Why Do Some People Get Acne From Birth Control?
If you had new or worsened acne from the pill, you’ve got to read this one!
I’ve been seeing more patients tell me that their hormonal birth control triggered their adult acne. Some patients have also told me that their hormonal birth control worsened their acne.
So, what’s happening?
Hormonal birth control is honestly a useful tool for people who experience severe menstrual symptoms! It is also a commonly-prescribed medication for females who experience acne. It is also one of the valuable tools for contraception and family planning!
So, there are positives to hormonal birth control. And, weighing the pros and cons with your provider can help you choose the best path to take.
This blog post is not an anti-birth control article and is not anti-pharmaceutical.
As an integrative medicine expert, I see the value in both natural and pharmaceutical options. And, why not capture the whole spectrum of medicine and healing for patients to reap benefits from?
So, this is more of an educational article about why some people experience new or worsened breakouts with hormonal birth control, and what their other options can look like when they speak to their doctor.
Disclaimer: This post does not constitute as medical advice; is not meant to diagnose, prevent, treat, or cure any medical conditions or disease; and is meant for educational purposes only. The information in this post does not replace the advice of your medical provider. Speak to your doctor before starting anything new OR schedule your appointment with me.
Why does acne happen & how does hormonal birth control help?
Acne happens because of hormones
When looking at acne, science tells us that androgen hormones are the main culprit.
Androgen hormones are basically male sex hormones, and some examples are testosterone, di-hydrotestosterone (DHT), and DHEA.
These androgen hormones are also made in different parts of the body. From what science tells us, DHEA is made in the adrenal glands, testosterone is made in the ovaries and testicles, and DHT can be made in the skin, liver, and prostate.
How do hormones cause acne at the skin level?
Well, science tells us that androgens kick off the cascade that causes acne. When looking at why acne happens at the skin level, there are 4 elements that are needed:
Excess oil production
Excess cellular debris
Bacteria
Bacteria-caused inflammation
Androgens drive acne by causing excess oil production and excess cellular debris, which lead to clogged pores.
And, if there is bacteria in the pore, that can lead to inflammation, and therefore, the development of inflamed acne.
How does hormonal birth control address acne-causing hormone imbalance?
The short way of putting it, hormonal birth control uses synthetic hormones to reset the body’s production of acne-causing androgen hormones.
By using synthetic estrogen and synthetic progesterone, the brain tells the body to stop making androgens. And because of this, hormonal birth control could be helpful for females with acne.
But, why do some people experience new or worsened acne with hormonal birth control? Keep on reading to learn more!
How could hormonal birth control trigger acne?
When females with acne are prescribed hormonal brith control, it can take some time for the medication to take into effect.
How long birth control takes to kick into effect:
According to science, it can take up to 3-6 months for hormonal birth control to start making significant improvements to skin health.
And during those 3-6 months, the body’s hormone system is still being reset. So, the body can still produce androgens during that time, which could trigger acne.
What if it’s been more than that time and acne is still there or continues to worsen?
Well, there are certain types of synthetic progesterone (called progestins) in hormonal birth control that are androgens (meaning that they can activate androgen receptors).
Some examples of androgenic progestins are:
Levonorgestrel
Norgestrel
Norethinidrone
Norethinidrone acetate
Are there less-androgenic progestins?
Yup! According to science, newer-generation progestins have lower androgenicity. So, they shouldn’t trigger acne! And, some progestins are actually anti-androgenic.
Some examples of these newer-generation progestins are:
Ethynodiol diacetate
Norgestimate
Desogestrel
Drospirenone
So, if someone still wants to be on hormonal birth control and want clearer skin, they can speak to their prescribing provider about these less-androgenic progestin options.
What if someone wants to address the cause of acne-causing hormone imbalance? Keep on reading to learn more!
Are there other hormone balancing options for acne?
Beyond hormonal birth control, there are other options that providers commonly prescribe to drive down acne-causing androgen imbalance.
One commonly prescribed medication is spironolactone.
This medication works by blocking the effect of an enzyme that converts testosterone to a highly-active androgen hormone called di-hydrotestosterone (DHT).
There is also a topical prescription cream called clascoterone that has been shown to block the effects of acne-causing hormones on the skin! The cool thing is that both females AND males can use this! Some of my patients have been using this alongside natural treatment, and they have been seeing great results!
What if someone wants to address the cause of acne-causing hormone imbalance?
If someone wants to address the deeper causes of their hormone imbalance, they will want to work with a provider who is holistic-minded and asks WHY acne-causing hormone imbalance is happening.
How to address acne holistically:
As a licensed naturopathic doctor, I aim to holistically and integratively address my patient’s skin issues. And, I strongly believe that skin health is a reflection of inner health - and acne is no different!
From what I’ve seen in my clinical experience, addressing underlying root issues can provide more-meaningful and more-sustainable solutions, as my patients understand how to best-manage their triggers and how to treat the causes of their breakouts.
What are these underlying root issues of acne? Read more to find out!
WHAT ARE the UNDERLYING ISSUES CONTRIBUTING to acne-causing hormone imbalance?
Here’s a quick breakdown of what science has to say:
Diet/nutrition: Science shows that excessive consumption of specific proteins and carbohydrates could trigger acne-causing hormone imbalance. When treating my patients with acne, I assert the importance of diet and nutrition, and how it is the foundation of health and wellness. I always provide my patients hormone-supporting dietary recommendations to address overall health for healthier skin.
Supplements: There is literature saying that certain types of protein powders, B-vitamins, and minerals could trigger acne in some individuals. In my clinical experience, I have seen that swapping out some supplements have been helpful for some of my patients.
Medications: It is widely known that some prescribed medications can trigger acne-causing hormone imbalance or just trigger acne in general in some individuals.
Stress & adrenal response: Stress hormones could trigger acne! There are many dietary and herbal options that I can recommend to my patients to support optimal adrenal response and healthy stress response.
Ovarian conditions: Polycystic Ovarian Syndrome (PCOS) is a complex metabolic-hormone disruption where people have high levels of testosterone and DHEA, leading to acne and other symptoms of high androgens, such as head hair loss and facial hair growth. And, there are several tests, imaging procedures, and other work-up options to identify PCOS.
Gut health & Gut bacteria: Science shows that both IBS and gut bacteria imbalance are linked to acne. In people who experience IBS symptoms and acne, I recommend gut bacteria testing. And, I usually see that people with acne have gut bacteria imbalance! After treating that gut bacteria imbalance, I have seen many of my patients start to achieve healthier and clearer skin AND start to experience positive gut changes. So, get testing first before starting any gut bacteria protocol.
Nutrient insufficiencies: Science shows that people with acne are more likely to experience vitamin D deficiency and zinc deficiency. And, researchers have found that when these vitamin D and zinc were repleted in people with those deficiencies, it lead to positive skin changes. And, there are labs that I can recommend to my patients to see if this is a contributing root issues to understand which supplements and dosages are safe for them.
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