Treat Post-Pill Acne with Naturopathy
Have you had acne since stopping the Pill, despite always having clear skin in the past?
Do you want to come off the Pill but, every time you try to, you experience severe skin breakouts?
Were you originally prescribed the Pill to treat acne or to ‘regulate’ your period?
Have you experienced other androgen excess symptoms such as weight gain, male-pattern hair loss, increased facial and body hair, and/or irregular periods since stopping the Pill?
If you answered yes to any of the above questions, you may be experiencing a temporary surge in androgen levels and sebum (skin oil) production that can cause post-pill acne and other androgen excess symptoms.
What is post-pill acne?
When you were initially prescribed the Pill by your GP, they may not have told you about the potential side effects of coming off it.
One of the main side effects, post-pill acne, can be caused by a temporary surge in androgen levels and sebum production after coming off certain oral contraceptive pills, including Yasmin, Yaz, Brenda, and Diane.
These Pills contain the anti-androgen progestins, drospirenone and cyproterone. These progestins suppress both androgen and sebum production to prepubescent levels whilst you take them. However, when you come off the Pill, your body up-regulates the production of androgens and sebum.
This causes post-pill acne along the jawline and sometimes on the neck, back, and chest, which can often be cystic and painful.
How long does it take to treat post-pill acne?
Post-pill acne usually peaks around 3-6 months after stopping the Pill and can take up to 1-2 years to improve as sebum production and androgen levels slowly begin to normalise again. However, naturopathic dietary and lifestyle advice as well as herbal and nutritional medicine can help to speed up this process. By following the advice in this blog post, you can help to clear your acne within approximately 6 months’ time, especially if you start the treatment 1-2 months prior to stopping the Pill.
Does post-pill acne mean I have PCOS?
The post-pill androgen surge can cause other androgen excess symptoms such as weight gain, irregular periods, increased facial and body hair, and/or male-pattern hair loss which may lead to you receiving a PCOS diagnosis.
If you did not have these symptoms prior to going on the Pill, you most likely have post-pill PCOS, which is temporary and will resolve once your androgens eventually reach normal levels.
However, if you did have some or all of these symptoms prior to going on the Pill, you most likely have the most common cause of PCOS, insulin-resistant PCOS.
Your GP may have originally prescribed the Pill for suspected insulin-resistant PCOS to clear your acne and/or to ‘regulate’ your periods. Whilst your skin improved and you had regular withdrawal Pill bleeds (which are not actual periods) whilst you were on the Pill, the post-pill androgen surge can cause your insulin-resistant PCOS symptoms to return, often worse than ever.
The elevated androgen levels of PCOS can be diagnosed by blood test or by your symptoms. If you have symptoms like acne, male-pattern hair loss, and increased facial or body hair, you can be assured you have androgen excess, even if your blood levels are within the normal range.
If you suspect you have PCOS, please read the PCOS page of my website here to find out more about how I can help you correctly diagnose and treat your type of PCOS with naturopathy.
What is the conventional treatment for post-pill acne?
Your GP may suggest that you just go back on the Pill or prescribe you a similar androgen-suppressing medication called spironolactone. However, these are band-aid approaches and unless you want to continue taking the Pill or spironolactone long-term, you will eventually need to come off them and experience the drug withdrawal process.
Both can also have additional unwanted side effects and the Pill can increase insulin resistance and also affect fertility by disrupting the hypothalamus-pituitary-ovarian (HPO) axis, making it more difficult to resume ovulating once you stop it.
Naturopathic treatment for post-pill acne
You should start the dietary modifications and supplements a couple of months before you stop taking the Pill and you will need to continue for at least 6 months after stopping the Pill to receive the full benefits. Although, you should start to see improvement within a few weeks as skin inflammation and histamine levels decrease.
A1 casein free diet:
A1 casein in cow’s milk can worsen acne by causing skin inflammation and stimulating mast cells, increasing histamine production. A2 casein does not have these effects, so can still be included in your diet if you are treating post-pill acne.
You can reduce your A1 casein dietary intake by:
swapping to A2 milk and Jalna A2 yoghurt or coconut yoghurt
switching from cow’s cheese to sheep’s and goat’s cheese which contain A2 casein (e.g. Greek feta or haloumi, Meredith Dairy goat’s cheese)
Butter and cream are okay to consume as they contain minimal casein and consist of mainly the fat component of dairy.
Reduce sugar:
Excessive sugar intake increases skin inflammation as well as keratin and sebum production, exacerbating acne.
Avoid foods containing high amounts of added sugar including desserts, sugary cereals, soft drinks, lollies, chocolate, etc.
Did you know that sweetened yoghurts often have as much sugar as icecream?
Don’t forget to avoid highly concentrated natural sugars in foods such as honey, dried fruit, and fruit juices. ‘Raw’ slices, cakes, and biscuits often contain high amounts of natural sugars from dates, coconut sugar, maple syrup, rice malt syrup, agave, etc. and should also be avoided.
You don’t have to permanently eliminate A1 diary and sugar as you can usually include moderate amounts back into your diet once your skin improves.
Zinc:
The nutrient zinc helps post-pill acne by:
being antimicrobial, killing off the bacteria that causes acne
decreasing androgen production and increasing the production of progesterone, an androgen blocker
down-regulating 5-alpha-reductase, the enzyme that converts testosterone into DHT, a more potent androgen than testosterone that stimulates excess sebum production
reducing keratin production, opening your skin’s pores.
Zinc deficiency can occur in 1 in 3 women and can be caused by vegetarian or vegan diets and taking the Pill. A safe daily dose of zinc is 30mg with food, as zinc on an empty stomach causes nausea.
Berberine:
Berberine is a herbal medicine that helps post-pill acne by:
reducing inflammation
lowering androgen levels
improving insulin sensitivity
having antimicrobial activity, eradicating the bacteria that causes acne.
Berberine should not be taken during pregnancy and breastfeeding, can interact with certain medications, and is contraindicated in some health conditions. Please consult with your naturopath or pharmacist to determine if berberine is suitable for you and to establish both a safe dosage amount and an appropriate treatment duration.
Diindolylmethane (DIM):
DIM is a natural compound formed when the body digests brassica vegetables, including broccoli, Brussels sprouts, and cabbage.
DIM helps post-pill acne by:
down-regulating 5-alpha-reductase activity, reducing the formation of the more potent androgen, DHT
acting as a natural androgen blocker
reducing the skin’s sensitivity to androgens
preventing the growth of biofilm which protects the bacteria that cause acne, making them easier to eliminate.
A safe daily dosage is 100mg daily. DIM should not be taken during pregnancy and breastfeeding, can interact with certain medications, and is contraindicated in some health conditions. Please consult with your naturopath or pharmacist to determine if DIM is suitable for you and to establish both a safe dosage amount and an appropriate treatment duration.
Following an A1 casein-free diet, reducing sugar intake, and supplementing with nutrients such as zinc, berberine, and DIM can help support a quicker reduction in sebum production and androgen levels, so you can be rid of your post-pill acne as soon as possible.
Want TO FIND OUT MORE ABOUT HOW i CAN HELP YOU TREAT YOUR POST-PILL ACNE with naturopathy?
As a hormone naturopath, I can develop a personalised treatment plan to treat your post-pill acne so you can have clear, blemish-free skin. Take a look at the My Process page on what to expect during a consultation with me…