While the primary purpose of birth control is… birth control, many women turn to the pills to help clear acne. But after weaning from them, many women experience acne after stopping birth control. Why does acne come back, and sometimes symptoms are worse than before pills? How to prevent it and how to treat it? This article will answer these questions based on my experience as a doctor, skin therapist, and medical cosmetologist.
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Why Are You Breaking out after Stopping Birth Control?
While these synthetic estrogens and progesterone-containing pills help with acne and clear skin, they do not treat any underlying acne conditions, such as PCOS, insulin resistance, and others. I call them symptomatic treatment, but not real treatment.
Birth control pills artificially raise the levels of estrogen. Estrogen levels get higher than the levels of natural androgen. This is why acne goes away while a woman is on oral combined contraception.
No surprise that untreated conditions come back after weaning from contraception, and acne after stopping birth control also comes back. It is also called “post-pill” acne.
Moreover, your acne may worsen because birth control pills prevent the natural regulation of hormones and suppress your own hormones. After stopping the pills, your natural hormones undergo drastic changes suddenly. Something similar to teenage years. It’s like a hormonal rollercoaster.
Sebum production also suddenly increases, leading to acne flares, sometimes even cystic acne.
Acne after birth control is a type of hormonal acne covered in this ultimate guide. You may read more about hormonal imbalances, testosterone, estrogen, progesterone, and other hormonal changes and all possible treatments there.
How Long does Post-pill Acne Last?
You may experience acne comeback right after you stop taking birth control pills, but usually, it shows up in the second month. The peak is typically reached around 3 – 6 months. Generally, acne after stopping birth control may last up to 18 months or even longer if untreated.
Cystic Acne After Stopping Birth Control
Unfortunately, after stopping birth control, acne sometimes returns in its worst shape. Even if you did not have bad acne before starting the pills (or did not have acne at all), weaning from contraception may suddenly mess up your hormones and cause severe cystic acne. It does not happen to everyone, but sometimes it happens.
Cystic acne causes painful, pus-filled cysts deep under the skin. Acne nodules may accompany cysts. Nodules are similar to cysts, only harder and more solid, as they do not contain any fluids.
What can you do if you develop cystic acne? Check for any underlying conditions. I have reviewed the most common causes of high testosterone in women in this article.
Also, see a dermatologist. In the beginning, a course of antibiotics (oral pills or topical creams) may be prescribed to reduce inflammation, get rid of cysts, and prevent scarring.
After a course of antibiotics, follow your doctor’s advice or look for any treatments suitable for hormonal acne here.
Back or Chest Acne After Stopping Birth Control
The back and chest are areas that contain many oil glands producing sebum. Same as the face. No wonder acne flares may appear not only on the face but also on the back and chest after stopping birth control.
You may see your dermatologists or try over-the-counter products, such as deep cleansers, body washes containing salicylic acid or benzoyl peroxide (such as Differin Daily Deep Cleanser), retinoid creams (such as La Roche Posay Effaclar 0.1% Adapalene Gel), salicylic body treatments (such as Paula’s Choice Weightless Body Treatment 2% BHA).
Also, do not forget hydration. Our skin needs moisture to prevent excessive oil production (not only the skin of the face).
Light therapy might also help. Consider getting light therapy or photodynamic therapy at your dermatologist’s office, or choose one from at-home devices. Blue light reduces inflammation and has an antimicrobial effect. It can treat pimples, but light therapy might not be enough for cysts and nodules.
If you are planning to be outside, do not forget a broad-spectrum sunscreen to prevent dark spots in a place of a pimple and hyperpigmentation after acne treatments containing salicylic acid, benzoyl peroxide, and others (because the treatments exfoliate the upper layer of the skin and make your skin more sensitive to UV rays).
How to Avoid Acne After Stopping Birth Control?
If you want to avoid acne after stopping birth control, you need to prepare beforehand.
Many times stress and stress hormones are involved in acne. Make sure to lower your stress levels, balance your work and leisure time, get enough sleep, and take supplements that strengthen your nervous system, such as magnesium and B group vitamins.
Secondly, eat healthy plant-based foods, more vegetables and fruit, and less fast or fried food. Consider taking probiotics, as the gut microbiome imbalances may lead to various skin conditions, including acne.
Thirdly, build a good skincare routine. If you were on the pills for a long time and had acne-free skin, in that case, you may need to incorporate some new products, such sebum regulating lotions or serums, salicylic acid washes a few times a week, or pads, containing salicylic acid to go over your face when needed.
Later on, when you stop birth control and notice emerging acne, you may include anti-acne products and treatments into your skincare regimen. Think about topical retinoids (tretinoin or adapalene gel) and benzoyl peroxide.
Retinoids are vitamin A derivates that regulate skin keratinization (normalizing the outer layer of the skin), decrease the size and secretion of the oil glands and shrink pores.
You may also try oral retinoids (isotretinoin, Accutane), which will have a more substantial effect. Just keep in mind: if you went off birth control to get pregnant, do not use retinoids as they are teratogenic and may cause congenital disabilities.
Benzoyl peroxide has antibacterial properties (kill acne-causing bacteria), dries the skin, and prevents clogged pores.
Also, check if you are not lacking any vitamins. It is very common to develop acne if you lack some nutrients. Make sure to supplement your diet if you lack any of the essential vitamins. Read more on how the lack of vitamins causes acne here.
Lastly, try to regulate your hormones naturally by taking herbs (whether as teas, tinctures, or supplements). You may take herb supplements before stopping birth control as they take time to work. The best natural androgen blockers are maca, spearmint, licorice, soybean isoflavone, and garden angelica.
Additionally, zinc and vitamin B6 are good androgen blockers. Zinc stops the conversion of testosterone to a more potent DHT and has anti-inflammatory, wound-healing properties. Vitamin B6 can decrease cortisol (a stress hormone responsible for acne development), reduce oil production, and increase zinc absorption.
How to Treat and Stop Acne After Stopping Birth Control?
Acne after stopping birth control is a type of hormonal acne. I have written an ultimate guide to hormonal acne, which covers everything – causes, treatments (both medical and over-the-counter), the best skincare ingredients to look for, natural androgen blockers, and more.
Going off birth control may feel like a rollercoaster because your hormones suddenly get messed up.
Moreover, oral contraceptives suppress your natural hormones, and drastic weaning off artificial hormones may cause an imbalance in your natural hormones and lead to post-pill acne.
Also, birth control pills do not treat underlying conditions, such as PCOS, obesity, insulin resistance, etc. Untreated health conditions come back after stopping birth control. Acne caused by these conditions also comes back.
You may prevent acne after stopping birth control by building a skincare routine, regulating your hormones naturally, eating well, checking if you lack any vitamins, and supplementing if you are.
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C. Requena, B. Llombart. Oral Contraceptives in Dermatology. Actas Dermo-Sifiliográficas (English Edition), Volume 111, Issue 5, 2020, Pages 351-356, ISSN 1578-2190 https://doi.org/10.1016/j.adengl.2019.06.008. Read