Metformin is an anti-hyperglycemic drug used to treat patients with type 2 diabetes and to treat women with polycystic ovary syndrome (POCS) and hirsutism, excessive or unwanted facial or body hair 1. Metformin also has benefits in treating acne in patients with hyperandrogenism or excessive production of androgen. Hyperandrogenenism causes acne vulgaris, which is the increased accumulation of oil and bacteria in the skin pores and the formation of papules, pustules or nodules.

Metformin Effects

Metformin was approved by the Food and Drug Administration (FDA) in 1995 only for the treatment of type 2 diabetes 1. According to the Northwestern University website, metformin is not FDA approved to treat POCS symptoms. However, treatment with metformin benefits women suffering with POCS because of its effect in reducing insulin, testosterone and glucose levels. These effects help to reduce the symptoms of acne, hirsutism, abdominal obesity and amenorrhea that are all symptoms of POCS.

Metformin Effects on Acne

Metformin is used to treat acne in specific conditions such as PCOS, which causes serious hormonal imbalances that cause acne outbreaks. Metformin works to balance the hormones and control the acne outbreaks.

Side Effects

The side effects of metformin include gastrointestinal symptoms of nausea and vomiting, abdominal bloating and diarrhea. These symptoms may be minimized by starting with a low dosage that is gradually increased over a few weeks. Metformin will also affect the absorption of vitamin B12; long-term treatment with metformin may lead to anemia. A rare and serious side effect of metformin is lactic acidosis, too much acid in the body. Therefore, it’s important to have a serum creatinine test prior to starting metformin therapy and to have liver enzymes levels monitored every six to 12 months to prevent this side effect.

Considerations

A discussion with a health-care provider is important before taking metformin if there is any history of liver or kidney problems. According to the Ovarian Cyst POCS website, metformin alters liver function and is excreted by the kidneys 2. Liver and kidney function tests should be done prior to taking metformin, and these tests should be redone yearly.

Warning

Metformin is a category B drug; this means its safety for use during pregnancy has not been established 13. However, it is commonly used to treat infertility in patients with PCOS and is sometimes continued during pregnancy, according to the EMedTV website 3. Metformin has been found in breast milk and breastfeeding is not recommended while taking metformin.