When I switched my contraceptive to Nexplanon, the birth control implant, my face turned into a pimply oil slick. After feeling helpless, I finally found a skincare routine that banished the breakouts.
My entire life, I was that girl with great skin. Friends would ask me for the secret to my clear complexion, coworkers said they were envious of my glow, and complete strangers stopped me on the street to complement my face.
I took these mini confidence boosts for granted until six months ago, when I started a new birth control method, the Nexplanon implant. A month after my ob-gyn inserted this long-acting hormonal contraceptive in my arm, my skin did a 180. Hormonal acne popped up on my forehead, around my nose and mouth, and on my chin. My skin, which I used to get away with cleansing once a day before bedtime, felt like an oil slick.
At first I ignored the symptoms, attributing the oiliness to the sweltering summer heat and all the traveling I was doing on weekends. I was really pleased with Nexplanon because it was as effective as birth control pills yet so much easier—no popping a pill every day. But this side effect was hard to ignore, and new whiteheads and redness kept appearing.
I called my gynecologist's office and explained my situation. I hadn't changed my skincare regimen or my diet, yet my face was freaking out. The nurse practitioner suggested a try an over-the-counter drugstore spot treatment. "It could get worse before it gets better," she said. I wanted to cry, but I bought a 10% benzoyl peroxide formula that same day and started covering my pimples in the white goop each night before bed.
My newfound oil slick of a face wasn't a figment of my imagination. The birth control pill, my old contraceptive of choice, contained a combination of the hormones estrogen and progestin, while Nexplanon only contains progestin, explains Charles Ascher-Walsh, MD, director of the gynecology and urogynecology division at the department of obstetrics, gynecology and reproductive Science at Mount Sinai Hospital in New York City. "Both hormones may effect the amount of oil produced by the glands on the face, chest, and back. Some may improve acne while others may worsen it," Dr. Ascher-Walsh tells Health in an email.
But even though skin changes are a known side effect of hormonal contraception of any kind, it's not understood why some women develop clearer skin and others, like me, end up plagued with pimples.
Other common side effects of Nexplanon include irregular bleeding, breast tenderness, and nausea. Although I felt lucky to only experience skin issues and the cessation of my period (an arguably great side effect), I was miserable. Was this amazing implant, which keeps me pregnancy-protected for three years, worth my skin woes?
Every morning when I woke up, the ointment-covered spots had miraculously shrank. But new pimples popped up in places I hadn't used the spot treatment. One day at work, I could literally feel my skin becoming oilier and felt a pimple growing on my chin. Enough was enough.
I picked up my cell phone and furiously texted my friend, a self-proclaimed skincare junkie and beauty writer. I explained my situation and she proposed a few tweaks to my typical routine. I called in backup just to be sure, reaching out to Health's assistant beauty editor. She suggested similar skincare recommendations as my friend did.
After raiding Rite-Aid, I was ready to implement my new skincare regimen. My old regimen meant that I washed my face once in the evening, went to bed, woke up the next morning, applied a light moisturizer, and put on my makeup. Here's what my new routine looks like:
1. Cleanse with a gentle face wash. Right now I'm using Neutrogena Naturals Purifying Facial Cleanser ($7, target.com).
2. Tone with Paula's Choice Redness Relief Toner ($21, dermstore.com). This toner evens out my skin tone, which has become increasingly red in the areas I've been experiencing breakouts. I put the toner on a cotton round and swipe across my entire face to get rid of any extra dirt that my cleanser might have missed.
3. Use a chemical exfoliant to even out my skin texture. I apply Paula's Choice Skin Perfecting 2% BHA Lotion with Salicylic Acid ($28, amazon.com) to help minimize my skin's bumpy texture and soothe redness. Like a physical exfoliant (think a face scrub with beads), a chemical exfoliant also reduces dead-skin buildup and clogged pores. For me, the physical exfoliant seems to be gentler and more effective on my skin.
4. Apply a hydrating moisturizer all over. I like Cetaphil Daily Hydrating Lotion ($13, walmart.com) since it's noncomedogenic (in other words, it doesn't block pores) and fragrance-free. Since the BHA lotion and spot treatment can be a bit dehydrating, it's important to moisturize so my skin doesn't overcompensate and produce even more oil.
5. Never forget sunscreen! The BHA lotion makes skin more sensitive than usual, so protecting my face from the sun is a must. I use PUR Minerals Rescue Squad DD Creme SPF 25 ($35, kohls.com). The nongreasy formula smooths on easily and feels lightweight.
1. I cleanse, tone, and apply the same chemical exfoliant I used during my daytime routine.
2. I apply one drop of Kiehl's Midnight Recovery Concentrate ($46, sephora.com) as a nighttime moisturizer, patting it gently onto my face. Not only does it smell amazing, it counteracts dryness from my other products.
3. I dab on my 10% benzoyl peroxide spot treatment to dry out any existing pimples. I use a generic cream called Daylogic Vanishing Acne Treatment Cream ($5, riteaid.com) and it's perfectly effective.
4. I also try to do a clarifying face mask once a week with the Boscia Luminizing Black Mask ($34, sephora.com) to unclog my pores. I apply the gel just to the areas where I'm prone to breakouts. And I tried out a one-time facial, which helped eliminate some on the bumpy spots on my chin where buildup occurred.
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I've been doing my new DIY skincare program for three months now, and my acne is a lot more manageable. When I do get a pimple, I'm able to shrink in within a couple of days. I no longer feel ultra-oily; I've added products that combat oil but don't completely dry out my skin and its protective oil barrier. Best of all, I have peace of mind. Knowing I can take control of my skin means I don't have that feeling of hopelessness I did when I first got my Nexplanon implant.
For me, adjusting to a new regimen was worth the effort if it meant I could keep using the Nexplanon implant. But my decision isn't necessarily the right decision for everyone dealing with hormone-driven acne or other birth-control symptoms.
"All the side effects are essentially natural reactions to the hormone,s but some are tolerable while others are not," says Dr. Ascher-Walsh. "It is up to the individual to decide on this tolerability." If you're not happy with your contraceptive, ask your ob-gyn about other types of birth control pills or hormonal methods—or non-hormone ones—that could better meet your needs.