Why does low progesterone or estrogen dominance cause acne in women with pcos? how does that happen?

Hyperandrogenism: Acne in women with pcos is caused by hyperandrogenism (too much male-type hormones) including testosterone, produced by the ovaries. Insulin resistance promotes hyperandrogenism. Treatments include Insulin sensitizers like metformin if you're trying to conceive, or birth control pills and anti-androgens like spironolactone if not ttc. 'low progesterone' occurs in women with pcos who don't ovulate.