What Questions Should I Ask My Healthcare Provider
- How severe is my acne?
- What lifestyle changes should I make to prevent hormonal acne from forming?
- What are the side effects to my acne treatment?
- Can I take this treatment if I become pregnant?
A note from Cleveland Clinic
It can be frustrating to see breakouts on your skin as an adult, considering they are most frequent among adolescents. Talk with your healthcare provider if your acne is persistent and they will be able to offer advanced treatment options to eliminate pesky pimples.
Last reviewed by a Cleveland Clinic medical professional on 09/10/2021.
References
How To Get Rid Of Acne Scars: The Path To Smoother Skin
Congratulations you finally won your ongoing battle with acne! Though the journey was probably tough , getting rid of your blemishes for good deserves a celebration.
That is until you realize some of those spots left a not-so-nice parting gift acne scars and discolouration. Does the journey ever end?
Although it can be discouraging to see those scars when you look in the mirror, getting rid of them isnt as tough as you might think. We sat down with Madison Noakes, Senior Medical Aesthetician, to learn all about acne scars and how to achieve a smooth, clear complexion.
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Treatments That Dont Need A Prescription
If you have mild acne, your pharmacist can help you choose an acne wash or cleanser, a lotion or cream with ingredients such as benzoyl peroxide, azelaic acid or glycolic acid that can treat the condition. Use these products right across the area where there is acne, not just on the individual spots. For example, if you have acne on your neck, you should wash your whole neck with the product. If these treatments make your skin feel irritated or dry, try using them less often.
Other treatments can help with mild acne, such as light microdermabrasion, chemical peels and light diathermy. They may need to be repeated regularly and are not suitable for people with severe acne.
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How Can Birth Control Prevent Acne
Acne is a direct result of an imbalance of hormones produced by the ovaries: estrogen and progesterone . Sometimes, when the ovaries produce estrogen, it gets turned into progesterone it is the excess of this hormone that can lead to acne. Fortunately, birth control pills turn this function off, preventing the excess of male hormones in your system. More specifically, being on the pill creates a protein that binds to the extra male hormones, resulting in less production of them.
What Foods Trigger Acne
Foods that trigger acne include milk, whey protein, refined carbohydrates, high GI foods, sugar, alcohol, and inflammatory fats. These foods impact your skin by increasing the production of hormones that worsen acne. Not everyone will react to all these foods, but consider eliminating them if you deal with stubborn acne.
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Optimize Your Circadian Rhythm
Your circadian rhythm is your body clock, determining your sleep/wake cycle. Disruption of this incredibly important rhythm eventually leads to the dysfunction of EVERY SINGLE ONE of your hormones and throws off your metabolism!
Birth control can throw a wrench in this diurnal rhythm, altering the timing of hormonal release from the brain. By sticking to a regular sleep/wake schedule, you support your endocrine system and the delicate balance of your hormones.
What Is Menopausal Acne
Menopausal acne is when acne appears in women in their 40s and 50s. The cause of menopausal acne is a decrease in estrogen levels or an increase in androgen hormones like testosterone in menopause. Some of the hormonal treatments for menopausal symptoms can also cause hormonal acne. This is especially common in women taking a progestin.
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Get A Good Skincare Routine
Again, theres only so much you can do from a topical standpoint at home when it comes to treating hormonal acne. As long as you have a good skincare routine , the only other powerful cystic-zit fighter to try is benzoyl peroxide. Benzoyl peroxide not only kills acne-causing bacteria, but it also decreases oil production by decreasing lipid and fatty acid production, and has mild whitehead and blackhead-fighting abilities, Dr. Imahiyerobo-Ip has told Cosmo.
As a rule, always start off with a low dose of 2.5 or 5 percent benzoyl peroxide . That being said, this stuff can still be highly irritating, so if you have sensitive skin, try starting with a benzoyl peroxide face wash before trying spot treatments.
Support Estrogen And Testosterone Metabolism
There are specific nutrients your liver requires to effectively detox your hormones. And you know what, those happen to be some of the same depleted by the pill.
Using a supplement that is formulated with DIM, Calcium-D-Glucarate, green tea extract, and broccoli seed extract will support natural liver detox pathways, plus how your gut eliminates excess estrogen.
Balance by Dr. Brighten is a comprehensive women’s formula designed to harmonize sex hormones and improve common hormone related issues. Formulated with B Vitamins, antioxidants and hormone supporting herbs, this product helps support the body in eliminating excess estrogens and environmental toxins.
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Problem: A Toxic Af Environment
We’re inundated with tens of thousands of chemicals daily, most of which we know very little about or how they affect long-term health. They’re everywhere , and it’s difficult to avoid them.
Toxic load means your liver works overtime. Add the pill to that problem and you often overwhelm your detox system. Your skin also helps detoxify. When your liver gets backed up, the repercussions show up asâyou guessed itâacne.
Solution: Minimize Toxin Exposure From Food Cosmetics And Household Products
You can’t eliminate toxins. They are everywhere. But you can reduce your exposure to them. I love the Environmental Working Group , which provides some super-helpful guides for helping you find food, household products, and cosmetics with the fewest toxins possible.
- The Dirty Dozen guide to the best and worst choices for buying organic or conventional produce
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Whats Involved In Taking Hormonal Therapy For Acne
These medications must be prescribed by a doctor. Each is a pill that you would take daily.
If youre wondering whether hormonal therapy could help clear your acne, you may want to make an appointment to see a dermatologist. After examining your acne and gathering the necessary information about your health, this doctor can tell you if hormonal therapy may be an option.
Before you see a dermatologist, it helps to prepare for your appointment. Youll want to be able to tell your dermatologist the following:
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Medical conditions you have , including high blood pressure, heart disease, blood clots, migraines, or cancer
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Medications you take
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Supplements and other natural products you take
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Surgeries youve had
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Medical conditions of close blood relatives, including cancer, kidney disease, or heart disease
If the pill is an option for you, you will have your blood pressure taken to rule out high blood pressure. You dont need a Pap smear or pelvic exam before a dermatologist can prescribe the pill to treat acne.
Before your dermatologist prescribes spironolactone, you will need some blood tests.
If you begin hormonal therapy, you will need to keep follow-up visits with your dermatologist. Spironolactone requires that you gradually increase the dose, so youll need to see your dermatologist every 4 to 6 weeks when you start taking it.
The Cause Of Hormonal Acne
Changes in the body hormonal levels can cause acne which is why teenagers typically experience acne as they go through puberty.
In women, specifically, hormonal acne often occurs around the menstrual cycle. During menstruation, the hormonal levels in the body fluctuate, and due to this, the formation of acne is typical among many women.
Another cause for hormonal acne is specific issues like PCOS, menopause, and increased androgen levels. Menopause occurs most commonly when women reach the age of 45 and above. Every woman is different and some may experience it early and some much later. These hormonal changes in the body can be a contributing factor to acne.
Menopausal acne occurs because of a drop in estrogen levels and or an increase in androgen hormones like testosterone. Many women take hormone replacement therapies to help with menopausal symptoms, so they are still likely to experience hormonal acne. This is because HRTs use the hormone progestin to replace the estrogen and progesterone hormones in your body. Using this hormone may even be what causes acne in your body.
The rise or fall in hormones can cause excess sebum production that accumulates with dirt into the pores and causes acne and skin cells can also become clogged in the pores.
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Does Progestin Cause Acne
In most cases, an excess of progesterone causes hormonal acne. Progestin is a synthetic version of progesterone found in birth control. Some progestins activate androgen receptors and ultimately make your skin more oily, resulting in acne. But in some cases, progestins can block androgen receptors and do the complete opposite, lessening acne.
More Hormone Balancing Resources + Support
While these strategies can help you transition off birth control as seamlessly and naturally as possible I want to emphasize the fact that everyone is unique, thus eliminating birth control side effects and going off the pill still demands an individualized approach. I recommend finding a naturopathic or functional medicine practitioner or working with a coach who understands the potential side effects of being on/transitioning off the pill and is comfortable addressing post-birth control syndrome.
If youre ready to make the switch I highly recommend checking out my 28 Day Hormone Balance Reset Plan, which contains one months worth of recipes, supplements + lifestyle tips to help you balance your hormones and reconnect with your cycle and body.
Additionally you can check out these helpful hormone balancing resources/blog posts
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Holistically Address Your Leaky Gut
Not only do oral contraceptives negatively impact your gut flora, but they damage your gut lining by altering the tight junctions between your intestinal epithelial cells. Normally only water and nutrients from your digested food would make it past the intestinal barrier, but a hyperpermeable gut allows all sorts of substances through into systemic circulation, where your immune system encounters them and rightfully freaks out. This creates a chronic inflammatory response that triggers a number of symptoms, including acne.
Many natural medicine practitioners will address leaky gut by recommending specific nutrients and demulcent herbs to soothe and repair the gut lining. They might also recommend probiotics to address birth controls affect on the microbiome. These are great first steps and sometimes can address the root cause, depending on the person.
Yet this approach is often a band-aida temporary fixfor a deeper dysfunction, as your gut is essentially your inner skin and reflects any dysregulation of your internal organs. Usually gut hyperpermeability can be resolved by addressing either the nervous system, certain endocrine glands, detoxification and elimination, or supporting immune system regulation via T-reg cell production.
S To Eliminate Hormonal Acne Naturally At Home
In this section, were going to look at how to use your diet, lifestyle and skin care routine to start clearing up your skin quickly.
If your acne is really severe, its best to follow all of these steps.
However, you can start with whichever ones make the most sense for you and add on others as time goes by.
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The Dr Schultz Difference
Dr. Schultz is an expert in treating acne affecting women of all ages. During your appointment, he will perform a careful examination of your skin to analyze your skin and look into other factors that could be contributing to your breakouts.Depending on your skin type and the type of post-birth control acne you are experiencing, Dr. Schultz will recommend a treatment or combination of treatments that target the symptoms you are experiencing, such as redness, inflammation, or whiteheads.Laser treatments, microdermabrasion, corticosteroid injections, chemical peels, and extractions can be used to control and soothe acne that developed after stopping birth control.BeautyRX is Dr. Schultzs award-winning line of skincare that is designed to help you achieve your best skin possible. If appropriate, he may recommend a specific product to help with your post-birth control acne.
Do Hormonal Contraceptives Treat Or Cause Acne
In general, hormonal birth control pills are considered an effective treatment for acne in some women. In fact, using the pill to treat acne has been an accepted FDA-approved practice for many decades. Heres why it works.
As we mentioned, all women need androgens for their overall health , but when they have too much coursing through their veins, their skin gets too oily, their pores clog, and they develop acne.
But the estrogen and progesterone in oral contraceptives lowers your androgens, calms down the sebum production, and decreases your acne breakouts.
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Factors That Affect Post
Post-birth control acne may largely depend on your pre-birth control hormone levels, genetics, type of birth control used, and lifestyle factors such as smoking.
The following factors play key roles in the acne risk of different birth control methods:
- Amount of estrogen and estrogen:progestin ratio. In general, higher doses of estrogen yield higher risk of insulin insensitivity and thus acne.
- Type of progestin. Higher androgen effects of the given progestin yields higher risk of post-birth control acne.
Numerous studies also suggest that:
- Combination pills containing newer progestins are less likely to cause acne than those with older-generation progestins
- Progestin-only methods such as the Depo-shot are more likely to cause post-birth control acne
- Vaginal rings are less likely to cause post-birth control acne than pills
How I Treated The Hormonal Acne I Got From Birth Control
As a teenager, I hated my skin. While I know now that my acne wasnt actually that bad, I was convinced it was blotchy, red and terrible. In my early 20s, my skin was fine not glowy or perfectly smooth, but fine. Whenever that time of the month came around, Id wake up to a few pimples here and there, particularly along my jawline and neck, but they usually went away within a week .
Last year, when I turned 26, everything changed.
I decided to get an intrauterine device, aka an IUD . Little did I know that while the small T-shaped device prevented me from getting pregnant, it would also wreak havoc on my skin.
It was January 2017. After not being on any sort of birth control for a few years, I got the hormone-based Mirena IUD. Aside from the extremely painful insertion process yes, it hurts A LOT I was happy with my decision.
A month later the breakouts started.
I began developing red, painful and downright angry cystic breakouts along my jawline and neck. After doingsome research, I realized my experience wasnt unique. I just wish Id had some sort of warning of how bad it could get before I had a foreign object placed inside my uterus.
Although Id experienced this type of acne in the past, especially around my period, there was something different this time. Before, I would get one, maybe two decent-sized pimples, but theyd typically disappear within a week or so. After the IUD, the breakouts just wouldnt go away.
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Types Of Birth Control To Treat Acne In Women
The last decade has seen an explosion in new types of birth control. But so far, only three types of birth control pills have been approved by the FDA for treating acne. All three are “combination” oral contraceptives that contain both estrogen and progesterone. In fact, birth control pills that contain only progesterone can actually make acne worse.
Each type of birth control pill used for acne contains a low dose of the same form of estrogen. But each one uses a different form of progesterone.
The FDA has approved the following types of birth control for acne:
- Ortho Tri-Cyclen uses estrogen combined with a progestin called norgestimate. A progestin is a synthetic, or manmade, form of progesterone. The pill is available with different doses of progestin.
- Estrostepuses estrogen combined with a progestin called norethindrone. The pill is available with different doses of estrogen.
- YAZ uses estrogen combined with a manmade form of progestin called drospirenone. The FDA has concluded that birth control pills containing drospirenone may have increased risk for blood clots compared to pills containing other progestins. Other brands containing drospirenone include Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, and Zarah.
Studies have not shown a major difference among these three pills in terms of how well they treat acne.
How To Treat Acne Caused By Birth Control
When dealing with acne caused by birth control, check which formulation you are using and see if it is a progesterone-only or androgenic progestin, and inquire with your doctor to see if you can switch to a combination pill on our list .
Also keep in mind that birth control can make your acne-flare up at first before you start seeing improvement in your acne. It may be beneficial to wait a few months before deciding to switch to another formulation.
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