Fluctuating hormones can be a nasty surprise for your skin.
Going off birth control can be a major change—for your skin. Quitting hormonal contraceptives can lead to pimples, skin inflammation, or a decided uptick in oil production. Yep, going on birth control and going off it can both lead to side effects.
“Your skin can really go haywire,” says Ava Shamban, MD, a Beverly Hills dermatologist and founder of SKINxFIVE.
What's behind this upheaval? The progestin and estrogen in hormonal birth control create a stable environment for your skin, points out Melanie D. Palm, MD, MBA, a board-certified dermatologist and cosmetic surgeon, medical director of Art of Skin MD, and assistant clinical professor at University of California San Diego. When you stop taking birth control, you disrupt that peace.
Here's the good news: This chaotic period for your skin is temporary, says Dr. Shamban. How long it lasts can vary, but you can probably expect to see your skin normalize within months. That transitional time, however, can be like a "hormonal roller coaster" for your skin, says Dr. Shamban. Just think of it as the very worst amusement park ride ever.
Eager for a speedy exit and a return to clear, consistent skin? Try these strategies.
Don't wait until you stop taking the pill—and the first breakout occurs—to manage your skin. Steven Wang, MD, board-certified dermatologist and co-founder of Dr. Wang Herbal Skincare, recommends a holistic approach beginning two to three months before you quit your oral contraceptive. “You have to figure out your way of life, from stress levels to what you eat,” he says.
Keep stress low, make sure to get enough sleep, and drink lots of water. And watch what you eat too. “Try to have an anti-inflammatory diet with high omega-3s and fruits and vegetables, and minimize any fried food,” says Dr. Wang. Because there’s an interaction between your gut and your skin, he also recommends probiotics. “If you can control inflammation internally, that can help mitigate some of the skin inflammation.” (Try these five meals that contain a dose of probiotics.)
Institute a skincare routine
While you wait for your hormones to settle, "it is important to begin a consistent skincare regimen,” says Dr. Shamban. Most likely, you're familiar with the basics of caring for your skin. But if years or even decades of consistently clear skin have made you complacent (I’ll wash my face in the morning!) here's a quick refresher:
Wash your face. Get rid of makeup and the environmental contaminants that your face was exposed to throughout the day by cleaning skin each night, says Dr. Palm. (More on which cleansers to use below.)
On the go? Don't let oil linger on your skin. “One of the common complaints women have is greasy skin,” says Dr. Wang, who recommends oil-blotting pads to reduce the sebum, or oily secretions, on your face. No time for a post-workout shower? Try running a salicylic acid pad over your face, says Dr. Palm.
Don’t touch. Resist the urge to squeeze pimples and pick at your skin. “It’s only going to make things worse,” says Dr. Wang.
Check labels. Opt for makeup and hair products that won’t make skin problems worse. Make sure the packaging says “non-comedogenic.”
Apply topical medications
“The gold standard of acne treatment should begin with a topical retinoid (such as tretinoin, adapalene, or tazarotene) and benzoyl peroxide,” says Dr. Palm, describing recommendations from a recently published consensus paper in the Journal of American Academy of Dermatology. A retinoid product–a prescription derivative of vitamin A–accomplishes several things, explains Dr. Wang: It decreases oil production, treats acne, and (bonus!) reduces signs of aging. Benzoyl peroxide, an active ingredient in many drugstore skin cleansers, kills acne-causing bacteria.
For her patients, Dr. Palm usually prescribes a combination benzoyl peroxide/clindamycin gel in the morning, and a topical retinoid in the evening. (Clindamycin is a bacteria-fighting antibiotic.)
Dr. Shamban has a similar treatment strategy: “If your skin is sensitive, using a gentle salicylic acid cleanser along with [a prescription] azeleic acid in the morning and a very mild retinol at night with a lightweight moisturizer can be quite effective." Retinol products are also derived from vitamin A but available over the counter and not quite as powerful as retinoids. A salicylic acid cleanser, which can be found at drugstores, removes the dead skin cells that clog pores, leading to whiteheads and blackheads. "If your skin is oily," says Dr. Shamban, "you can do the same except add some benzoyl peroxide in the morning and a higher-strength retinol at night."
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter
If you've gone off birth control because you're trying to get pregnant, avoid retinoid treatments, Dr. Shamban says. Instead, your doctor might prescribe a topical metronidazole gel at night, along with the a.m. routine of a gentle salicylic acid cleanser and lightweight moisturizer.
These combos of topical treatments and cleansers are generally effective for acne, whether or not it's a reaction to quitting birth control. “If breakouts still persist, I am a proponent of considering oral treatment with the anti-androgen spironolactone," says Dr. Palm. As with birth control pills, this prescription medication will create a hormone balance that favors acne-free skin, she says.