Coming off of birth control with acne-prone skin

For a staggering 14% of women using birth control, the primary reason for going on the pill is to control severe, cystic acne. Sadly however, many of us reach a point when it’s time to let go of the pill and face the reality of our acne returning. So whether you’re thinking of starting a family, or just ready for a change, how can you best support acne-prone skin while coming off birth control?

A Quick Background on the Pill

Before we get into it, it’s important to understand how the pill affects your body. At the most basic level, it shuts down natural hormone production which prevents ovulation. By doing this the pill also decreases the production of androgens, AKA “male hormones”, which reduces acne-causing sebum (oil) in the skin. It sounds simple, however shutting down natural hormone production influences many, if not all other systems in the body. This plays a big role in understanding how to best support recovery post-pill.

Here are a few ways in which the pill affects our other systems:

Gut Health

Birth control has been linked to significant inflammation of the digestive tract. In fact, use of birth control has been associated with a 50% increase in risk of Crohn’s Disease. While they haven’t discovered the exact link, it looks like the pill may increase intestinal permeability (AKA leaky gut) and a change in your gut flora while on the pill. Unfortunately, your gut will not heal on its own after coming off the pill, and poor gut health is often a cause of acne.

Skin Health

While reducing your body’s oil production seems like a good thing, it can actually backfire. Having such little sebum in the skin is actually abnormal, so our body responds by - you guessed it - making more sebum. While we’re on the pill we don’t notice this ongoing battle, but when we come off the pill our sebum production increases significantly, contributing to the development of acne.

Nutrient Deficiencies

Last but not least, the pill can trigger nutrient deficiencies, including vitamins B12, B6, B2, magnesium, folic acid, zinc, tyrosine, and vitamin C. Many of these nutrients are important in the healing and maintenance of healthy skin. Keep in mind that coming off the pill will still not correct these deficiencies on its own.

Coming Off the Pill

I know all of that information sounds scary, but all hope is not lost! Here are a few changes you can make to help your skin adjust to life off the pill:

Cut Out Sugar & Dairy. Both sugar and cow’s dairy has been shown to have acne-aggravating effects. Both increase the hormone IGF-1 which contributes to the development of acne. Sugar and dairy may also cause further inflammation of the gut, which we want to avoid post-pill.
Consider Anti-Androgen Supplements. When we get off the pill, many of us experience something called the “androgen rebound”. Basically, while your body is relearning how to properly produce and cycle estrogen and progesterone again, our androgens skyrocket, contributing to acne. My favourite supplements for reducing androgens post-pill are zinc, berberine, and DIM. Keep in mind there are so many other amazing anti-androgenic herbs and supplements out there, these are just my preferences for post-pill support. Always speak to your healthcare practitioner to find out which supplements are right for you.
Heal Your Gut. I can’t say it enough: your gut is the key to good health. Inflammation of the gut that occurs with birth control use will worsen your skin. Don’t neglect your gut on your path to better skin health. In addition to reducing sugar and dairy to control inflammation, be sure to consider probiotics, prebiotics, and L-glutamine to start you on your road to gut and skin recovery.
Tackle The Source: Topical Resveratrol. Topical resveratrol is amazing for acne prone, and post-pill skin. Topical resveratrol seems to tackle all the big players contributing to acne: it reduces sebum production, kills and inhibits the growth of acne-causing bacteria in the skin, and it topically reduces androgens by targeting androgen receptors in the skin specifically.
Address Nutrient Deficiencies. Many of the nutrients depleted by the pill are important in the healing and maintenance of healthy skin. Taking a good multivitamin may be an easy and effective way to restore nutrient levels post-pill.
Make Time for Stress Reduction. Possibly one of the most important pieces of advice I can offer is make time for stress reduction. Psychological stress is one of the most commonly reported triggers of acne, and physiological stress has been shown to worsen existing acne. Make time for yourself, develop daily stress reduction strategies such as meditation, and set regular times for eating and sleep daily.
Don’t Forget Your Liver. Last but not least, consider adding in some liver support. Supporting liver detoxification pathways to rid the body of the synthetic estrogen and progestin found in the pill is very helpful in preventing acne and maintaining good skin health going forward. Liver-supporting herbs can sometimes aggravate acne, so opt for gentler agents such as B vitamins, NAC, amino acids, and sulfurophane (a compound found in cruciferous vegetables) instead, and always speak to your Naturopathic Doctor before adding these into your routine.

Remember, if you went on the pill to prevent acne, you never really dealt with the underlying cause of your acne to begin with. As a result, acne often resurfaces when you come off the pill. Also, depending on how long you were on the pill, it could take varying amounts of time for your body to fully recover. It’s important to exercise patience during this time, and see a Naturopathic Doctor if you feel you need additional guidance.

The good news is with proper support, nutrition, and knowledge, you can finally discover why you had acne to begin with and correct it for good. While it’s best to wait 3 months post-pill before testing your hormones to get a true baseline of how your body functions, this is a good guide to get you started in the meantime.

You can learn more about how Naturopathic Medicine can help support your acne here.