Hormonal disorders and acne severity in women aged 18–50: the role of PCOS and insulin resistance

Abstract

Background. Acne in young and adult women is a chronic hormonal-metabolic dermatosis that significantly impairs self-esteem and quality of life, owing to its predominantly facial distribution.Aim. To assess the relationship between selected endocrine disorders — polycystic ovary syndrome (PCOS), insulin resistance, hyperandrogenism, and thyroid disease — and acne severity in women aged 18–50, and to evaluate patients' subjective skin assessments and the outcomes of hormonal treatment.Material and methods. One hundred women aged 18–50 with self-reported skin problems completed an original online questionnaire covering sociodemographic data, diagnosed endocrine disorders, acne characteristics, skin hydration and sebum secretion, and the perceived effect of hormonal treatment. Statistical analysis was performed using the chi-square test (p < 0.05).Results. Hormonal disorders were identified in 63% of participants, most commonly PCOS and insulin resistance (21% each). Acne was reported by 79% of women; moderate-to-severe disease predominated in those with hyperandrogenism (91.7%), PCOS (78.3%), and insulin resistance (72%; χ² = 133.84; p = 0.0019). No significant association was found between hormonal disorders and skin hydration or sebum secretion. Women receiving hormonal treatment more frequently reported skin improvement than untreated women (50% vs. 27.4%; χ² = 14.64; p = 0.0055).Conclusions. Acne in adult women is strongly linked to endocrine disturbances — particularly PCOS and insulin resistance — underscoring the need for hormonal-metabolic work-up in patients with moderate-to-severe disease and for a holistic therapeutic approach that addresses both systemic causes and psychosocial burden.