndrome, it doesn't mean that you are destined to have poor health. There is a lot you can do to take charge, minimize symptoms and keep yourself healthy."
– Amanda Stathos, M.S., R.D., L.D.N.

Personalized care is essential because PCOS symptoms and hormonal imbalances vary widely from person to person. A tailored plan that addresses your specific needs offers the best chance for success, especially when supported by regular follow-ups and adjustments.

For added convenience, telehealth platforms like Oana Health provide science-backed treatments delivered right to your doorstep. These services ensure timely support and expert care that fits seamlessly into your routine, helping you stay on top of your hormonal health.

FAQs

How does insulin resistance increase DHT levels in women with PCOS?

Insulin resistance, often associated with PCOS, leads to elevated insulin levels in the body. These higher insulin levels can overstimulate the ovaries, prompting them to produce more androgens, including DHT (dihydrotestosterone). This hormonal shift is frequently linked to symptoms like oily skin, acne, and hair thinning.

Taking steps to manage insulin resistance - whether through lifestyle adjustments, medications, or specific treatments - can help lower DHT levels and support better skin health. For tailored guidance, it’s a good idea to consult a healthcare provider who focuses on PCOS and hormonal health.

What dietary changes can help reduce DHT levels and control oily skin in women with PCOS?

To manage oily skin caused by PCOS and reduce DHT levels, focusing on a diet that supports hormone balance can make a big difference. Include foods that naturally help lower DHT production, like green tea, pumpkin seeds, flax seeds, edamame, fatty fish, and lycopene-packed options such as tomatoes, watermelons, and carrots.

An anti-inflammatory diet can also play a big role in improving skin health and maintaining hormonal balance. Opt for high-fiber foods, lean proteins, and healthy fats like avocado and olive oil. On the flip side, steer clear of processed foods, refined sugars, and trans fats, as these can trigger inflammation and throw hormones out of sync. Simple adjustments like these can help improve your skin and overall health.

When should someone with PCOS-related skin problems see a doctor?

If you’re managing PCOS and struggling with skin problems like severe acne, excessive oil production, or noticeable hair loss that don’t improve with store-bought products, it might be time to reach out to a healthcare provider. These issues could be linked to hormonal imbalances, such as high DHT levels, which often require specialized treatments to manage effectively.

It’s especially important to seek medical advice if these skin concerns are accompanied by other PCOS symptoms, like irregular menstrual cycles, sudden weight fluctuations, or other signs of hormonal shifts. A qualified medical professional can pinpoint the underlying cause and suggest treatments tailored to your specific needs. For women in the U.S., telehealth platforms like Oana Health provide convenient, evidence-based care that’s delivered straight to your doorstep.

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