What causes it?
The reason the oral contraceptive pill (OCP) and other hormonal contraceptives are so effective at managing hormonal acne is because they suppress the production of your natural hormones, including androgens. The synthetic steroids in hormonal birth control such as ethinylestradiol (synthetic oestrogen) and the progestins drospirenone, norgestimate and cyproterone stunt sebaceous oil production that can be causing acne. In response to these chemicals, your skin upregulates sebum production to protect and moisturise the skin.
However, when you stop taking the hormonal contraceptive, this upregulation of sebum often continues. Your ovaries start to produce their own hormones again and before they regulate themselves, they can often overproduce androgens (testosterone) which can also ramp up the production of sebum. This doubled-up production of sebum can be more than your body ever had previously and can cause cystic acne, particularly around the jaw line and on the back. This is often why women who never experienced acne prior to taking hormonal contraceptives can find themselves with it after coming off..
How can you help manage it?
From personal experience, treating post-pill acne is very much a two-pronged approach; supporting it from a nutritional perspective and topically with good skincare that is tailored to your needs.
If you are considering coming off hormonal birth control, for whatever reason, you can start to support your hormones before you come off the contraceptive.
In the three months prior to stopping your hormonal contraception, you can support your skin by;
- Reducing refined sugar consumption: studies have linked the consumption of high-glycemic-index carbohydrates and processed foods to worsened acne
- Increase fibre intake: excess hormones are removed from the body via stool so increased fibre consumption will support this process
- Take a good quality multivitamin/mineral: the oral contraceptive pill has been shown to hinder the absorption of some micronutrients including; B vitamins, zinc and selenium
Post-pill acne typically peaks after about 6 months (it can take longer for some women) and after this peak your shin should start to improve. Some of the other hormones that your ovaries will start to make again such as progesterone post ovulation are actually very good for the skin so stick with it!
There are some ways you can look to treat post-pill acne, most of which are centred around reducing the level of androgens (male hormones like testosterone) and balancing your hormones (naturally):
- Zinc: is a mineral that is depleted by hormonal contraceptives. It helps to support optimal testosterone levels. A zinc supplement in the form of zinc citrate can be helpful in treating post-pill acne
- DIM & Milk Thistle: DIM is a compound found in cruciferous veg (green leafy vegetables like broccoli and sprouts) that is very effective in supporting the removal of excess androgens from the body. It can be very potent when taken in supplement form, for this reason, a milk thistle supplement should be taken in conjunction with DIM to support the liver. Please note that milk thistle cannot be taken if you are taking the contraceptive pill as it interferes with its efficacy!
- Omega 3: is an anti-inflammatory and nourishes the skin
- Increase Fibre: as noted above, excess hormones are removed from the body via stool, so it is important that you have regular bowel movements to allow your body to detoxify itself and prevent the reabsorption of unwanted hormones back into the bloodstream
- Reduce Refined Sugars: excess sugar can cause inflammation in the body which can exacerbate acne
- Dairy: while the link between dairy consumption and acne in literature is quite weak, anecdotal evidence suggests that dairy can make acne worse for some people
Everyone’s skin is so individual, for this reason it is important that you seek tailored advice from a skincare professional (I recommend the Monica Tolan clinic to anyone who asks – they are amazing at what they do).
- Oil-based pre cleansing oil: an oil based cleaner will help to breakdown the sebaceous oils that are clogging the pores to ensure your cleanser can effectively to its job. This is the one I love.
- Salicylic acid cleanser: salicylic acid is a hero ingredient for treating acne by chemically exfoliating and deep cleaning the skin, the environ brand is my personal favourite!