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I'm a women's health educator, a nerd when it comes to learning "all of the things", and my obsession is teaching women how to take control of their health and create a life they love!
Here’s a secret – there is one single thing that I miss about being on the pill, and it’s how damn clear my skin was!
Like our teenage years aren’t angsty enough without having to experience the highs and lows of breakouts too. But once we make it to the other side of puberty, not all of us emerge with clear skin. Our hormones like to remind us who’s boss and often around ovulation or our periods, a few fresh spots will emerge.
In this episode, I’m breaking down how to manage your skin as you transition off hormonal birth control. We’ll cover how to identify the underlying cause of your acne and what to do about it.
Acne is a sign that your hormones happy, and there’s only so much that topical creams and lotions can do to help!
Hello, and welcome to episode 33 of The Mana Women’s Wellness Podcast. I’m your host, Rachel and today we are talking about post-pill acne.
Here’s a secret – there is one single thing that I miss about being on the pill, and it’s how damn clear my skin was!
I started having breakouts when I was about 11 and it’s seriously traumatising to have the other kids at school asking what those red spots are on your face! I tried so hard to listen to my mum and not pop them, but my teenage years were not fun. I wore way too much makeup and I was so aware of my skin all the time. Then I started taking the pill and oh wasn’t this glorious. To have days where I wouldn’t wake up to another fresh breakout was heaven. And I had seriously forgotten all of the past trauma until I went off the pill and they all came back. I’ve been off the pill for years now and I’m 30 – I’m in an age bracket where I’m waking up to discover both pimples and grey hairs in the morning and that’s something I didn’t think was possible!
So I am by no means an expert on this, and I will never be in a Clearasil commercial. So in this episode I’m going to talk about the biology behind acne and how it relates to the pill and hormone balance. And I’ll share some tips to help you to manage your breakouts and love your skin as best you can.
Like our teenage years aren’t angsty enough without having to experience the highs and lows of breakouts too. But once we make it to the other side of puberty, not all of us emerge with clear skin. Our hormones like to remind us who’s boss and often around ovulation or our periods, a few fresh spots will emerge. For some, our skin can get worse as we get older and the pill can be prescribed and used as a band aid solution to control breakouts. So when we decide to come off the pill, acne is something that a lot of us fear returning. Acne in adulthood can be different to our teen years. It can be cystic, painful and can indicate that your skin is really sensitive to things like weather, sun, certain fabrics, make up or a sign of underlying hormonal imbalances.
Sure, the pill can be helpful in managing acne but like all the other things it helps to fix, it’s a band aid solution. And coming off the pill, it can be worse than before. There’s only so much makeup can do and when you’re struggling with acne the very last thing you want to do is caking on product after product to hide your sensitive skin. While it’s easy for some that aren’t living with it to say they don’t notice your skin, that it’s just a few spots, it’s no big deal…trust me, I know that it’s so much more than that to you. It has a huge impact on your mental and emotional wellbeing and it can absolutely be a factor in staying on the pill for longer than you want to.
And so, how do you manage your skin after coming off the pill? First we need to identify the underlying cause, and this can be broken down into 4 key areas.
Like so many women who experience different types of hormonal imbalance, the pill was likely prescribed before they ever really got to the bottom of their concerns. And when you’re on the pill, the symptoms disappear, so you’re not going to persist with investigating something if it’s not worrying you anymore, right? So we forget about it. But just like reproductive conditions like endometriosis or PCOS, your symptoms aren’t being cured or treated by being on the pill, they’re being masked and they will emerge again when you stop taking it.
Unless the underlying cause of your acne and breakouts is addressed, unfortunately your skin issues will return when you come off the pill and that’s where working with a qualified healthcare professional is really important.
The first thing to think about when it comes to your skin symptoms is when it’s at its worst. This is usually at puberty, during pregnancy, during times of high stress, after travelling when we’re often sleep deprived, jetlagged and out of our regular routine, as well as approaching menopause. These key seasons of life in particular are associated with changes in your hormone balance.
But your skin will likely fluctuate throughout your menstrual cycle too. Like I said, around ovulation and in the lead up to and during your period is often when breakouts happen. Timing is everything and yet another reason to really get on board with charting your menstrual cycle and understanding exactly what phase of the cycle you’re in every day. All of these symptoms are clues about your internal hormone balance and what could be going on inside your body.
If you’re still new to charting or figuring out your menstrual cycle, then have a listen to my Menstrual Cycle Masterclass Series, where I dive deep into each stage of the menstrual cycle, what hormones are doing during each phase and how to support your body with nutrition, exercise and self care.
And so we know about the potential imbalance between our key sex hormones oestrogen and progesterone and how this imbalance can often contribute to PMS or ovulation symptoms. Oestrogen is dominant in the first half of the menstrual cycle, then drops suddenly as progesterone surges after ovulation, then progesterone is dominant in the second half of the cycle until it suddenly drops at the time of our period. We then have low levels of both oestrogen and progesterone, and oestrogen gradually rises again as our next cycle of ovulation approaches. So all of the factors that I’ve talked about so far, often linked with physical or emotional stress and the effects that stress has on the body, can significantly impact our sex hormones and contribute to imbalance. If you want to learn more about the effects of stress on the menstrual cycle, listen to Episode 5, and to learn more about hormone imbalance you can listen to Episode 23.
So what about testosterone? It’s still considered a female sex hormone even though it’s thought of as a male hormone, and breakouts during our teenage years, and puberty in general, is due to testosterone. Studies suggest that during puberty, teenage girls experience really high levels of testosterone that not only turns us into monsters but also puts us into a similar state that we see in women with PCOS – excess androgens, of which testosterone is one. The majority of us will transition through this phase and move on into adulthood relatively unscathed, but for some, these levels linger longer than we would like.
So we can blame testosterone for our breakouts because one of its jobs is to stimulate the glands in our skin that produce sebum, which is an oily, waxy kind of substance that makes up most of your body’s natural oils. Among other things, it contains triglycerides and fatty acids as well as cholesterol. Sebum is really important because it protects the skin, but if you have very oily skin, your body may be producing an excess amount of sebum, which leads to acne.
That’s right, stress is at it again. I know it’s easier said than done, but seriously if we could eliminate stress then 99% of our problems would be solved when it comes to our health and our hormones! Once again, episode 5 is one to listen to about the direct effects of stress on the menstrual cycle, and there is a very good chance that some kind of internal or external stress is contributing to your skin problems. We know that when we are stressed, cortisol is released from the adrenals. Not only does this dominate progesterone, also produced by the adrenals, causing lower levels of progesterone and oestrogen dominance and hormone imbalance, cortisol also leads to increased production of sebum. So our skin gets oilier and more prone to breakouts, plus cortisol also triggers inflammation meaning those of us who are predisposed to redness, acne and other skin irritations like eczema or rosacea, well stress will likely trigger those too.
Next, we need to look at your thyroid gland. The thyroid is really closely linked with oestrogen and thyroid dysfunction is a really common culprit for wonky menstrual cycles due to its regulation of oestrogen levels, again causing that hormone imbalance with progesterone.
So, as a bit of a guide, if you find that your skin is very hot and sweaty and you’re red and blushing a lot, your thyroid could be overactive. If your skin is really dry, not smooth and you don’t sweat much, your thyroid could be underactive. If the thyroid is working too hard, or not hard enough, oestrogen levels will be off, causing that imbalance with progesterone and breakouts happen around ovulation and your period.
Are we sensing a theme here? Our delicate hormone balance is everything and there’s such a domino effect on every other area of our bodies and aspects of our health when our sex hormones are off.
So the final step in identifying the underlying problem is to look at our skin itself. Our skin is an organ, it’s the body’s largest organ it’s our body’s protective layer, its barrier, between the inside and outside worlds. Your skin absorbs about 80% of what goes on it and absorbs it directly into your bloodstream. I’ve used this example before, but think of how a nicotine patch works and it’ll make you think twice about everything you put on your skin. I’ve talked a lot about xenoestrogens and chemicals that disrupt our delicate hormone balance in Episode 24 and these chemicals can cause fertility issues, thyroid dysfunction, some breast and reproductive cancers as well as hormone issues like endometriosis and PCOS. So if you think you’re being really diligent with a super extensive skin care routine, there’s a chance you could be making the problem worse if what you’re applying to your skin contains these chemical disruptors that are disrupting your hormones as well as the good bacteria on your skin. You might have heard before that scrubbing your face multiple times a day strips of skin of its good oils, creating overproduction of oil – sebum – and that’s absolutely true. And if the skincare and makeup products we’re using are full of chemicals, it’s disrupting oil balance, bacteria balance and hormone balance too. The natural pH of the skin is disrupted and hello breakouts.
Make the switch to natural skincare and makeup products that don’t contain these chemicals that won’t disrupt your skin’s natural state, and I promise you’ll be surprised that sometimes less is more.
So while your hormones could absolutely be contributing to your skin problems, don’t forget to look at the obvious contributing factors of what is going on your skin and how well you’re looking after it. And for a lot of us with skin problems, we’re probably doing too much and irritating it further!
Ok, so we’ve identified some of the most common underlying causes of our breakouts that have been masked for the time we’ve been on the pill, our first step to managing the problem is to start before coming off the pill. For some of you, you might have already stopped taking the pill, and that’s totally ok. But if you’re still contemplating and worried about your skin flaring up when you ditch the hormones, start caring for your skin a little more now and your body may adjust better down the track.
So, here’s how we do it. And we’re going back to the basics.
Eat lots of fresh vegies and avoid crappy processed foods with zero nutritional value. Gut health is everything and when your gut microbiome, the good bacteria in your digestive tract, are disrupted, then your health is affected. If your guts not healthy, it can’t properly absorb the nutrients it needs from food and it can’t detoxify the toxins that are going in too. You are what you eat and gut health is enormously linked to skin health. You might also want to speak with a nutritionist about potentially inflammatory foods like gluten and dairy. I don’t recommend eliminating entire food groups just for the hell of it, but you can work with a nutritionist or dietitian to determine if there are particular foods that are making your skin worse. This may change according to the phases of your menstrual cycle too, so you might need to avoid inflammatory foods in the lead up to your period. Again, this is something you could be charting throughout your cycle.
Next, talk to a healthcare professional about taking a good quality supplement, especially if you’re coming off the pill because you’re preparing for pregnancy! Hormonal contraceptives can lead to nutrient depletion and we want this to be under control asap so that we are in the best possible position to support our hormones as they transition off the pill. Don’t self-prescribe and get a high quality supplement.
Next, drink more water. If you’re feeling thirsty, you’re already dehydrated, remember that. Aim for 1.5-2L of fluids every day (coffee doesn’t count) and vary this according to your size, the weather and how physically active you’ve been.
Which brings me to exercise. We all know exercise is good for us, but sweating helps our body to release toxins. If our gut health is poor and there are too many toxins in our body, our skin is the first place this shows up. Sweating every day helps get those toxins out.
When it comes to shitty skin, I feel your pain, I really do and nobody wants to put themselves in a situation where they know their skin is about to get worse, which is why so many women stay on the pill for non-birth control related reasons! Hormone balance is a huge factor, but so is how you treat your skin. Your skin is going to reflect what’s going on inside your body, and while the pill has been masking those underlying concerns, you’ll need to address it once the artificial hormones are flushed from your body.
Acne is a sign that your hormones aren’t as happy as they could be and there’s only so much that topical creams and lotions can do to help you. It’s so important to know your own triggers, whether that’s particular times of your menstrual cycle, foods, weather…any factors that you have recognised as aggravating your breakouts. Don’t dismiss it just because it’s the lead up to your period. Acne is really frustrating to deal with but you can absolutely help the problem if you know what’s causing it.
That wraps up today’s episode. If you learnt something new or found value in today’s episode, I’d love to hear from you! Send me an Instagram DM, and let me know what you want me to talk about. This episode was created because the fear of post-pill acne has popped up a couple of times in my DMs now, so if there’s something you want me to talk about let me know!
I will see you in next week’s episode where I’ll be talking about why you should be charting your menstrual cycle, even if you have no plans to get pregnant soon.
Ok, bye for now and don’t forget that knowledge is power!
When you truly understand your body, you are empowered to make informed decisions and take control of your health!
Until next time.
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I'm obsessed with all things periods, pregnancy, pelvic floor and helping women just like you to navigate all of life's major milestones!
I'm a physiotherapist and natural fertility educator and my passion is teaching women how to take control of their health.