We’re all hopeful that once our raging-hormone teen years are behind us, acne will become nothing more than a distant memory. Unfortunately, for many women, that is not the case.
Adult acne can be rooted in various imbalances or problems within the body, but the most common treatment for women does nothing about those root causes, and simply slaps a big ol’ Band-Aid on it: birth control.
Does This Mean Birth Control Pills Actually Help Acne?
Acne is one of the many reasons women are prescribed birth control. Take Emily, one of my patients, for example. At her first visit, she admitted that she hadn’t let anyone take her picture in three years. Three years!
Emily’s doctor had put her on the pill to control her acne, and while she had tried several types, none of them resulted in the clear skin she hoped for. She was embarrassed, frustrated, and confused. Why was this happening? It’s simple: The pill does not “fix” hormones. It merely masks them.
But while the pill did not clear Emily’s skin, it does often work…unless you try to come off it. I’ve heard dozens of cases of women trying to stop the pill, only to have a raging acne flare—even if they never suffered from acne prior to being on the pill!
Alice developed acne shortly after stopping birth control. Her doctor recommended Accutane (a medication for acne) and that she get back on the pill (it is not considered safe to get pregnant while on Accutane). Alice was leery of starting more medications…and she was puzzled. You see, Alice had never had acne until she stopped taking the pill.
Acne after stopping birth control is often caused by Post-Birth Control Syndrome (PBCS), and it is a common side effect of going off the pill. PBCS acne can appear anywhere, even unexpected and totally unpleasant places like your butt!
Now, if you’ve followed me for a while, you know I don’t accept that “common” translates to “normal”. So, while PBCS acne is not unusual, you do not have to simply accept it.
Post-birth control acne is real and it is common, but it does not have to be your new normal.Post-birth control acne is real and it is common, but it does not have to be your new normal. Click To Tweet
Why We Develop Acne After Stopping Birth Control
There are several factors that contribute to post-birth control syndrome acne. Many of which are a direct result of what birth control has done to our bodies while on it.
Alice explained that her skin seemed oily within the first couple months of stopping the pill. What followed were small zits on her chin and jawline the week before her period. When she presented in my office she was noticing acne that was deeper and more inflamed 10 days before her period.
“It seems to be coming on sooner and sooner and I’m afraid my face is going to look like this all the time,” she shared during her first visit with me.
There were several reasons why Alice’s skin was rebelling and they are common after coming off of hormonal birth control.
Hormonal contraceptives suppress your natural hormones, including testosterone. When you discontinue them what is known as an “androgen rebound” can occur. Or in other words, your body kicks into high gear creating more testosterone. The elevated androgens cause an increase in sebum production, which is why oily skin is common, and acne follows.
Androgen rebound is something I talk about a lot in my book, Beyond the Pill, because that testosterone coming back rapidly post-birth control can cause you skin to flare like crazy and make you want to jump back on.
For Alice, her symptoms were pointing towards excess androgen production, which we confirmed with lab testing.
Birth Control Depletes Zinc
Alice’s labs also revealed she was low in zinc. Birth control depletes nutrients like crazy, including zinc. Zinc is necessary for healthy immune function and skin. It has the ability to inhibit bacteria from growing in your sweat glands, which is one way that pimples arise.
Zinc is necessary for helping you use vitamin A. Vitamin A is well recognized for its ability to support healthy skin and reduce acne. It's important to keep your testosterone in check to allow your skin to flourish, and as mentioned, support the immune system in regulating the bacteria that can lead to acne.
Birth Control Disrupts the Microbiome.
Birth control messes with your microbiome in the worst of ways. It can lead to leaky gut (intestinal hyperpermeability), which in turn, can lead to food sensitivities, increased inflammation, and even autoimmune disease. Yikes!
The pill has been shown to cause changes to the oral, vaginal and gut flora. This can leave you more susceptible to infection. Plus, imbalances in good gut bugs can lead to further hormone imbalance.
Whenever acne is the main complaint with my patients, the gut is the first place I look. If your gut isn’t functioning properly then your skin can be a common area for your body to express that disharmony.
Alice was experiencing difficulty passing stool and reported that sometimes her food wasn’t digested. Because of this, we began a comprehensive digestive enzyme and spore-based probiotic to begin shifting her gut to a more favorable state.
Overwhelmed Liver Detox
The liver is the main organ that has to process all those hormones and get them ready to move out. And if it doesn't do its job well then acne can flare. You need a liver that is detoxing and bowels that are moving if you stand any chance at getting rid of acne.
While some would argue that hormonal birth control isn’t too much for the liver to handle, I’d like you to consider a couple of things.
High Amounts of Synthetic Hormones
You need enough hormones to shut down your brain and ovary communication. That is how the pill works. It floods the system with so much hormones that the brain doesn’t bother signaling the ovaries to make more. These hormones you make naturally are vital to fertility and ovulation.
While the newer pills have lower hormones, they still contain enough to shut down FSH (follicle stimulating hormone) signaling to the ovary and have side effects.
The Environment is Toxic AF
We’ve got phthalates, BPA, BPS, and plastic endocrine disruptors coming at us every which way!
We all eat or drink out of plastic at some point. Straws, water bottles, cups, and other plastics contain harmful chemicals that must be detoxified by the liver. And even if you aren’t drinking out of plastic, all those other billions of people are dumping this into our environment and our water supply. Yikes!
Then there are the pesticides, herbicides, perfumes, air fresheners, dryer sheets…am I freaking you out yet? I don’t mean to be, but we all need to understand that our liver is working overtime on the daily due to the changes in the environmental toxin load. Now you add the pill and based on your genes and your environment, this can be enough to overwhelm your detox system.
And your body, being brilliant like she is, has to push this junk out. Your skin is one way in which you detox and while your acne is the worst, understand that it is your body doing the best she can to keep your vital organs safe. And it is a sign that you need to look deeper because your body is begging for it and getting your attention in an unsightly way.
If you are feeling overwhelmed by this info, you need to check out Lara Adler's class during our free online women's hormone conference. She lays down the facts and then gives you actionable steps to start cleaning up your environment in a sustainable way.
How to Heal Acne After Stopping Birth Control
Many women begin birth control to reduce or eliminate acne. Because of this, it can come back full force when you stop hormonal birth control as part of post-birth control syndrome.
Acne after stopping birth control, how long does it last?
For Alice, she had never had acne before starting the pill. This was a new struggle and one that left her feeling embarrassed and confused.
Whether you had acne or not before starting birth control, you can develop post-birth control acne, which is a common symptom of post-birth control syndrome.
If you're coming off the pill, and you're feeling afraid of having that post-pill acne or cystic acne come back, let me assure you there are steps that you can take that don’t include another round of hormonal contraceptives.
Support Gut Health
We started Alice on a prenatal to help replenish nutrient stores. She also began Gut Rebuild because, in addition to supporting gut health, it also contains zinc, which supports the health of our skin.
As mentioned previously, I recommended Alice start a digestive enzyme and probiotic to support her overall gut health, maximize nutrient absorption and help her become more regular with her bowel movements. If you are not eliminating your waste every day then your skin is going to be the default organ to move toxins out.
Dial in your diet to be nutrient dense. Need help getting started? Grab my Quick Start Guide, which has a sample meal plan and outlines the foods you need to be eating if you’re on the pill or coming off.
Consider, like Alice, a prenatal vitamin to replenish the nutrients the pill has depleted. B12, folate, selenium, zinc, magnesium, vitamin C and other nutrients are vital to your hormonal health and can be lower in women who are on birth control or have ever used it. Prenatal vitamins are higher in nutrients to help you replenish what has been lost.
Your gut is where your immune system lives, and if your immune system is healthy and happy then your skin is going to be healthy and happy.
Probiotics for Gut Support
Is birth control bad for my gut? Can I take probiotics with birth control? If these are some of your top questions know that you’re not alone. These questions are sent to me regularly from readers.
Yes, birth control is bad for your gut, as I explained. And yes, you can take probiotics while using birth control. In fact, you should take probiotics because birth control disrupts the microbiome.
In my clinical practice I recommend Women's Probiotic because it is a spore based organism that promotes microbial diversity in the gut. It also helps with creating healthy antioxidant status in the body. And it doesn’t cause the same kind of issues a Lactobacillus species can if you have SIBO.
Balance, Prenatal Plus, and Women's Probiotic are all part of the post-birth control basic supplement kit that you can check out here.
Ditch the Dairy
Nobody likes it when I say take out any foods, but it is just so common to find that women who struggle with acne also have a dairy sensitivity.
Dairy can aggravate your skin, and I've seen this in my naturopathic medical practice with many patients.
That doesn't mean you can't do dairy ever, but before you come off these hormones, or while you're coming off of them, pull dairy from your diet. You can always reintroduce to determine if it contributes to your acne.
Blood Sugar Balance is a Must
If testosterone is your issue then working to balance your blood sugar is a must. When your blood sugar is wild then your ovaries and adrenals get the signal to make androgens.
Eat regular meals and include protein and fat with each meal. This will help you optimize your blood sugar, which will balance all your hormones.
Support Estrogen and Testosterone Metabolism
There are specific nutrients your liver requires to effectively detox your hormones. And you know what, those happen to be some of the same depleted by the pill.
Using a supplement that is formulated with DIM, Calcium-D-Glucarate, green tea extract, and broccoli seed extract will support natural liver detox pathways, plus how your gut eliminates excess estrogen.
Balance by Dr. Brighten is a comprehensive women's formula designed to harmonize sex hormones and improve common hormone related issues. Formulated with B Vitamins, antioxidants and hormone supporting herbs, this product helps support the body in eliminating excess estrogens and environmental toxins.
Eat Fiber Daily
You have to poop to get your estrogen out! And if you’re using probiotics then you need to feed those critters. They eat fiber, the stuff you can’t digest, and it helps them thrive.
When your gut bugs are in check and your bowels move daily then you’re less likely to suffer from acne and your hormones can begin to balance.
Eat artichokes, flax seeds, chia seeds, avocados, onions, garlic, celery, and as many plants as you can fit on your plate!
To help Alice’s skin quickly, I recommended a doctor grade 14-day detox, which I have had tremendous success with in my clinical practice.
We also started Alice on a hormone supportive supplement that contains DIM, broccoli seed extract, green tea extract, Rosemary, and Calcium D-Glucarate to support overall hormone balance. These nutrients help you process estrogen and testosterone to promote optimal hormone health.
DIM helps at the skin level and safeguard against the harmful types of testosterone. Testosterone's not all bad by the way, but it certainly can feel bad when your skin is breaking out. My goal in working with patients is to always help them find the optimal balance of their hormones.
For supporting skin health and resolving acne after birth control I typically recommend women stay with this product for a minimum of six months.
Can Birth Control Pills Help Acne?
The pill works by giving you such a high dose of hormones that your brain stops talking to your ovaries. This mechanism reduces production of testosterone, which is why some docs think birth control pills fix your acne.
By lowering testosterone, oil production (known as sebum) is also reduced. The theory is that the oil is why you get acne and by lowering the hormone that influences its production then you can eliminate acne. Of course, you’re also eliminating your mood, motivation, and libido too because women need testosterone.
An Acne Story by Emily
“I haven’t let someone take my picture in over 3 years,” 26-year-old Emily confessed at her first visit. She came to see me with one burning question— What's the best birth control for acne, can birth control pills help acne or am I doomed to have hide from every camera I see?
Emily had tried several pills with varying degree of success. And while some had reduced the number of breakouts, none of them gave her the clear skin her doctor had promised.
Like many women, Emily was prescribed the pill to treat a symptom—her acne. Her acne was a symptom of something deeper, I explained.
Her doctor had told her that the pill would help her balance the hormones he believed was causing her to break out.
But the pill doesn’t balance hormones—it masks them.Do Birth Control Pills Help Acne? Read this article to find out! Click To Tweet
What's the Best Birth Control for Acne?
Quite frankly, there isn't one.
Emily was experiencing the symptoms of low testosterone (diminished desire and mild depression) and lab testing showed that she was indeed lacking adequate amounts. But her acne persisted.
That’s because the pill doesn’t fix acne or regulate hormones for that matter. It simply suppresses it.
And for some women, acne is worse after stopping birth control.
Over 2 years Emily had been on 5 different birth control pills and felt like her skin was getting worse. So, instead of reaching for another new prescription, it was time to take a holistic approach to her skin.
Going Off Birth Control = Acne?
We got to work doing everything we could to reduce symptoms and build Emily up before coming off the pill. Including, and here’s the real talk—skin almost always gets worse before it gets better.
Did you cringe a bit with that last sentence? I know, I hate that I have to say it, but it is true.
And think about it, your skin is not your most vital organ. So, your body being wise, takes to healing the most important organs first.
The pill creates gut inflammation, suppresses healthy hormones, and burdens the liver (the ultimate hormone ally) so that it can’t clear out unnecessary hormones. This is why so many women experience Post-Birth Control Syndrome and can have a horrendous acne flare when they finally stop birth control pills altogether.
But it doesn’t have to be this way. In fact, in my practice, we create individualized protocols and plans for each woman who decides to come off the pill.
Acne after stopping birth control: how long does it last?
My clinical experience shows most women who are actively working to heal their body experience acne flares for the first couple of months post-pill, which decreases generally by months 3-5 off the pill. In women not actively working to undo the effects of the pill, the skin battle is often much longer.
Eight months into working with Emily I got a message with an image attached. It was Emily! The girl who had hid from the camera for years just took her first selfie and sent it to me with this message:
Dear Dr. Brighten,
I can not tell you how amazing it is to see my face looking this good after so many years. Not a single birth control pill could do what I’ve been able to do with your help!
I not only look better, but I feel better too. I never told you I was seriously considering an anti-depressant before our first visit because my mood had become so bad. I’m glad I found you before I started any other medications.
I feel like I have my life back and I’m confident I’d never be able to say that if it weren’t for you.
Supporting Post-Birth Control Acne and Healing Your Skin
Imagine no longer dreading monthly outbreaks and receiving more and more compliments about your skin by the day. All of this renewed confidence can come about from healing your skin without having to get back on the pill.
If you're struggling with acne after stopping birth control or Post-Birth Control Syndrome, I want to invite you to grab my free quick start guide to help you start balancing hormones and working towards clear skin quickly.
I've also helped thousands of women heal their skin with the Brighten Protocol that I have developed within my naturopathic medical practice. It is now available to you through the Birth Control Hormones Reset.
You do not have to stay on hormonal birth control to have amazing skin. You can heal your skin naturally. So today, take the challenge to implement these three steps. Trust me, your skin and whole body will thank you for this.
- Achilles SL, Hillier SL. The complexity of contraceptives: understanding their impact on genital immune cells and vaginal microbiota. AIDS. 2013. 27 Suppl 1(0 1). S5-15.
- Afshin A. et al.i. “Effect of Oral and Vaginal Hormonal Contraceptives on Inflammatory Blood Biomarkers,” Mediators of Inflammation. Article ID 379501. 2015. vol. 2015.
- Ali I, et. al. Oral Health and Oral Contraceptive – Is it a Shadow behind Broad Day Light? A Systematic Review. Clin Diagn Res. 2016. 10(11). 10.7860/JCDR/2016/19439.8790.
- Association Between Long-term Oral Contraceptive Use and Risk of Crohn's Disease Complications in a Nationwide Study. Gastroenterology. 2016. 150(7). 1561-1567.
- BRIGHTEN, JOLENE. BEYOND THE PILL: a 30-Day Plan to Eliminate Period Problems, Boost Libido, Improve Mood, Clear Skin, and Ditch the Pill When You're Ready.. HARPER ONE. 2019.
- Falony G, et al. Population-level analysis of gut microbiome variation. Science. 2016. 352(6285). 560-4.
- The impact of oral contraceptives on women's periodontal health and the subgingival occurrence of aggressive periodontopathogens and Candida species. J Periodontol. 2010. 81(7). 1010-8.