“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?
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.
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.
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, I decided to take a holistic approach to Emily’s skin.
Here are the 5 big steps that really helped Emily heal her acne
Heal Your Gut.
Getting lab testing and treating your gut appropriately is a first step in creating gorgeous skin. If your gut is inflamed then your skin will be too. For Emily, we found she had SIBO and yeast overgrowth (candida). We got to work clearing those infections right away.
I shared with Emily that the skin is a reflection of what is happening internally. When there is acne, we almost always find imbalances in the gut.
Eat Hormone Harmonizing Fats.
Eating healthy fats, like avocado oil, macadamia nut oil, fish and olive oil was one of Emily’s first prescriptions. We swapped out inflammatory fats like canola and corn oil for fats that are beneficial to skin. You see, the fats you eat influence your skin’s oil production and quality. Low quality (aka inflammatory) oils can make skin flare with plenty of zits to follow. Grab my free hormone balancing recipe guide to help you get started.
We also started her on seed cycling to help set a rhythm for her cycles and provide her with the nutrients she needed to balance her hormones.
Get Good Gut Bugs.
I’m talking about probiotics here. In my house, my son refers to them as the “good gut bugs.” These are the guys that not only play a role in your mood, your weight, but skin health too.
Part of Emily’s acne issues had to do with those good bugs living in the wrong place, as is the case with SIBO. And we know that SIBO is way more prevalent in certain types of acne.
But for other patients, I’ve seen, getting more of the good gut bugs in can be a total game changer for their skin. Once we cleared Emily’s SIBO and yeast we got her going with kombucha, fermented beets, kimchi, and other probiotic-rich foods.
While a full elimination diet was in order for Emily, the number one food we had her cut quick was dairy. Dairy seems to be one of the worst offenders for the majority of people’s acne. I recommend taking it out for at least 6 weeks to see if it helps improve your skin.
Kill the Bad Cosmetics.
Kill the cosmetics that you know aren't doing your skin any favors—endocrine disruptors (chemicals that mess with your hormones), heavy metals, and plastics hide in our everyday makeup and personal care products. They make acne worse and can cause a lot of health problems.
Instead, check out the Environmental Working Group’s Skin Deep site to find the cleanest, most hormone friendly makeup and beauty supplies you can.
I’m also a big fan of Annmarie Skin Care. I personally know and trust the owners. They care about what you put on your skin and how it affects your health. They are committed to providing you with the best quality ingredients.
Emily had been using cover up on every blemish she ever had. When we took at look at what she was using we found all kinds of scary ingredients that you wouldn’t want in your house, let alone on your face. Emily did a serious detox on her personal care products right away.
Coming Off The Pill — Real Talk
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.
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.