Post Birth Control Acne

"The pill" is one of the most popular forms of birth control and many of us have been on it at one point or another. However, when a woman decides to get off the pill sometimes there are some not so desirable side effects that happen to the skin. I refer to this as "post-birth control skin syndrome." This is basically when the skin throws a tantrum for a few months while the body acclimates back to its normal hormone levels. Unfortunately, if you suffered from oily skin or acne before the pill some old skin issues may return. There are definitely some things you can do to help the process along and not make it so miserable on yourself.

Your Skin On & Off Birth Control Pills

To fully understand what happens to our skin when we stop taking birth control pills we must first understand what the skin is like when on the pill. Most birth control pills contain two forms of synthetic female hormones: estrogen and progestin. We produce both of these hormones naturally, but when taking birth control pills those levels are increased and kept at stabilized levels. Consequently, it also lowers our body's testosterone level.

How this affects the skin is lower levels of testosterone, means the skin produces less oil. Since oil is a breeding ground for bacteria and bacteria can lead to acne, producing less oil, in turn, leads to little to no acne. Or at least how the theory goes!

Now if you've decided to get off the pill for one reason or another this when things can go a little bananas for your skin. All of a sudden you have normal monthly hormonal shifts plus your testosterone level increases. The ratio of too much estrogen and too little progesterone can be off balance as well. This can mean an oily face can trigger acne and blackheads not only on your face but possibly your back and chest as well since these areas have similar oil glands to your face. Yikes.

What you can do

First, understand and accept this is part of the hormone detox process that is going on inside your body. Everyone is different but this process can take months. On the pill, your skin may be very different. It may be a bit drier, you may have minimal to no acne or blackheads and you've adjusted your skin routine and makeup for that skin. Now all of a sudden you are off of the pill. You are producing more oil due to adjusting hormones, plus whatever your skin conditions were like pre-pill may pop back up, so what once worked for your skin on the pill, may not work for your skin off of it. 

Don't wait for your skin to start breaking out before you start treatment! I would highly recommend thinking about the following things and preparing before you get off the pill, however, if you are already off the pill many of the following tips can absolutley help. Remember acne is a very individual skin issue even if two people have hormonal breakouts, what works for one may not another. While our first reaction is to seek out new skin care products to treat the skin, please remember that much of acne and especially hormonal acne is internal and not just topical. Without treating the internal factors topical products may be ineffective or just a temporary fix. So in addition to changing up a few skin care products, treating the internal factors is absolutely crucial! 

1. Cut out Sugar

I know cutting out certain foods like refined carbohydrates and sugar may not what you want to hear but these types of food/drinks can absolutely contribute to acne. Eating sugar and refined carbohydrates give the body a surge of insulin. When this happens it creates a burst of inflammation and it puts hormones and oil glands into overdrive. So think of it this way, sugar, and refined carbohydrates ➝ hormones ➝ sebum ➝ bacteria ➝ acne.

Screen Shot 2017-09-24 at 2.00.17 PM.png

2. Remove Hormone Disruptors

This means anything with synthetic fragrance! From beauty products and personal care to cleaning supplies, laundry detergent, synthetic fragrance filled candles and room fresheners. According to the Environmental Working Group, over 70% of fragrances contain phthalates. It's a chemical compound used to make fragrances last longer. However, phthalates mimic estrogen in women and can disrupt your hormones. And if you got off the pill to try to have a baby, it's been shown to lead to the abnormal development of the male reproductive system which can affect boy babies and can lead to fertility issues later in their lives. 

3. Cut out Dairy

The deal with dairy and acne isn't as simple as "it's full of hormones" as one thought and there is actually another underlying reason in addition to the hormones in dairy. What happens when we consume dairy is the minerals and calcium speed our metabolism. And with a faster metabolism, we must have adequate nutrition to support that. One of the most important vitamins in keeping the skin clear is vitamin A and guess what is most deficient in people with acne? You guessed it vitamin A. So if you've quit dairy and noticed your skin clearing up it because you are getting adequate vitamin A! That leads me to my next point....

4. Consume Vitamins + Minerals

An overlooked and little talked about contributing cause of acne is the process of keratinization. This is basically when keratin, a natural protein found in the skin which blocks pores by binding dead skin cells together. Normally the gradual growth of hair (even peach fuzz) pushes out dead skin cells from the follicles and we wash them away when we cleanse our skin. However, when the body fails to regulate keratin production because of vitamin and mineral deficiencies it goes into overdrive. Then with the combination of thick keratin plugging the follicle which causes inflammation and swells the pore plus the overproduction of oil, acne is born. This can include blackheads, whiteheads or cysts. 

Vitamin A - In a 2006 study published by "Clinical and Experimental Dermatology" testing the relationship between acne and blood levels of vitamin A and E. The results showed that patients with acne had significantly lower levels of those vitamins than people without acne. Furthermore, the study concluded that consuming more of those vitamins from food or supplements improved acne. 

Vitamin E - A big portion of keratin overproduction is caused by a condition called sebum oxidation. Our skin produces a fatty acid called squalene that forms lipids in sebum. When exposed to free radicals like UV rays, pollution, cigarette smoke etc. it causes this fatty acid to oxidize making it the most comedogenic (pore-clogging) substance on earth. Woah. The problem is, most people with acne are very vitamin E deficient. 

Vitamin B - Since birth control pills deplete the body of vitamin B6, which in turn lowers progesterone this can lead to the hormones being out of balance. Having low progesterone in relation to estrogen can lead to acne by increasing insulin which can lead to excess testosterone. (Just like sugar!)

I highly recommend trying to consume foods with these vitamins and minerals first as it's the best source before taking supplements.  

Zinc - The mineral zinc may also benefit people with acne because it dramatically increases the delivery of vitamin A which we now know is super important in reducing keratin. In this study, it was found that 54% of people with acne were deficient in zinc and when people that started taking a zinc supplement acne was decreased by 49.8%!! I have found with my cientThis zinc facial soap by Medicine Mama's Apothecary has worked wonders for many of my clients and adding a topical application to internal  Plus, it's babe on a budget-friendly at $12.

5. Take a probiotic

Gut health and hormones play a much bigger role than people think. Because your gut is very connected to your skin and is a big source of body-wide inflammation it's important to treat your gut too. The more inflamed your body is, the more inflamed your acne can be.

6. Limit Caffeine

I love coffee, but the truth is caffeine can wreak havoc on the endocrine system. It messes with your blood sugar levels and increases insulin which increases hormones, oil production, and acne. Of course, some people are not affected at all by caffeine but some are very sensitive and if you are you may want to cut or limit your intake.

Screen Shot 2017-09-24 at 1.54.09 PM.png

7. Add an AHA/BHA Skin Serum

Regardless of skin type prepare for your skin to be a little more oily. Even the driest skin type can have a bit of shine or develop a hormonal breakout while combination and oily skin types may really be oil ridden. Adding a resurfacing hydroxy acid product will help to break down the keratin that can plug the pores causing a blackhead or a pimple. Night time serums are great and so are salicylic acid cleansers even if you use them every other night.

I love both of these night serums by Naturopathica. The AHA Refining Night Serum is glycolic acid and is ideal for dry, combination, mature and sensitive skin types. While the AHA Purifying Night Serum is best for oily, acne prone and combination skin since it contains both glycolic and salicylic acids.

8. Sea Buckthorn Berry Oil

Sea buckthorn berry oil is a natural oil derived from a shrub native to Europe and China. It's high in vitamin A, E, and C. Which makes it a great antioxidant. But also since we read above those people with acne typically are vitamin A and E deficient this is the natural topical application in addition to ingesting those vitamins. What I find to be super cool about this oil is that it contains two anti-androgen compounds. Androgens are the male hormone testosterone which is responsible for oil production. These two compounds bind receptors and counteract them. Reduced androgen ➝ reduced oil production ➝ reduced acne. To elaborate even further, in a split face 8-week study, one side of the face sea buckthorn berry oil was applied and the other side, a placebo oil. In just ONE week oil was decreased by 17% and after 8 weeks 45%! This is fantastic for hormonal acne! It can be used as a moisturizer or under your moisturizer. Note - as most people with acne are concerned with oils, this oil will not clog pores. On the comedogenic index scale, it's rated as a 1. Also, sea buckthorn BERRY oil is different than the seed oil so the berry is where are the beneficial nutrients are. I recommend this organic version by the brand SeaBuck Wonders.

9. Get a Prescription Retinoid

Retinoids which are a form of vitamin A and particularly prescription strength work by speeding cell turnover and keeping pores clear. So not only is it great for wrinkles and preventative aging, it's great for acne and blackheads. Remember retinol is the precursor for retinoic acid which is found in the prescription strength Retin-A, so that means retinol has to convert within the skin to retinoic acid. So it can take up to 12 weeks for that to happen and if you are breaking out who has 3 months? See a doctor and they can write you a prescription. 

A few warning with retinoids. If you got off the pill to try to conceive a baby you can not use retinoids as they are unsafe during pregnancy and breastfeeding. They also need to be washed off the skin before heading outside and wearing sunscreen daily is highly advised.

10. Use Light Therapy

Get yourself a handheld light therapy machine. Blue light is good for killing acne bacteria and red light is good inflammation in the skin as well as calming redness. Did you know that blue light reduces acne by 67% and blackheads by 50%? Wow right? This light mask by Neutrogena is a combination of blue and red which ends up looking purple. 

11. Back + Chest Acne

Since the oil glands on the back and chest are similar to the oil glands on the face back and chest acne can also pop up. Treat that skin as you would your face and apply those skin care products to those areas as well.

12. Lifestyle

Eat well, sleep well and self-care. Sounds pretty simple right? Lack of sleep and nutrients and stress increases hormone levels. Remember to take a break for yourself. Go for a run, take a yoga class, enjoy a bath, read a book. Do anything that calms and makes your soul happy.

Conclusion

Remember acne is very individual and not all treatments will work for everyone. But taking some steps and being educated on what is happening in your body will definitely help make the process of transitioning to being free of synthetic hormones a lot easier. I encourage you to do your own research!

+ Reduce sugar, dairy, and caffeine intake
+ Reduce exposure to synthetic fragrances
+ Increase vitamins A, E, B6, and zinc with foods and/or take supplements
+ Switch up your skin care products - zinc facial soap, sea buckthorn berry oil