Ugh, that Zit tho: The 411 on Acne & Your Birth Control
What was worse as a teen than getting a pimple before a first date? Nothing, right? But, how about getting a pimple before a first date as an adult? Totally the worst. There are many reasons women get adult acne, and your birth control may be one of them
OMG, is that a pimple?
Yes, that is a pimple. If you’ve just started hormonal birth control, and you’re noticing a zit or two creeping up, it’s completely normal. Annoying, but normal.
How is my birth control making me breakout?
Hormones. Hormones and acne are inextricably linked: when hormones fluctuate, pimples are more prone to pop up. You know how you sometimes breakout before your period? That’s because your hormone levels are going crazy. The same happens when you start birth control–everything becomes unsettled. Estrogen and progesterone are the biggest hormones at play here, but androgens and testosterone play a role, too.
When you begin hormonal birth control, you’re flooding your system with synthetic hormones and upping your levels of estrogen and progesterone. But what goes up must come down. During your cycle, both your estrogen and progesterone levels drop. This drop can cause many side effects including mood swings and fatigue, but also acne. Why? Because when your estrogen and progesterone levels take a dip, the concentration of testosterone rises. (Your levels of testosterone actually stay the same, but because your estrogen and progesterone levels go way down, testosterone becomes more dominant.) Testosterone can play a definite role in acne.
Androgens, like testosterone, can increase sebum in the body when their levels get high. Sebum is an oily, waxy substance that is produced when the adrenal glands are stimulated. When there is extra sebum lying around, pores get easily clogged with dead skin, debris and bacteria, and pimples start to form. Though your ovaries and adrenal glands usually produce a low level of androgens, when your hormone levels fluctuate, androgen can be high in relation.
Progesterone can also lead to acne. Every oral contraceptive includes one kind of progesterone or another, with some kinds being worse for your skin. Androgen-based progestin is a huge player in the production of sebum. As you may have guessed, the more androgen-based progestin you have in your system, the worse your skin will get. So if you’re already prone to acne, you may want to stay clear of progestin-only oral contraceptives, especially with the progestins, norgestrel and levonorgestrel.
How do I know its hormones and not something else?
- You’re not a teenager. You thought you were leaving it behind, but it’s still here: acne. Hormonal acne actually occurs most often in women in their 20s. Your body wants to make babies when you’re at this age so your hormones are raging into the wee hours. Raging hormones do not do well with our skin.
- Your acne is cyclical. Hormonal acne usually flares up around the same time each month when your hormone levels fluctuate. (Hello, menstrual cycle.) You may also find that your acne is popping up in the same place cycle to cycle.
- Your breakouts occur mostly around your chin and jaw area. The location of your acne can be telling of its cause. If your pimples are sprouting around the chin and jawline, it’s probably hormonal. It’s not known exactly why this happens, but it happens often enough that an association has been made. You may also see acne along the sides of your face or on your neck as well.
- You’re super stressed. Don’t forget that cortisol is a hormone, too. Like your sex hormones, when cortisol levels are out whack, you become out of whack, and everything is connected. Because of this, stress can cause acne. So if you’re stressed, you may expect a pimple or two.
Wait, isn’t birth control supposed to improve acne?
For many women, birth control does clear up acne. In fact, some oral contraceptives, like Ortho Tri-Cyclen and YAZ, are approved by the FDA to treat acne, and some women take these not to prevent pregnancy, but to primarily reduce breakouts. If fluctuations in estrogen and progesterone can cause acne, it makes sense that when the levels stabilize, which birth control does over time, acne abates.
How does birth control help your skill? Estrogen has a direct effect on oil glands. Higher levels of the hormone can reduce the size of the opening of your glands, so your pores become smaller and your skin smoother.
Estrogen can also amp up the production of hyaluronic acid causing your skin to glow and look full. This is why doctors recommend a combination birth control pill when fighting acne as opposed to progestin-only pills. Progestin-only pills can increase androgen activity, unless they contain an anti-androgen like the drospirenone in YAZ.
Birth control’s ability to increase the production of sex hormone binding globulin (SHBG) is another way it clears up acne. Estrogen and progesterone increase production of SHBG, which binds testosterone and lessens its circulation in the body. This reduces the available androgens in your system, which decreases the production of that oily stuff called sebum that clogs your pores. Less sebum = clearer skin.
Could something else be going on?
Of course, there could be other factors attributing to your acne. Here are just some of the alternatives:
- Family genetics. Life other conditions, if you have a family history of acne, you’re more prone to suffer yourself.
- Your makeup and other skin products. You already know what happens when you forget to take off your makeup after a night on the town (hello, breakout!). Makeup and other skin products often contain preservatives and ingredients that can irritate your skin. Also, the more products you use, the more likely you are to get acne.
- Stress levels. While stress cannot directly cause acne, it can definitely exacerbate it. Stress can lead to the release of inflammatory chemicals and can cause, as we know very well, huge hormonal changes. Stress can also increase the severity of flare-ups and make your pimples bigger, redder and more inflamed. Ouch.
- Your diet. Diets high in carbohydrates may cause a predisposition to acne. Foods with a higher glycemic index can up the severity of your breakouts. Abrupt changes in diets, just like the fluctuating levels of hormones, can also cause you to flare up.
- Other medications. Like birth control there are certain medicines that can make acne worse. When choosing a medication, you should look for the addition of bromides and iodides. Also, any steroid use can worsen the effects of acne.
I’m seriously struggling, what should I do?
Besides mitigating other factors causing acne, switching your type of birth control pill can help. Every brand of birth control can be a little different. Some have higher estrogen levels, others have lower, and some don’t have any estrogen at all. To clear acne, you want to find low-estrogen triphasic birth control, like Ortho Tri-Cyclen.
A study published in the November 1997 issue of the Journal of the American Academy of Dermatology showed that 93.7% of women on Ortho Tri-Cyclen saw improvement in their skin. That’s a crazy high number, right? This particular birth control works to reduce androgens (male hormones) while stabilizing your hormone levels.
Patience also helps. Most women don’t see improvement for 3 months when first taking the pill, so you may have to wait it out for a bit to see the magic at work. If you’re having trouble with acne for any reason at all, you should visit your dermatologist. They’ll work with you to find a method that works, whether it’s a topical gel, a birth control or an oral medication. And trust, something will work.
Replenishing your body with key nutrients that birth control depletes it of also helps with skin health. Birth control has been shown to deplete levels of zinc and vitamin C which are both essential nutrients for skin healing and regeneration.
Zinc also has incredible anti-inflammatory properties, and has been shown to alleviate some of the redness and irritation caused by moderate to severe acne. Top Up Tonic replenishes your body with these anti-inflammatory nutrients, minerals, and antioxidants, which are essential for healthy skin.
One option for preventing some of birth control’s ugliest side effects? Top Up Tonic. Our Top Up Tonic works by replenishing the nutrients your body needs. Want to learn more? Visit here to discover everything you need to know.