When we initially get on the birth control pill (BCP), we are told it’s a miracle drug. It is thought to ‘regulate’ your periods, get rid of your menstrual cramps, clear your skin. Best of all… stop you from getting pregnant when you don’t wish to have a child. What we are not told is that these effects are typically temporary, and that post-birth control acne is very common.
However, preventing pregnancy in this way comes at a hefty price. As most of you know, the side effects of one day discontinuing birth control—can be downright excruciating to cope with.
One such side effect is acne. So ,why does birth control cause acne to develop when you stop taking it, and what can you do about it?
Why do we get post-birth control acne?
Birth control pills introduce synthetic hormones into the body, which naturally will shut off our own hormone production. In some cases this can help curb symptoms that come along with the natural fluctuations in our sex hormones. For example, taking the pill can temporarily help with hormonal acne by increasing estrogen and decreasing testosterone.
The natural fluctuations in estrogen, progesterone and testosterone can cause the sebaceous glands under our skin to produce more sebum, the oily substance that lubricates the skin. When sebum builds up, it can clog your pores and leads to acne. Therefore taking the birth control pill can technically prevent these hormone fluctuations and prevent that sebum buildup. Many birth control pills also include an anti-androgen to help directly block androgenic hormones like testosterone, DHEA and androstenedione that also contribute to acne in some women.
When you one day decide to stop taking the pill, you are no longer receiving synthetic hormones, and with time your own natural hormone production kicks back into gear. When you start making your own hormones again, there is this rebound effect – where testosterone tends to shoot up to levels that can wreak havoc on our skin, hair, mood and more.
Essentially, once you come off the BCP, your hormones need time to rebalance themselves. This can be a shock to your body that leads to symptoms returning in full force. Other possible reasons acne makes a return after you stop taking the pill can include:
- Nutrient depletion: Going off the pill can cause your vitamin D levels to drop, and people with low vitamin D levels are more likely to develop acne.
- Effects on the microbiome: Using birth control changes the diversity in your gut, so when you stop taking it, that situation is rectified slowly over time. Since the microbiome also plays a role in sebum secretion, those changes can lead to more acne once you stop taking the pill and the diversity in your gut begins to restore itself.
- Liver congestion: Oral birth control pills are been shown to increase the risk of liver dysfunction. When the liver isn’t working as it should, it gets overwhelmed by excess hormones and other substances that can drive acne.
How is post-birth control acne treated?
Many of my patients tell me they are terrified to get off the pill, for fear of acne. Many say they get off and just get right back on once they start breaking out. I want to reassure you that there are other avenues you can explore.
Ideally we want to target the temporary elevation in androgens to reduce the immediate acne. The truth is though, many women that get on the birth control pill start out with elevated androgens already. Therefore it is important to uncover the underlying cause of the original imbalance. Assisting liver detox can also help clear out any buildup of hormones that could contribute to this acne. Blood testing is an accurate, affordable and quick method I use in my practice to get us to the underlying cause of elevated androgens.
While we work to understand how to shift your hormones back into balance, some quick and easy natural treatments include:
- Tea tree oil: Tea tree oil doesn’t work by balancing your hormones, but it can decrease the inflammation that helps with acne development.
- Alpha hydroxy acid: Plant acids are great additions to a hormonal acne treatment plan because they remove any excess dead skin cells that can lead to clogged pores.
- Green tea: Drinking one or more cups of green tea every day can decrease systemic inflammation, which helps mitigate the stress on the body that comes with stopping the pill.
- Diet: You want to include lots of antioxidant and omega-3-rich foods in your diet to help reduce inflammation for clear skin. Also, avoiding dairy, processed sugars, and refined carbs fights post-pill acne.
Balancing your hormones may take a while, but if you think it’s been long enough and there might still be something wrong, exploring other techniques to ensure your hormone levels are where they should be is a great way to manage acne after you stop taking the pill.
How can you tell if it’s post-pill acne and not something else?
It can be hard to tell if what you’re experiencing is post-birth control acne or something else. The truth is, many presentations of acne look similar, so it’s crucial to diagnose your specific type before treating.
The best thing you can do to figure out if your post-pill acne is hormone-related is booking a free 15-min discovery call. We can discuss your concerns, the possible causes, and aim for a treatment plan that will work for you.
PS: I am a big fan of testing hormones to avoid any guessing. However, once coming off any hormonal birth control, it is critical to wait a couple months before testing your hormones! You want to make sure the reading is accurate.