There are many reasons why women want to get off the pill, whether it’s wishing to get pregnant or realising a birth control pill might not be the best option for their mental health. Whatever the situation, some side effects are inevitable, and one of them is acne

Our skin is greatly affected by fluctuations in hormonal levels — and this is especially so for females. During menstruation, the drop in progesterone and oestrogen levels trigger the oil glands to produce more sebum. This excess oil results in more clogged pores and thus acne breakouts. A fluctuation of hormones also creates an environment for acne-causing bacteria; these fluctuations, often responsible for pre-menstrual symptoms, causes psychological stress which can worsen acne. 

In such instances, hormonal-causing adult acne is suppressed by birth control pills. Most birth control pills contain oestrogen and a progestin that goes against the effects of testosterone. Higher levels of circulating oestrogen means softer and smoother skin. So with a birth control pill, you’re essentially building more circulating oestrogen in your system to block the effects of testosterone, which is the main cause of most adult acne breakouts. In fact, some birth control pills can treat blackheads, whiteheads and cystic acne especially in stubborn areas along the jaw and neckline.

What’s with the breakouts after getting off birth control pills?

When women decide to get off the pill, certainly there will be some side effects like hormonal acne due to the withdrawal of oestrogen that the body is used to. This is especially the case for women who have been taking the pill for years, and even more so for those with a personal or family history of acne conditions. Fortunately, this abrupt change will settle on its own but should there be other symptoms like increased hair growth and irregular periods, perhaps you might want to consider seeing a gynaecologist.

Dealing with side effects of acne

Many female patients usually deal with bouts of acne breakouts after getting off birth control. One way of course is to wait while the body settles, but this process can be mitigated with:

Topical supplements

Some topical supplements may help in improving the condition of your hormonal acne. I suggest adding prebiotics (‘good bacteria’ to counter acne) to your supplement routine and looking out for ingredients like niacinamide, retinoids and chlorella vulgaris extracts to reduce pore blockage and comedones formation. But of course always consult a professional first before going ahead with anything. 

A good skincare routine

The condition of our skin is greatly influenced by our environment and our skincare routine. Consult any aesthetic doctor in Singapore for your acne and they’ll probably probe you on your skincare routine first. I recommend a routine that’s gentle and fuss-free as this will help reduce the risk of sensitive breakouts. Consider introducing products with anti-microbial properties as these allow less bacteria on contact surfaces, which help to keep your face clean overall. Be careful of hair and makeup products too; they should be non-comedogenic or should not cause blockage of pores.

My approach

Topical supplements and a helpful skincare routine should be the first steps to take for the pill stop, but in certain cases, that combined with treatments like peels, hydradermabrasion and laser therapy might be helpful. 

When treating acne, I believe an aggressive multi pronged approach consisting of treatment, medication and lifestyle changes should be implemented as soon as possible to control acne and prevent permanent scarring. While you want to be conservative when doing aesthetic treatments, an overly conservative approach when it comes to acne might result in irreversible scarring. Thus, initial tight control is imperative. Once the situation improves, we can gradually de-escalate therapy. 

I tend to implement the following: 

  • Fractional energy devices to treat active acne and post-inflammatory erythema. Fractional devices are especially helpful if you have depressed scarring and want to treat both your active acne and acne scars at the same time. 
  • Discovery pico plus carbon peel which uses a carbon photo-enhancer to kill acne bacteria and stimulate collagen renewal. 
  • Hydradermabrasion for a 3-in-1 concoction that consists of chemical peels, crystal-free exfoliation and vacuum extraction. What we do here is first unblock the pores, treat the acne and then stimulate skin renewal. 
  • Photodynamic/light therapy to kill acne bacteria and create an anti-inflammatory effect.

Conclusion

For many women, dealing with acne or troubled skin after stopping birth control might be a harrowing experience, but you don’t have to go through it alone. There are ways to mitigate this side effect naturally, so do not worry.

References

  1. Lortscher, D., Admani, S., Satur, N., & Eichenfield, L. F. (2016). Hormonal Contraceptives and Acne: A Retrospective Analysis of 2147 Patients. Journal of drugs in dermatology : JDD, 15(6), 670–674.
  2. Bagatin, E., Freitas, T., Rivitti-Machado, M. C., Machado, M., Ribeiro, B. M., Nunes, S., & Rocha, M. (2019). Adult female acne: a guide to clinical practice. Anais brasileiros de dermatologia, 94(1), 62–75. https://doi.org/10.1590/abd1806-4841.20198203