Post pill acne or acne occurring after cessation of the oral contraceptive pill (OCP) is an unfortunate and very unsettling occurrence that far too many women today are encountering. Whether the pill has caused difficult side effects you have finally had enough of, you are looking to conceive or are just wanting to get back to your natural cycle, dreading the skin flare that could follow can really limit your choices when it comes to taking control of your own hormonal health. If you have experienced acne prior to staring the oral contraceptive or have dealt with a new acne incidence when trying to withdraw I want you to be informed on your options. As there are natural solutions to enable you to get your hormonal health back on track.
What is Post Pill Acne?
It’s good old fashion hormonal acne with a twist. The synthetic hormones contained in birth control derail your entire sex hormone system. While these synthetic hormones are in your body your own innate sex hormone production does not occur or regulate itself in the way it was intended to, at all. Synthetic forms of oestrogen in the OCP have the ability to suppress adult sebum production into the childhood range. Many women feel as though their pores disappear entirely while on the pill, this is not a natural scenario and as your body withdraws from the medication you can experience a rebound hyper secretion of sebum your skins natural oil production. The other main issue here is that your ovaries are learning how to communicate with your brain again and vice versa sending you back to the dark ages of puberty. After such a period of sex hormone suppression including suppression of androgen production, there can be a rebound effect where over production of androgens can occur. I say can because every woman’s body is unique and not everyone experiences post pill acne, some may only experience a few premenstrual blemishes and others may be faced with very angry inflamed cystic acne on their face and body.
A transient form of polycystic ovarian syndrome (PCOS) can also occur for women in this timeframe, due to all the confusion the synthetic forms of sex hormones rain down on the endocrine system. Imbalances in progesterone and oestrogens due to changes in production or detoxification further add to the issue, as negative oestrogen clearance can also be very inflammatory for acne. This presentation of acne can take a couple of months to set in, so some women don’t even make the connection between their decision to stop hormonal birth control and their new found skin trauma. Generally the post pill acne presentation has peaked by 3-6 months and can remain like this for 18 months or at times longer, that is without intervention. As there are most definitely tools at your disposal to help you navigate this period of hormonal chaos.
What can be done for Post Pill Acne?
Replenish nutrient deficiencies, as nutrients depleted by the OCP are some of those very necessary for hormonal regulation, it’s important to restore optimal levels. These include; magnesium needed for COMT function the enzyme that regulates phase-2 liver detoxification of steroid hormones and oestrogen.
Vitamin B6 that modulates the effects of oestrogen while improving progesterone production and B12 needed in the methylation pathway for liver detoxification of steroid hormones. Selenium and zinc are also depleted by the OCP and both are able to lower the DHT form of testosterone, DHT being very problematic in hormonal acne. Of these nutrients Zinc is the priority for supplementation and can be used in preparation for OCP withdrawal. In addition to DHT lowering effects, zinc also aids acne wound healing, scar preventions and regulates the normal desquamation process of keratinocytes, this essentially
means that dead skin cells are shed rather then clogging the hair follicle causing blemishes.
Supplement with Omega-3, as its another important nutritional intervention in hormonal acne. Omega-3 is an essential fatty acid, this means your body cannot make it, therefore it must be procured from your diet or supplementation. Benefits of Omega-3 supplementation in acne stem from its anti-inflammatory effect and an ability to keep sebum fluid. Sebum that is fluid moves easily rather then thickening where it can form stasis, clogging the hair follicle causing congestion and acne lesions. It’s important to use good quality Omega-3, as what you pay for is what you get with fish oil.
Reduce inflammatory diet factors, dairy contains a protein called IGF-1 that increases androgens in the female body, through this mechanism dairy exacerbates hormonal acne. Sugar and chemically refined oils such as trans fats also exacerbate and inflame acne presentations, so both should be avoided in prevention and management of post pill acne.
Eat plenty of brassica vegetables, this includes broccoli, cauliflower, cabbage, brussels sprouts, kale and collard greens. The Brassica family of vegies contains naturally sourced DIM, a phytochemical that promotes healthy oestrogen and androgen clearance in hormonal imbalances.
Drink Spearmint tea, this cup of freshness is often used in the middle-east regions as a remedy for hirsutism another androgen excess condition. A Turkish study showed that 2 cups per day was sufficient to lower testosterone levels in women with PCOS, an androgen excess condition.
These are great interventions and first line treatment strategies in hormonal acne. However if your skin condition has progressed in severity quickly, is a level 2 or above acne grading or is not responding to the above suggestion you will do best with a customized supportive protocol from an expert. As with hormonal acne in general there are many herbal and nutritional interventions that can be used to regulate patterns of hormonal imbalance. Specific imbalance can be unique from one hormonal acne case to the next and high quality hormone testing is often needed to direct treatment efficiency for optimal acne resolution.
Written by Elissa Roy.
Naturopathic Skin, Digestive and Hormone Specialist
Master of Applied Sciences (Traditional Chinese Medicine) -currently undertaking