the ins and outs of pcos and acne

pcos, or polycystic ovarian syndrome, is complicated. it’s an endocrine condition that affects 8-20% of women of reproductive age worldwide1 and it is characterized by at least two of the following three symptoms: cysts on the ovaries, elevated male sex hormones and/or absent or irregular periods. pcos is a highly misunderstood condition whose symptoms manifest differently among women. many women with pcos gain weight while others have thin body types, some have acne and regular periods while other haven’t menstruated in months. because almost all women with pcos test high in androgens (male sex hormones), many symptoms include infertility, male-pattern hair loss, oily skin and acne along the jawline, and facial hair growth. these symptoms can be frustrating to deal with because they are persistent and can often make women feel like they have no control over their bodies. but these symptoms appear for a reason. and usually that reason is that our bodies are chronically stressed and something about our lifestyles needs to change. women with pcos are at increased risk for developing type 2 diabetes, hypothyroidism and cardiovascular disease, so acknowledging these signals from our bodies is key to keeping ourselves healthy for a lifetime. 

 

what causes pcos? 

  • genetics – while pcos is not a genetic condition, per se, predisposition to pcos can be passed down through generations. those who are exposed to higher androgens by their mothers while in the womb are also at greater risk of contracting pcos later in life.

  • stress – both physical and emotional stressors can contribute to pcos. some examples of physical stressors include over-exercising, eating foods you are intolerant to, not eating enough and constant blood sugar issues. many women who suffer from pcos are stressed to the max in their everyday lives – they take on extra work at their jobs, juggle familial responsibilities, endure harrowing breakups and family stress and then often criticize themselves for not working or trying hard enough.

  • blood sugar imbalances – this is one of the most common root causes of pcos and often stems from excessive intake of refined sugars and carbs, or the standard american diet. it often leads to weight gain and involves chronically elevated blood sugar. these blood sugar imbalances cause systemic inflammation in the body and directly influence the production of testosterone, which then inhibits ovulation and fertility.

  • over-exercising and under-eating – our society places a tremendous amount of pressure on women to look a certain way. many women internalize the pressure to be thin and spend years of their lives under-eating while engaging in excessive (usually cardio) exercise. high-intensity exercise always causes testosterone spikes, but they are usually temporary, subsiding when we refuel our bodies with calories. but when women exercise for too long without replenishing their energy stores, their hormone balance starts to suffer.

dealing with facial hair growth and acne

if you struggle with facial hair growth, you are not alone. this can be particularly frustrating if it accompanies hormonal acne – they often show up in exactly the same places along the jawline and chin. because of the cultural expectation that women maintain hairless faces, this type of hair growth can be embarrassing – but there is absolutely nothing wrong with you, there is no reason to feel shame, and there is no reason for you to change in order to appease the people in your life. having pcos is hard enough without having to navigate gendered cultural expectations.

if you are a client here at sS and you to decide to undergo laser hair removal or electrolysis, we just ask that you wait at least two weeks between those treatments and our acne face treatments – we don’t want to stress your skin out too much! if you have hair on your face that you want to remove by shaving, try the tinkle razor, which we sell in the clinic. these razors are more gentle than conventional razors. as for waxing, we don’t recommend it! the heat can be irritating to the skin and who knows what kinds of comedogenic ingredients are lurking in those waxes! 

if your doctor diagnoses you with pcos, they will most likely send you home with a prescription for one or both of two medications: metformin for insulin regulation and spironolactone for decreasing testosterone levels. it is entirely up to you whether you decide to take these medications or not, and whatever your decision, here are a few herbal, dietary and lifestyle changes to implement to keep pcos symptoms under control (and, as always, ask your doctor before making any major changes to your health plan):

  • two cups of spearmint tea each day has been shown to reduce free testosterone levels in women with pcos and has resulted in reduced hirsutism with none of the side effects of pharmaceutical-grade drugs.2 

  • 400mg of saw palmetto, a plant native to the americas, has been found to inhibit the 5-alpha reductase enzyme. the inhibition of this enzyme helps reduce the conversion of testosterone to dht, which is the male sex hormone that leads to oily skin, hair loss, acne and facial hair growth.3

  • balance out your blood sugar by reducing your consumption of refined sugars and carbohydrates – ditch the morning cereals for eggs and greens; instead of a sandwich at lunch, try a salad with tuna or grilled chicken. and pasta for dinner? no way! zucchini noodles will do the trick. eat plenty of good fats and protein and aim for three square meals a day to get your blood sugar on track and to give your digestion a break.4 and supplementing with chromium picolinate has been shown to decrease insulin resistance in women with pcos.5

  • dial in your digestion. take a test to determine any foods you might not tolerate or try an elimination diet to get to the bottom of any digestive woes. this is hugely important because digestive distress is another physical stressor on the body that can ultimately contribute to elevated cortisol and testosterone levels. similarly, make sure your elimination is on track – we flush excess hormones out of the body through our stool, so eat your fiber!

  • practice stress management. this is absolutely huge. take up meditation, improve your time-management skills, see a therapist to work through emotional stress, start a gratitude journal – do what you can to reduce chronic stress in your life as this is often the root cause of pcos.

  • cut the coffee. this is a double whammy – not only does coffee contribute to acne, but it also elevates cortisol levels and contributes to systemic inflammation. instead, try green tea, which has a healing effect on the skin due to its high anti-oxidant polyphenol content.

  • ease up on the exercise. instead of intensive cardio like running or hiit several days a week, switch these out for yoga, walking or light swimming. this will give your adrenal glands a break and will allow your body to more readily recover from stress. 

  • sleep. give your body a chance to do its healing work by getting a solid eight hours of restful and uninterrupted sleep each night. try to make this a priority – this can have a huge impact on the health of our hormones!

  • find a support group near you to work through your emotions around pcos. it’s a tough condition to deal with so finding support in different areas of your life can be a huge relief. 

 further reference:

8 steps to reverse your pcos by fiona mcculloch

paleo for women

pcos diva

pcos awareness association

soul cysters

footnotes

1. sirmans, s. m., pate, k. a. (2014). epidemiology, diagnosis, and management of polycystic ovary syndrome. clinical epidemiology. 6, 1–13.

2. grant, p. & ramasamy, s. (2012) an update on plant derived anti-androgens. international journal of endocrinology metabolism. 2012 Spring; 10(2): 497–502.
3. hudson, t. (2008) polycystic ovarian syndrome (pcos). dec 8, 2008.
4. liepa, g.u., sengupta, a & karsies, d. (2008) polycystic ovary syndrome (pcos) and other androgen excess-related conditions: can changes in dietary intake make a difference? nutrition in clinical practice. 2008 Feb; 23(1):63-71.
5. rabinovitz, h., et al. (2004) effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. international journal for vitamin and nutrition research. 2004 May; 74(3):178-82.

product replacement alert: new face sunscreen!

ch-ch-ch-ch-changes! as kim mentioned in an earlier blog post, we are switching things up in the realms of serums and sunscreens. we are working with a new manufacturer that is more aligned with our values as a small business and along with a few other items, we have replaced our superlight spf15 moving forward with a new sunscreen.

we are thrilled to announce that we will now be stocking a face sunscreen from the miami-based company, beyond complexion, whose owner, olga valencia, worked closely with our beloved dr. fulton (the author of the acne bible, acne rx). olga has done extensive research on comedogenicity and has closely monitored the efficacy of her products for years through direct client interaction at her miami skin clinic.

beyond complexion’s daily facial moisturizer with spf30 is wonderfully lightweight and it offers more protection for longer periods of time while keeping your skin moisturized and healthy. it’s also perfect for helping prevent and reduce hyperpigmentation and redness. the combination of aloe and plant botanicals in this formula help nourish the skin while protecting it from uva and uvb rays. plus, it’s got double the spf of superlight, which means tons more protection!

as always, we’d love to hear your feedback! let us know what you think about the new beyond complexion sunscreen by emailing us at frontdesk@skinsalvationsf.com. thanks for your patience while we determine our next steps with our products!

how to be a happy acne-safe camper (plus tips for burning man)

so you wanna be an acne-safe camper, eh? you’ve come to the right place! camping season is well under way here in the bay area. with burning man just around the corner, it’s time for an updated guide to experiencing the wilderness in an acne-safe fashion. i just got back from a week-long camping and backpacking adventure in the glorious yosemite backcountry, where i didn’t let my acne-safe lifestyle ruin my fun. experiencing the bountiful nature that california has to offer is one of the many privileges of living in the bay area, but there’s no need to derail all of the hard work you’ve put into achieving clear skin just for a few days off the grid. here are some essential acne-safe camping tips from a pro backpacker!

camping in the summer heat is a perfect excuse to ice your face. it’s cool, it’s refreshing and once others see how much fun you’re having, they’ll want to join right in. since it’s not always practical to travel with your sS ice pop, we recommend bringing plenty of clean ziplock bags, putting fresh ice directly inside and then placing them in your cooler. when you’re ready to ice, pop out some clean ice cubes and go to town, inflammation be damned!

plan your meals. seriously. just do it. here is a sample meal plan from my last camping trip. planning your meals ahead of time ensures that you bring exactly enough food for the number of days you’ll be camping so you won’t go hungry and you won’t have an excuse to eat a ton of dairy and soy. bring acne-safe packaged foods that don’t need a ton of preparation – epic bars for protein, trail mix for good fat, hard boiled eggs, low-sugar fruit and cans of sardines (truly). and yes, you can enjoy some soy-free smores around the campfire at night, too.

greet the day with some fresh herbal or black tea. revel in your body’s chance to reset its circadian rhythms to match the cycles of the sun and moon.

bathe in the refreshing waters of nearby lakes and streams. this is a great way to reset if you’re feeling like your hygiene game is suffering. you can rinse away any dirt or dust and follow up your dip with a swipe of some sS hydrating toner and sunscreen.

and don’t forgot your product essentials. pick ’em up from the sS clinic before you begin your camping adventures:

  1. for sun protection, along with layers and a hat, we recommend amping up your spf by using sS safeguard spf40 for your face and goddess garden sunscreen for your body. their sport line is water resistant up to 80 minutes and is completely biodegradable so you can splash around in some cool alpine lakes with nary a worry. don’t forget to protect those luscious lips with our lip balm and reapply as needed. always seek shade when possible and get yourself a good pair of sunglasses.
  2. if you’ve been out hiking all day and anticipate sore muscles the next morning, pop a magnesium pill or two before bed. this will ease any bodily tension and help you sleep peacefully.
  3. if you’re worried about mosquitoes, grab some greener ways bug spray, an organic and safe alternative to deet and picaridin.
  4. if you won’t have access to clean water for bathing, bring along our hydrating or sterilizing toners and some toner pads to freshen up throughout the day. if you’re on the road and don’t have access to these products, yes to cucumbers face wipes will work in a pinch.
  5. feeling like your hair is melting into a colossal oil slick? bring along a homemade arrowroot starch dry shampoo in a small jar to apply as often as necessary. combine 1/4 cup arrowroot starch with 5 drops of essential oil of your choice (lavender, cedarwood, etc) and store in an airtight jar for the duration of your trip. for dark hair, combine 2 tablespoons arrowroot plus 2 tablespoons cacao powder with the essential oils. experiment and find what works for you!1

 

but what about burning man? the dusty environment of “la playa” is an entirely different ballpark from heading out onto the foggy, fragrant trails of marin with a few friends. so here are some burning man-specific tips and tricks to stay acne safe.

  1. stay hydrated internally and externally. bring at least a gallon of water per person per day and hydrate your skin frequently with sS hydrating cream to combat the dusty dry landscape. bring along some rosewater hydrosol and spritz your face all throughout the day. and don’t forget to ice your face!
  2. stay sun-safe. bring several hats – you don’t want to be caught in the desert without one! reapply safeguard spf40 sunscreen and sS lip balm often and bring some acne-safe aloe just in case you burn.
  3. deal with the dust. bring sunflower oil in a tiny jar to dab in your nostrils and to moisturize your feet at night – you can avoid “playa foot” by keeping all nooks and crannies of your skin moisturized constantly. wear gloves and goggles to avoid getting too dusty and dirty, and bring a few bandanas as protection when the wind picks up.
  4. stay clean. since you probably won’t have access to a shower (unless you have a very kind neighbor with a solar shower), bring an extra tub to fill with water for makeshift “showers” and foot baths. bring some sS hydrating toner with toner pads to freshen up throughout the day.
  5. plan out your meals ahead of time so you only bring what you need. bring snacks and food that need little preparation and pack your cooler full of acne-safe food so you aren’t tempted to snag a bite of your friend’s dairy-filled lunch.
  6. sleep well. if you’re a light sleeper, pack some ear plugs to drown out the rowdy campers. pack extra pillow cases to switch out over the course of the week and bring layers for the nighttime temperature drop
  7. most importantly, relax, enjoy the festivities, and have a good time! plan to come in for a treatment 7-10 days after you get back so your skin has a chance to heal from the sun exposure.

how do you enjoy nature while staying acne-safe? 

footnotes

1. dry shampoo recipe adapted from mommypotamus

acne-safe hand soap back in stock!

many of you have been awaiting our beloved aloe80 hand soap to return to the shop, and great news, it has arrived!

a few things to know:

  • it’s the same amazing formula from lily of the desert with new and improved packaging! you may not recognize it because the package used to say “aloe80”, now it just says “liquid soap”.

 

  • its aloe based so it won’t dry out your hands, (remember your hands and your neck tend to show signs of aging first!)
  • acne safe ingredients, so you don’t have to worry about cloggy residue transferring to your face or body after to clean your hands!
  • pick it up any day in the shop or our online store!

 

Emily long-time sS client turned front of house cutie showing off the new goods!

 

 

product discontinuation alert:

by: kerry watson
 
after many years of carrying reviva stretch mark lotion, we will be discontinuing and no longer recommending this product as an acne safe option. the company has reformulated the product to now include a highly comedogenic ingredient, cocoa butter. if you have this product at home please read the ingredient list to make sure that your bottle does not contain this ingredient. you can use the following non-comdeogenic products in place of this product:
 
– organic safflower oil
– organic sunflower oil
– pure shea butter
 
about our acne-safety testing process:
 

finding acne-safe products is a very painstaking and time consuming process.  we carefully shop for products with acne-safe ingredient listings, and then test them in-house for at least 6 months on skins that are already clear, and on people who are religiously living the acne-safe lifestyle, so that we can isolate any new breakouts to that one variable – the product he/she is testing.