My top five natural supplements for hormonal acne with PCOS are inositol, zinc, reishi mushroom, saw palmetto and white peony. The main cause of hormonal acne is excess androgens and poor blood sugar management, so natural treatment aims at restoring balance to these two key areas.
I spent much of my 20s dealing with hormonal acne, so I fully understand the confidence-crushing effect that adult acne creates. Acne that continues after adolescence, flares up in the week before your period or decides to grace you with its presence after you come off hormonal birth control is a sign of a hormonal imbalance. With PCOS, now also called PMOS, the most common hormone imbalance leading to acne is excess testosterone or androgens.
The PCOS/PMOS acne supplement evidence at a glance
Inositol balances your blood sugar and insulin, so your ovaries make less testosterone. Zinc kills the bacteria in your skin that are responsible for acne, reduces inflammation and supports skin healing and repair. Reishi mushroom and saw palmetto inhibit an enzyme known as 5-alpha reductase, which converts testosterone to a much more potent form called dihydrotestosterone (DHT). White peony has a long history in Traditional Chinese Medicine for acne and androgen levels, and it has anti-inflammatory effects.
A 2025 review identified seven studies of supplements that measured acne in women with PCOS. Among them, acne improved with berberine, selenium and chromium, which I cover below, and in a study of 96 women it improved on a combination of alpha-lipoic acid, N-acetylcysteine, vitamin B6 and SAMe, as it did on the pill (Pingarrón Santofímia et al. 2023).
Where I start with hormonal acne
Take an androgen-blocking supplement every day, with inositol alongside it. My favourite natural androgen blockers are saw palmetto, reishi, stinging nettle, zinc, green tea extract and white peony, and I have used a combination of them with my clients for many years and seen dramatic improvements to stubborn acne. This is the third daily ritual of my Anti-Androgen Plan, the one for faster results, alongside two cups of spearmint tea and a high-protein PCOS Repair Breakfast. The herbs among these blockers are not for pregnancy, breastfeeding or trying to conceive, when inositol on its own is my choice.
The benefits are incredible, but realistically that is way too many vitamins to take, and it can be time-consuming and quite expensive to track down and buy several of these in top-quality forms. My clients got sick of taking handfuls of pills each day, so I created AndroEase Plus, a daily androgen support blend that helps with hormonal acne, with saw palmetto, reishi, nettle, green tea, zinc and copper all in one convenient daily dose. Leave AndroEase out if you are pregnant, breastfeeding or trying to conceive, when inositol is my choice instead, and check with your doctor first if you are on the pill or another regular medicine.
If your acne is severe, scarring or getting worse quickly, or it comes with fast-growing facial hair or a deepening voice, see your doctor before any natural approach.
If unwanted hair, thinning hair or irregular cycles come with your acne, my guide to reducing androgens in women naturally covers the whole Anti-Androgen Plan and the tests worth asking for.
Does inositol help with PCOS acne?
Yes. Inositol is a nutrient similar in structure to a B vitamin that helps to naturally regulate blood sugar by improving your sensitivity to insulin, so that your body doesn't need to create as much to have the same response. That matters for your skin, because imbalanced blood sugar causes your body to ramp up its insulin production, which triggers your ovaries to produce more testosterone, worsening adult acne.
In a trial of 72 women with PCOS, acne scores after six months were better with myo-inositol and D-chiro-inositol plus metformin than with metformin alone (Bahadur et al. 2021).
In a six-month study comparing myo-inositol, D-chiro-inositol and placebo in 137 women with PCOS and insulin resistance, both forms of inositol significantly improved acne scores (Formuso et al. 2015), and a study of 100 women comparing inositol with placebo reported improvement in acne (Pezza and Carlomagno 2017).
Its effect reaches your skin. In a 2026 study, 45 adults with inflammatory acne on the back, 15 of them women with PCOS, took myo-inositol and D-chiro-inositol for 12 weeks: 82% improved, and markers of insulin resistance fell in the acne-affected skin (Vaccaro et al. 2026).
And in 50 women with PCOS who took myo-inositol for six months, testosterone and insulin fell within the first three months, and acne and excess hair decreased by the end (Zacchè et al. 2009).
My Cycle Regulate formula has been created based on one of the most studied inositol ratios: 2,000 mg of myo-inositol and 50 mg of D-chiro-inositol a day (40:1 ratio). Inositol is generally considered safe while you are trying to conceive, pregnant or breastfeeding; if you are already pregnant, confirm it with your healthcare provider before you start.
What about zinc, omega-3, and vitamin D?
Zinc is one of my top five, omega-3 calms the inflammation in your skin, and vitamin D is worth testing, because low levels make insulin resistance and excess androgens worse.
Zinc: When it comes to acne, zinc naturally supports the function of your ovaries, which helps to decrease excessive production of androgens. It also inhibits 5-alpha reductase, so less of your testosterone becomes the potent DHT, and it reduces oil production and helps existing acne scars heal. It's an all-round winner when it comes to adult acne, and I go deeper in my article on zinc for PCOS.
Omega-3: It helps reduce acne by lowering inflammation in your skin. In a 10-week trial in people with mild to moderate acne, both inflammatory and non-inflammatory lesions decreased in the group taking omega-3 (Jung et al. 2014). Aim to enjoy oily fish like salmon, sardines and mackerel three to four times a week, or if you struggle to eat that much, take a high-quality omega-3 supplement. If you are pregnant, trying to conceive or breastfeeding, keep oily fish to two portions a week, because of the pollutants it can carry (NHS fish guidance).
Vitamin D: In one study, people with acne were twice as likely to be low in vitamin D as people without it, and the lower their level, the more inflammatory spots they had; in the 39 who were deficient, two months of vitamin D3 improved those spots (Lim et al. 2016). A blood test is the best way to check your level. If you aren't getting enough sunlight, you likely need around 2,000 to 4,000 IU a day just to maintain normal levels, and if you are deficient, at least 4,000 IU a day for a few months, at the dose your doctor suggests.
What about berberine, selenium or chromium?
Because inositol already covers what they would do for your skin: berberine and chromium work on your blood sugar and insulin, and inositol does that too while also helping regulate your androgens. Berberine and chromium have their place when Insulin-Resistant PCOS is your root cause. For selenium, just two to three Brazil nuts a day meet your needs, and eating more than that can easily put you at a toxic level.
A berberine phytosome, a form of berberine made easier to absorb, improved acne in a trial of 130 women with PCOS: after 90 days, acne had improved in 12 of the 51 who completed the course, against 5 of the 55 who took nothing (Di Pierro et al. 2023).
With selenium, acne decreased in 46.9% of women with PCOS over eight weeks, against 12.5% on placebo (Razavi et al. 2016), but the journal has since issued an expression of concern about the integrity of the study's methods, results and analysis (Razavi et al. 2016 concern record).
A chromium trial in women with PCOS reported acne decreasing in 20% of those taking chromium against 3.3% on placebo (Jamilian et al. 2016), and in 2020 Springer added a notice that its editors were investigating concerns about the integrity of the trial.
Spearmint and natural androgen blockers for acne
Spearmint tea and the natural androgen blockers work on acne through the androgens behind it. Spearmint (not peppermint) tea lowers androgens like testosterone: in a 30-day trial, free and total testosterone fell in women with PCOS who drank spearmint tea twice a day (Grant 2010). Your goal is two cups a day, hot, iced or in a smoothie. I sourced my Androgen Relief Tea as 100% certified organic loose-leaf spearmint; leave it out while you are pregnant or breastfeeding.
Reishi and saw palmetto work one step further along, by inhibiting 5-alpha reductase, the enzyme that makes DHT, and DHT causes significantly increased symptoms of androgen excess like hormonal acne and hair thinning. A testosterone blood test doesn't show how strongly this enzyme is working in your body, which is why your acne can be hormonal even when your testosterone comes back normal. Stinging nettle raises sex hormone binding globulin (SHBG), which mops up excess androgens in your blood, and white peony helps decrease excess androgen levels.
What causes hormonal acne?
Your skin health is a reflection of your internal health. Breakouts, particularly around your jawline, mouth and chin and those which worsen around the time of your period, often reflect an underlying hormonal imbalance which triggers your skin to produce excess sebum (skin oil). This excess oil clogs the pores on your face, leading to whiteheads, blackheads and cystic acne, just as in any other acne.
Your doctor or dermatologist may offer you treatments too. The 2024 American Academy of Dermatology guideline strongly recommends benzoyl peroxide, topical retinoids, topical antibiotics and oral doxycycline, and conditionally recommends options including azelaic acid, the pill and spironolactone, depending on the person (Reynolds et al. 2024).
Topical retinoids and spironolactone are not pregnancy options, so if you are pregnant or trying to conceive, choose your acne treatment with your obstetric clinician or dermatologist (AAD pregnancy guidance).
My top five give you relief from your acne while we dig deeper and heal your root cause, and once that is reversed, your body will stop over-producing androgens. My free root cause quiz tells you whether Insulin-Resistant, Adrenal, Post-Pill or Inflammatory PCOS is behind your acne, and The PCOS Repair Protocol walks you through treating it.
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