Polycystic Ovary Syndrome-Associated Acne: The Interplay of Hyperandrogenism, Insulin Resistance, and Therapeutic Strategies

This narrative review explores the connection between polycystic ovary syndrome (PCOS) and acne, highlighting the roles of hyperandrogenism and insulin resistance (IR) in the condition. PCOS, prevalent among women of reproductive age, often presents with acne due to increased androgen levels and IR, which enhance sebum production and follicular changes. The review emphasizes the Rotterdam diagnostic criteria for PCOS and discusses the pathophysiology involving hormonal imbalances. It also considers genetic, environmental, and microbiome factors influencing the PCOS-acne phenotype. Management strategies include combined oral contraceptives, spironolactone, and metformin to address IR, alongside standard acne treatments. The review suggests that integrating therapies targeting androgens and IR with acne care offers effective control, and calls for further research into phenotype-specific treatments and the role of environmental and cellular stressors.