Is it possible to get rid of acne permanently if one has PCOS?

Yes, you are right in that acne scar treatments should be commenced once acne has resolved and become quiescent.

Acne scar treatments such as fractional CO2 laser can also cause scarring if there is active ace and secondly; ongoing acne can cause new scars to form.

PCOS is a condition that troubles many when it comes together with acne as the local skin factors are also affected by systemic hormonal issues.

Besides oral contraceptives, anti-adrogenic medications like Spironolactone can be helpful.

It is also worthwhile to target local skin issues that can contribute to the ongoing acne such as comedones and inflammation.

I usually treat my patients in a systematic manner with medications like antibiotics and retinoids (topical and/or oral). Treatments that you can consider to control the acne outbreaks and lighten the scars are Q switch laser and chemical peels.

I find that with a multi-pronged approach, the acne outbreaks can be better controlled and the outcomes (e.g. residual scarring) are much better.

PCOS is a fairly common condition in Singapore that usually goes under-diagnosed.

You are right, it's advisable to have a more stable skin condition, before going for acne scar treatments (in particular, fractional lasers).

However certain acne scar treatments like subcision are safe to do, even during minor acne outbreaks.

I noticed you mentioned you are taking contraceptive pills. As such we should consider adding on Spironlactone (which has an anti-androgenic effect) that reduces oiliness.

In fact, spironolactone might be a better idea as a first-line for the PCOS-associated acne.

Winston