Are endometriosis and acne related? Here’s what we know

Endometriosis is a painful chronic condition that affects millions of people worldwide. And as if that weren’t enough, endometriosis and acne may be linked. 

We’re here to explain the effects of endometriosis, its possible link with acne (if any), and effective acne treatments. If you’re experiencing endometriosis acne as a side effect, our team of licensed dermatology professionals may be able to help.

At Curology, we don’t treat or diagnose endometriosis—your in-person medical provider can help with that. But we want to provide information and help you achieve clearer skin. More on that below!

What is endometriosis?

Endometriosis is a condition in which the tissue lining the uterus is found outside the uterus. The tissue tends to grow on the ovaries, where it may form cysts, but it also grows on the fallopian tubes, supporting tissues, and other abdominal organs.¹

Endometriosis is a chronic gynecological condition affecting more than 11% of Americans with a uterus between ages 15 and 44. It’s more common for people in their 30s and 40s and tends to improve after menopause. The condition is often painful, causing cramping and heavy periods. Bleeding, spotting, and digestive issues also occur. Endometriosis can make it more difficult to get pregnant and may cause infertility.² 

Despite common misconceptions, polycystic ovary syndrome (PCOS) is not related to endometriosis. PCOS is a hormonal imbalance that causes changes in the ovaries and often leads to hormonal acne.³ Other than a shared connection with infertility (and possibly acne), the two conditions are distinct, and one doesn’t lead to the other. 

What are the symptoms of endometriosis?

Pelvic pain is the most common symptom of endometriosis. It’s often associated with uncomfortable and heavy periods. Some may also experience diarrhea, constipation, bloating, or nausea that worsens during their menstrual cycle.⁴ 

Here are other common symptoms:

• Painful periods (dysmenorrhea). Cramping and pelvic pain may begin before menstruation and last throughout the cycle. Back and abdominal pain are also common.

• Pain during bowel movements and urination. Pain upon defecating or pain when urinating during menstrual periods may occur. 

• Pain during intercourse. According to the U.S. Department of Health and Human Services, endometriosis pain associated with intercourse is described as “deep” pain and is common during and after sexual intercourse.⁵

• Infertility. Although research is still ongoing about what specifically causes infertility in women with endometriosis, there is evidence that shows about 30 to 50% of women with endometriosis are infertile.⁶

Risks of endometriosis and possible treatments

Many factors indicate a risk for developing endometriosis, including early menarche (younger than 11), shorter menstrual cycles (less than 27 days), and heavy bleeding. Those who have never been pregnant are at a higher risk.⁷

There is no cure for this condition, but if you’re wondering how to treat endometriosis, in general it depends on the severity. It usually involves medication and/or surgery. The first step in treatment if you’re not trying to become pregnant is taking hormonal birth control.⁸ Your medical provider may also prescribe pain medication or other hormonal treatments depending on your symptoms. Surgery is a treatment option, but this is usually reserved for those with severe symptoms who are not responding to other treatments. The primary goal of surgery is to locate and remove any areas of endometriosis.⁹

If you’ve been diagnosed with endometriosis, consult your medical provider about your treatment options. 

Can endometriosis cause acne?

Endometriosis and acne may be linked, but it’s not generally associated with breakouts. However, the treatments used to control endometriosis, such as hormonal birth control, may cause hormonal acne in some people. 

One study also found that women who had severe acne as a teenager were 20% more likely to develop endometriosis. The study suggests there may be a natural link between severe acne and endometriosis, and the two conditions may develop at the same age.¹⁰ 

Another study showed that women diagnosed with PCOS are at a higher risk of being diagnosed with endometriosis.¹¹ In other words, endometriosis may coexist with PCOS, which is commonly associated with hormonal acne. The good news is there are things you can do to fight hormonal acne.

How to treat acne if you have endometriosis

Having endometriosis likely won’t impact how you treat acne blemishes. The best method is still to stick with a consistent skincare routine. At Curology, we recommend a three-step routine: cleanse, moisturize, and protect in the morning and cleanse, treat, and moisturize at night.

Choose a gentle cleanser and moisturizer suited to your skin type. When it comes to hydrating, consider trying a humectant or emollient. Humectants, such as hyaluronic acid, attract and retain water in your skin. Emollients, such as ceramides, seal in moisture to prevent transepidermal water loss (TEWL).

It’s also wise to double-check the ingredients in your skincare products to ensure they’re non-comedogenic (here’s a cheat sheet!). 

Here are some ingredients to seek out or discuss with your dermatology provider: 

Over-the-counter topical ingredients

• Benzoyl peroxide is a great acne-fighting ingredient! It kills acne-causing bacteria.¹² You may want to try Curology’s Acne Cleanser with 2.5% benzoyl peroxide. 

• Salicylic acid is a beta-hydroxy acid (BHA) that works to unclog pores and help clear excess sebum (skin oil).

Prescription topical ingredients 

• Clindamycin is a topical antibiotic used to treat acne vulgaris—specifically Cutibacterium acnes. Clindamycin penetrates inside the pores to clear acne-causing bacteria.¹³

• Tretinoin helps to prevent clogged pores. When used for the treatment of acne, it has reduced visible acne lesions and helped prevent the development of new lesions. Topical retinoids also may help improve acne scarring.¹⁴

• Spironolactone is available in oral and topical forms. It’s used off-label to treat hormonal acne by blocking acne-causing hormones¹⁵ and androgen receptors.¹⁶

Spot treatments, such as Curology’s Emergency Spot Patch, are another skincare product to consider. Different brands may work differently, but Curology’s is more than a cover-up; it’s a hydrocolloid patch that absorbs pus and oil to help blemishes heal faster. Remember, squeezing, picking, and pinching pimples can cause acne scarring, especially for those experiencing cystic acne. 

Curology is committed to your skincare

At Curology, we help take the guesswork out of your skincare routine. Licensed dermatology providers work with you to examine your skin, assess your skincare goals, and provide custom treatment options.*

Many factors can contribute to the development of acne, but proven acne treatments, such as ingredients used by Curology, can help. Our personalized prescription formulas are designed for your unique skin concerns and goals.

Not a Curology member yet? Sign up today!

P.S. We did the homework so you don’t have to:

1. Tsamantioti, E.S. and Mahdy, H. Endometriosis. StatPearls. (2022 September 6).

2. U.S. Department of Health and Human Services. Endometriosis. (n.d.).

3. U.S. Department of Health and Human Services. Polycystic ovary syndrome. (2021 February 22).

4. U.S. Department of Health and Human Services. Endometriosis. Ibid.

5. U.S. Department of Health and Human Services. Endometriosis. Ibid.

6. Bulletti, C., et al., Endometriosis and infertility. J Assist Reprod Genet. (August 2010).

7. Tsamantioti, E.S. and Mahdy, H. Endometriosis. StatPearls. Ibid.

8. U.S. Department of Health and Human Services. Endometriosis. Ibid.

9. Tsamantioti, E.S. and Mahdy, H. Endometriosis. StatPearls. Ibid.

10. Xie, J., et al. Severe teenage acne and risk of endometriosis. Human Reproduction. (November 2014).

11. Hart, R. and Doherty, D. The Potential Implications of a PCOS Diagnosis on a Woman’s Long-Term Health Using Data Linkage. The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 3. (2015 March 1).

12. Matin, T. and Goodman, M.B. Benzoyl peroxide. StatPearls. (2021, October 20).

13. Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016).

14. Leyden, J., et al. Why topical retinoids are mainstay of therapy for acne. Dermatology and Therapy. (September 2017).

15. Zaenglein, A.L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

16. Patibandla, S., et al. Spironolactone. StatPearls. (2022 July 4).

Laura Phelan is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Benedictine University and went on to get her post-master’s certificate as a Family Nurse Practitioner at the University of Cincinnati.

* Subject to consultation. Subscription is required. Results may vary. 

Written by

Curology Team

Medically reviewed by

Laura Phelan, NP-C