Can myo-inositol help clear my acne? The science so far

Can myo-inositol help clear my acne?

This is a sponsored post in collaboration with Nature’s Best

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age,1 and is estimated to affect around one in ten women within this group.2

Among the side effects women may experience is acne, which is generally a feature of hyperandrogenism:3 when women have excess levels of androgen hormones, such as testosterone, inside their bodies. Androgen hormones can also be called ‘male’ hormones because they contribute to the presentation of ‘male’ traits and reproductive function.

Excess androgen is considered one of the three main features of PCOS, along with irregular periods and polycystic ovaries: when your ovaries become enlarged and may contain fluid-filled sacs that surround the eggs.4

It can be emotionally distressing to experience acne, particularly when you’re unsure what you can do to remedy it. Myo-inositol is a natural carbohydrate that is found in plants, animals, and the human body and has been studied for its impacts on PCOS symptoms. But can it help with acne?

How does myo-inositol work?

Myo-inositol is a type of inositol, which is a B-group vitamin that has the same molecular formula as glucose. Inositols work as part of a messaging pathway for many hormones, including insulin and follicle-stimulating hormone (FSH): a hormone essential to ovary function. When there are problems along these pathways, it can lead to insulin resistance, which is when your body is unable to break down the glucose that enters the blood so produces more insulin to compensate. Inositol is thought to aid in managing PCOS by strengthening these pathways, and thus reducing insulin resistance.5

The relationship between insulin, PCOS, and hyperandrogenism is still an active area of research and investigation

Most women with PCOS have insulin resistance,6 which can cause the ovaries to produce androgen hormones.7 There has been growing evidence in the last 20 years to support the idea that defects in insulin actions, or insulin-signalling pathways, are central to the development of PCOS,8 however, not all women with PCOS have insulin resistance. The relationship between insulin, PCOS, and hyperandrogenism is still an active area of research and investigation.

How is acne treated?

While there are pharmacological treatments available to treat acne — for example, topical creams, oral antibiotics, and anti-androgens — there are also methods that address hormone balance and function.

It is important that you speak with your doctor before embarking on any type of treatment. NICE guidelines acknowledge that topical treatment may be ineffective for some people and outline a range of different ways a doctor might approach your treatment plan.9 Acne can vary in severity, while treatment may include dietary interventions and techniques to manage scarring, depending on the patient.

Can myo-inositol help?

There is considerable research investigating the effects of inositol within PCOS treatment plans, with many researchers generally finding it to be useful in improving the regularity of the menstrual cycle, acne, and insulin resistance.10,11

In a 2009 study of 50 patients, participants received six months of myo-inositol therapy and saw a reduction in testosterone and insulin levels within three months.12 Both hirsutism — also a symptom of hyperandrogenism, describing excess hair growth on parts of the body where it doesn’t usually, or barely, grow — and acne decreased after the six month period.13 A 2017 review of nine pre-November 2016 randomised controlled trials investigating the impacts of myo-inositol on PCOS notes that for acne to see improvement from myo-inositol treatment, at least six months of supplementation is required.14

While inositol has generally been shown to have a positive impact on women with PCOS, it should not be considered a ‘catch-all’ or blanket solution for acne

Another 2017 study considered 50 patients who had been prescribed 2 grams of inositol twice a day, for six months, against 50 patients prescribed 2 grams of placebo twice a day, for six months.15 Patients who were prescribed inositol showed a marked improvement in skin, while only two patients in the placebo group showed an improvement. Inositol was found to improve the clinical condition of skin by reducing hyperandrogenism in women with moderate acne, and is nominated as a useful adjunct therapy for women with both PCOS and acne16 — that is, as part of a wider treatment plan.

Similarly, 137 women with PCOS were given 6 months of therapy with both myo-inositol and another type of inositol, D-chiro inositol, and showed improvement in the regularity of their menstrual cycle, acne, and insulin resistance.17 Researchers note that further examination over a longer period of treatment is needed.

However, not all studies investigating the impacts of inositol on PCOS showed an improvement in acne. A 2016 study of 50 women with PCOS and insulin resistance and/or hyperinsulinemia compared the impacts of metformin — a drug that helps lower blood glucose levels — and myo-inositol. Insulin sensitivity improved in both groups, BMI decreased, and the menstrual cycle was normalised in about 50% of women, however no significant changes in acne were observed.18 This suggests that while myo-inositol may indeed benefit many women who experience acne and PCOS, there may be other factors at play that define the role it is able to play in managing their acne.

Finding the right treatment for you

While inositol has generally been shown to have a positive impact on women with PCOS, it should not be considered a ‘catch-all’ or blanket solution for acne, or any other symptoms experienced. PCOS is a complex condition and can present in different ways: not all women with PCOS experience insulin resistance and may experience both insulin resistance and hyperandrogenism to varying degrees of severity. However, inositol is generally considered a safe treatment choice for managing PCOS symptoms.19

When you seek treatment for your PCOS symptoms, your doctor should consider the complete picture of all the symptoms you are experiencing, and how each of them interplay to impact your quality of life. For example, they may suggest lifestyle interventions, including dietary changes, alongside any medication or supplementation.

Featured image is a close-up of a woman’s eye and the skin surrounding it. She appears to have oily skin on her forehead. The image features a pattern of squiggly lines to indicate movement on and around the skin

References

1. Formusco, C., et al., Myo-inositol vs D-chiro inositol in PCOS treatment, Minerva Ginecologia, February 2015, vol 67, issue 4, pp 321-325

2. Dunaif, A., and Book, C.B., Insulin resistance in the polycystic ovary syndrome, Clinical research in diabetes and obesity, Humana Press, Totowa NJ, pp 249-274

3. Archer, J.S., and Chang, R.J., Hirsutism and acne in polycystic ovary syndrome, Best practice & research clinical obstetrics & gynaecology, October 2004, vol 18, issue 5, pp 737-754

4. NHS Choices, Polycystic ovary syndrome, NHS website, last reviewed February 2019

5. Kalra, B., et al., The inositols and polycystic ovary syndrome, Indian Journal of Endocrinology and Metabolism, 2016, vol 20, issue 5, pp 720-724

6. Goyal, M. & Dawood, A.S., Debates regarding lean patients with polycystic ovary syndrome: a narrative review, Journal of Human Reproductive Sciences, 2017, vol 10 (3) pp 154-161

7. Kalra, B., et al., The inositols and polycystic ovary syndrome, Indian Journal of Endocrinology and Metabolism, 2016, vol 20, issue 5, pp 720-724

8. Baptiste, C.G., et al., Insulin and hyperandrogenism in women with polycystic ovary syndrome, The Journal of Steroid Biochemistry and Molecular Biology, October 2010, vol 122, issues 1-3, pp 42-52

9. NICE, Acne vulgaris, Scenario: Management of acne vulgaris in primary care, last revised April 2018, NICE website

10. Formusco, C., et al., Myo-inositol vs D-chiro inositol in PCOS treatment, Minerva Ginecologia, February 2015, vol 67, issue 4, pp 321-325

11. Zacchè, M.M, et al., Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome, Gynecological Endocrinology, 2009, vol 25, issue 8, pp 508-513

12. ibid

13. ibid

14. Unfer, V., et al., Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials, Endocrine Connections, 2017, vol 6, issue 8, pp 647-658

15. Pezza, M., and Carlomagno, V., Inositol in women suffering from acne and PCOS: a randomized study, Global Dermatology, 2017, vol 4, issue 1, pp 1-4

16. ibid

17. Formusco, C., et al., Myo-inositol vs D-chiro inositol in PCOS treatment, Minerva Ginecologia, February 2015, vol 67, issue 4, pp 321-325

18. Fruzzetti, F., et al., Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS), Gynecological Endocrinology, 2017, vol 33, issue 1, pp 39-42

19. Zacchè, M.M, et al., Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome, Gynecological Endocrinology, 2009, vol 25, issue 8, pp 508-513

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