3 Ways To Get Your Skin Under Control After Going off Birth Control

Fluctuating hormones can be a nasty surprise for your skin.

Going off birth control can be a significant change for your skin. Quitting hormonal contraceptives can lead to pimples, skin inflammation, or a decided uptick in oil production. 

"Your skin can really go haywire," said Ava Shamban, MD, a board-certified dermatologist and founder of Ava MD in Los Angeles, Calif.

What's behind that upheaval? Well, the synthetic hormones, progestin and estrogen, in birth control create a stable environment for your skin, explained Melanie D. Palm, MD, MBA, assistant clinical professor at the University of California, San Diego. 

When you stop taking birth control, you disrupt that peace. But here's the good news: For most people, that chaotic period for your skin is temporary, explained Dr. Shamban. For others, once their natural levels return, those hormones may cause acne.

Basically, it all depends on you and your hormones. 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, noted 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? Here are three strategies to help get your skin under control after going off birth control.

Prepare Beforehand

Don't wait until you stop taking the pill—or after your first breakout occurs—to manage your skin. Steven Q. Wang, MD, board-certified dermatologist at Hoag Memorial Hospital Presbyterian in Irvine, Calif., recommended a holistic approach 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," said Dr. Wang.

Keep stress low, 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," noted Dr. Wang. "If you can control inflammation internally, [probiotics] can help mitigate some of the skin inflammation."

Institute a Skincare Routine

While you wait for your hormones to return to their normal levels, "it is important to begin a consistent skincare regimen," explained 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, here's a quick refresher:

  • Wash your face. Dr. Palm said to get rid of makeup and the environmental contaminants that your face was exposed to throughout the day by cleaning your skin with a gentle, non-drying cleanser each night. 
  • On the go? Don't let oil linger on your skin. Dr. Wang recommended oil-blotting pads to reduce your face's sebum, or oily secretions. No time for a post-workout shower? Try running a salicylic acid pad over your face, added Dr. Palm.
  • Don't touch. Resist the urge to squeeze pimples and pick at your skin, which makes things worse, said Dr. Wang.
  • Check labels. Ensure the packaging on your makeup and hair products says "non-comedogenic," meaning they contain ingredients that won't clog your pores. 

Apply Topical Medications

Topical Retinoid + Benzoyl Peroxide

"The gold standard of acne treatment should begin with a topical retinoid (such as tretinoin, adapalene, or tazarotene) and benzoyl peroxide," said Dr. Palm.

Retinoids, a derivative of vitamin A, decrease oil production, treat acne, and reduce signs of aging.

And benzoyl peroxide, which kills acne-causing bacteria, is an active ingredient in many drugstore skin cleansers. However, talk to your dermatologist before using benzoyl peroxide. Because acne-causing bacteria is more commonly associated with adolescent acne than the type of hormonal acne that birth control causes, benzoyl peroxide may not be the best solution.

Additionally, peroxide molecules have weak, unstable bonds between their atoms, making them a source of free radicals. Free radicals are harmful substances that generate from unstable chemical bonds. Like harmful ultraviolet (UV) ray exposure, the free radicals that come from benzoyl peroxide may lead to oxidative stress on the skin, causing premature aging, fine lines, and wrinkles.

Benzoyl Peroxide + Clindamycin Gel + Topical Retinoid

Dr. Palm recommended a combination of benzoyl peroxide and clindamycin gel (a bacteria-fighting antibiotic) in the morning and a topical retinoid in the evening.

However, avoid retinoids if you've gone off birth control because you're trying to get pregnant. Instead, your dermatologist might prescribe a topical dapsone for hormonal acne at night.

Salicylic Acid Cleanser + Azelaic Acid + Retinol

"If your skin is sensitive, using a gentle salicylic acid cleanser—along with [a prescription] azelaic acid in the morning and a very mild retinol at night with a lightweight moisturizer—can be quite effective," added Dr. Shamban.

A salicylic acid cleanser, which you can find at drugstores, removes the dead skin cells that clog pores, leading to whiteheads and blackheads. Retinol is a type of retinoid, available over the counter and not quite as powerful as retinoids.

"If your skin is oily," explained Dr. Shamban, "you can do the same except add some benzoyl peroxide in the morning and a higher-strength retinol at night."

Choosing the Right Combination

Those combinations of topical treatments and cleansers are generally effective for acne, whether or not it's a reaction to quitting birth control. However, it's important to speak to your dermatologist to determine the best course of action for your skin.

"If breakouts still persist, I am a proponent of considering oral treatment with the anti-androgen spironolactone," said Dr. Palm. As with birth control pills, that prescription medication will create a hormone balance that favors acne-free skin.

Of note, keep in mind that spironolactone is a teratogen, meaning it causes birth defects. So, if you're going off birth control and are using spironolactone, make sure that you're also using another reliable form of contraception.

Summary

Fluctuating hormone levels due to going off birth control can cause an influx of unwanted stubborn acne.

However, there are steps that you can take to prevent or minimize a crop of stubborn pimples on your face. Improving your diet, establishing a careful skincare regimen, and speaking to your dermatologist about prescription topical medications, like retinoids and clindamycin gel, can help get your skin under control after going off birth control.

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Sources
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  1. National Library of Medicine. Estrogen and progestin (oral contraceptives).

  2. National Library of Medicine. Acne - self-care.

  3. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris [published correction appears in J Am Acad Dermatol. 2020 Jun;82(6):1576]. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037

  4. National Center for Biotechnology Information. PubChem Compound Summary for CID 7187, Benzoyl peroxide

  5. American Academy of Dermatology Association. Retinoid or retinol?

  6. American Academy of Dermatology Association. Retinoid or retinol?

  7. Kim GK, Del Rosso JQ. Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris: Practical Considerations for the Clinician Based on Current Data and Clinical ExperienceJ Clin Aesthet Dermatol. 2012;5(3):37-50.

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