Worried About Post-Pill Acne? Here's How to Support Your Skin
WORRIED ABOUT COMING OFF THE PILL AND BREAKING OUT?
If you started the pill to manage acne, it’s natural to feel concerned about what might happen to your skin once you stop. Let’s take a closer look at how the pill works to keep your acne in check, and what you can do to support your skin when you decide to come off the pill.
How the pill works to clear acne
The pill contains synthetic hormones like ethinylestradiol (a synthetic oestrogen) and progestins such as drospirenone or cyproterone. These progestins act as androgen blockers, preventing your body's androgens (male hormones) from binding to their receptors. While on the pill, your ovarian androgen production decreases, and since androgens increase sebum (oil) production, this reduction in androgen activity means less sebum, preventing acne breakouts.
Why does skin get worse, when coming off the pill?
Once you stop the pill, your skin may start producing more oil than before. While the pill suppresses oil production, your body compensates by upregulating sebum production. When the synthetic hormones are withdrawn, this increased oil production continues, leading to clogged pores and breakouts. Additionally, when you stop the pill, your ovaries start working again and may produce more androgens, causing even more sebum production.
Another factor that can affect your skin when coming off the pill is extra-sensitive hormone receptors. Even if your blood tests show normal androgen levels, your body may still react to these hormones due to heightened receptor sensitivity. The pill increases SHBG (sex hormone-binding globulin), which binds to hormones and reduces the amount that attaches to hormone receptors in skin. After stopping the pill, SHBG levels can drop, leaving your skin more exposed to the surge in androgens, even if your hormone levels appear normal. This heightened sensitivity can be a key factor in post-pill breakouts.
The Good News
Once your natural hormones regulate again, they can actually help support healthy skin. Both oestrogen and progesterone play important roles in maintaining skin health. If you tend to break out premenstrually, it’s because both of these hormones drop at the end of your cycle—but that’s a topic for another blog.
TIPS FOR coming off the pill
If you're planning to come off the pill, it's important to prepare your body in advance—ideally 3-6 months beforehand. Here are the key steps to take:
Plan Ahead: Start preparing 3-6 months in advance, especially if your skin or periods were problematic before going on the pill.
Support Detox Pathways: Focus on optimising your liver and bowel function. Make sure your bowel movements are regular and easy to pass (1-2 times daily). Healthy detoxification pathways ensure that excess hormones and toxins are properly eliminated, helping to balance your hormones post-pill.
Support Gut Health: The pill can deplete good bacteria like Lactobacillus species, so focus on maintaining a healthy gut.
Optimise Nutrient Levels: The pill can deplete essential nutrients like zinc, B6, and selenium, which are all important for skin health and hormone balance. Consider increasing foods that are rich in these nutrients or supplementing (only if you have evidence that these levels are low) to replenish your body before coming off the pill.
Reduce Inflammatory Foods: Remove or reduce highly inflammatory foods like sugar and cow's dairy from your diet. Inflammation can worsen breakouts, especially when your body is adjusting to hormonal changes.
Assess Thyroid Function: The pill can have an impact on thyroid health, so it’s important to test your thyroid function before stopping the pill. A well-functioning thyroid is essential for hormonal balance and skin health.
Manage Stress: Aim to come off the pill at a time when your stress levels are manageable. Avoid coming off the pill when you know you will have periods of excessive stress, such as big life changes or tight work deadlines, this will help regulate your stress response and support healthy skin.
Get Testing Done: While on the pill, you can't test your reproductive hormones because they are suppressed by synthetic hormones. However, you can still test other important markers such as blood glucose levels, nutrient status, inflammatory markers, thyroid function, and liver function. These insights can help you address any underlying issues before transitioning off the pill. About 4 months after coming off the pill, you can investigate your hormone levels to better understand how your body is adjusting.
The pill is often used as a quick fix for acne, but coming off it requires some careful preparation to minimise breakouts. By focusing on gut health, managing stress, and understanding the hormonal shifts that occur, you can support your skin through this transition and set the stage for healthier, clearer skin in the long term.