Post-Pill Acne: Giving Your Body What It Needs to Heal
Coming off birth control is an exciting transition, and the good news is there are many ways we can support the body during this time. With some preparation and a few nutrition and lifestyle protocols, we can help minimize (and hopefully avoid) post-pill breakouts.
POST-PILL ACNE
The pill essentially shuts down the natural menstrual cycle. There is no cycle, which means no ovulation, which means no progesterone. Young women are meant to ovulate, not only for reproduction, but also to promote overall health. Skipping this vital process has been linked to nutrient deficiencies and gut dysbiosis. Having proper nutrients and a healthy gut are foundational for clear healthy skin.
Hormonal birth control suppresses sebum (skin oils), which is why it’s often prescribed for women experiencing acne around puberty. The skin responds by up-regulating sebum to protect itself, and when women come off the pill, they may have more sebum than ever before. This up-regulation can persist for months after stopping the pill, and it’s this sebum excess that may contribute to post-pill breakouts—even for women who may not have been acne-prone in the past.
Another factor that comes into play for post-pill acne is a temporary surge in androgens (stereotypical male hormones) as the ovaries kick back into action. The withdrawal process won’t last forever, but it could last up to a year or more. Typically, women who come off the pill without supportive protocols will see withdrawal symptoms spike at the three- to six-month mark.
It’s important to note that every woman’s body is unique and there are no guarantees. The best thing to do is listen to your body and adjust accordingly.
WHERE TO START
A good way to understand what your experience may be like coming off the pill is by thinking back on what your cycles were like pre-pill. If you had regular cycles with minimal symptoms, then a bit of support during the transition may be all you need; however, if you went on the pill for a hormonal imbalance like acne, PCOS (Polycystic Ovary Syndrome), or endometriosis, that imbalance is still there waiting for you. In these situations, I see amazing results when women follow a holistic protocol to support their nutrition, lifestyle, and mindset. A necessary step when coming off the pill to avoid post-pill acne is to become comfortable with tracking your cycle. Get an app that works for you and start to get to know your body and this amazing vital sign. Just know there are solutions out there—it’s just about finding what feels good for you.
Androgens & Post-Pill Acne
Are you experiencing jawline, neck, and cheek breakouts? Perhaps also with male-patterned hair growth on the face, around the nipples, and on the abdomen? Is this happening in combination with irregular cycles pre- or post-pill? Are you experiencing reoccurring acne even after stronger treatment like hormonal birth control or Accutane? These may be signs of a hormonal imbalance and excess androgens.
Androgens are one of the most common causes of acne. Androgens are stereotypically known as male hormones, like testosterone, DHT (dihydrotestosterone), and DHEA-s (dehydroepiandrosterone). Although it’s healthy for women to have these hormones too, when women have either elevated androgens or an imbalance, that can lead and contribute to acne. It’s thought that the level of androgens and androgen receptors in the skin are the greatest contributors to acne. Elevated androgens are common for PCOS and can sometimes be associated with a temporary post-pill androgen surge. In the skin, 5-alpha reductase converts testosterone into DHT1. These androgens increase sebum production, creating the perfect storm for acne to thrive.
SKIN SUPPORT
Reduce Inflammation
Reducing inflammation is vital for clear skin, and finding supportive ways to do that is key when mitigating post-pill breakouts. Consider balancing your blood sugar with adequate protein and loading up on healthy fats while reducing refined foods and inflammatory oils. Look at restoring a healthy metabolism by nourishing the body and eating every three to four hours. At bedtime, choose a snack that balances all three macros—protein, fat, and carbs—and experiment with eating breakfast within an hour upon waking.
Restore the Gut
We know that the pill disrupts the gut microbiome and makes you more susceptible to gut dysbiosis; therefore, while coming off the pill, it’s important to support and heal the gut. Gut health and skin health are interconnected, and when one is inflamed or unhappy, often the other is as well. Focusing on foods that help to replenish the gut lining (e.g., bone broth and collagen) is essential, as is the body’s elimination process. Pooping daily is step one for happy hormones and clear skin.
Nutrient Deficiencies
The pill depletes the body of many essential vitamins and minerals. If we think of the organs in terms of priority, it’s not hard to see why the skin may be on the bottom of the list. The body is working hard and is performing numerous vital functions behind the scenes. When lacking adequate vitamins and minerals, the body will do everything to protect itself; this often means that the skin and hormones suffer. To replenish nutrient stores post-pill, focus on real, whole foods and consider where to add nourishing skin foods that contain healthy fats, omega-3s, antioxidants, bioflavonoids, selenium, zinc, and B vitamins.
Reduce Stress
This is a big change for the body; give it space to heal and rest during this time by reducing stress and getting good quality sleep. Reducing stress and supporting adrenal health is especially important when balancing hormones (like androgens) and promoting ovulation to boost progesterone. Things like yoga, getting into nature, mindful meditation, journaling, movement, connection with friends and family, and anything that fuels the soul will all help reduce stress.
When coming off the pill, it may be beneficial to consider these supportive practices for two to three months prior, as hormone cycles are every three months. This will truly give your body the support it needs to make the transition as seamless as possible. Giving the body time and space to heal really helped me during this time.
Addressing acne holistically and supporting the body post-pill is not an overnight miracle cure. It is a continual process of knowing your body and practicing self-love. Follow things that truly make you feel good, and lean into what allows you to show up in your life as your best self. That’s where the magic happens.
Big love,
Caralyn
References
McCulloch, 2016.