It’s Not Just Acne

One of the common complaints I often encounter has to do with pimples. Everybody’s been there. You wake up on some random morning and, BAM! It’s literally right on your nose. You have to go to work with that thing, or give a big presentation, or go on a date, or worse. I remember my adolescence and remember the bane that was acne. My mother would tell me it was all that greasy food I would eat. I would look at her, thinking, I didn’t smear the pizza on my forehead! The one silver lining about getting older is that you usually outgrow acne.  

The acne complaints I get range in variety, from pimples on the face, to pimples on the ass and everywhere in between. In the majority of cases, its a pretty straight forward fix, from using an antibiotic to cleansers. They can also be difficult to treat in some cases, as it may not just be a simple case of acne. So when is acne more than just acne? 

Angela was a twenty four year old female that decided to come in and see me for her wellness visit. It was her first visit, and really didn’t really know what to expect. After going over her medical history and ordering her blood work, I asked her if she had any other concerns about her health. “Well, I am a little embarrassed about my acne, and I was wondering if there was anything more I can do about it.” She was a little overweight, Hispanic, and had some moderate acne along her brow and cheeks. She also had some mild facial hair around her ears. Upon further questioning, she also mentioned that she was somewhat irregular with her periods, that started about ten years ago, and had never been pregnant, even though she was fairly active with her boyfriend, who was inconsistent with the condom use. Her periods were heavy at times and she was really never regular from what she could remember. She had never had a Pap smear. 

It turned out that Angela had polycystic ovarian syndrome, or PCOS, which is a hormonal disorder that is characterized by irregular periods. Her acne and facial hair was a symptom related to an elevation in her androgen hormones. The reason as to why people develop PCOS is not well understood, but a genetic predisposition seems to be part of its inception. The increase in androgen levels may lead to the formation of multiple cysts on the ovaries, hence polycystic ovarian syndrome. 

Needless to say, PCOS is not a great thing to have. The good news, however, is that the consequences of PCOS are largely within the patient’s control. It starts with a healthy body weight. Usually, maintaining a healthy body weight can limit the impact of this disease’s progress. PCOS has an association to diabetes, metabolic syndrome, sleep apnea, dysfunctional uterine bleeding, liver disease, infertility, endometrial cancer, mood disorders, and eating disorders. These secondary associations are usually offset by keeping a healthy body weight and eating a balanced, healthy diet. Other treatments include possible medications, but diet is key to control. 

So, maybe in the end, my mother was right after all. Greasy food can lead to pimples, and possibly much worse, like PCOS. One out of ten women are affected by PCOS, but not everyone gets diagnosed. Talk to your doctor if you have concerns.

By: Dr. Juan Borja
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