Restore Your Glow: A Natural Approach to Post-Pill Acne

Written by Arabella Richards.

If you're one of the many women feeling anxious about coming off the pill due to the dreaded acne flare-ups, this article is for you.

So many young women go on the pill to manage acne, only to find that when they stop, their skin flares up worse than before. Post-pill acne is common due to hormonal fluctuations, increased androgens, and changes in gut and liver function. But instead of feeling stuck in a cycle of breakouts, we can support the body’s natural healing process through holistic strategies.

Why Does Post-Pill Acne Happen? Understanding the Androgen Surge

Many combination birth control pills work by suppressing androgens, hormones such as testosterone that can drive oil production and acne. When you stop taking these pills, your body can experience a rebound effect, where androgens surge temporarily before your hormones rebalance. The OCP lowers testosterone levels while you’re taking them, which is why they’re effective for acne. However, once you stop, your ovaries may temporarily produce more androgens than before, leading to increased sebum (oil) production and breakouts.

The Post-Pill Androgen Surge: What to Expect

When coming off an androgen-suppressing pill, you might notice:

• Increased oiliness and clogged pores

• Deep, cystic acne (especially along the jawline and chin)

• Irregular cycles as your hormones recalibrate.

• Temporary hair shedding (due to fluctuations in androgens and oestrogen)

This surge can usually last 3-6 months, but supporting your body through this transition can help minimise symptoms and restore balance faster.

As a clinical Naturopath who specialises in all thing’s hormones, this is how I would assist with the transition off the pill smoothly and manage post-pill acne naturally:

1. Balance Blood Sugar for Clear Skin

Blood sugar fluctuations can drive post-pill acne by increasing insulin and androgens (i.e., testosterone), which trigger oil production and breakouts. Keeping blood sugar stable is key to reducing inflammation and supporting healthy hormones.

How to optimise Blood Sugar Balance:

Optimising lean sources of protein at each meal, particularly breakfast, along with, healthy fats and fibre. Proteins (such as chicken, turkey, eggs, lean-red meat, or fish) and healthy fats (like avocado, olive oil, or nuts) help slow the absorption of carbohydrates into your bloodstream. This is because both protein and fat take longer to digest, providing a more gradual, sustained release of energy. This slower digestion helps prevent sharp spikes and drops in blood sugar, therefore keeping androgens at bay.

For example, swap your usual oatmeal for scrambled eggs (a great source of protein), turkey (another lean protein), and avocado (rich in healthy fats). Add a side of kiwifruit for fibre, which aids in digestion and regular bowel movements which support the removal of hormones (I will touch more on this soon).

Additionally, proteins and fats help you feel fuller longer, which can reduce overeating and the blood sugar fluctuations that come with it. This balance supports better overall metabolic health, including maintaining a healthy weight, controlling hunger, and stabilising hormones that regulate blood sugar levels, ultimately reducing the risk of conditions such as PCOS or hormonal acne.

Incorporating magnesium-rich foods can play a crucial role in improving insulin sensitivity. Insulin sensitivity refers to how effectively your body's cells respond to insulin, the hormone responsible for helping your body use glucose (sugar) from food for energy. When your cells are insulin sensitive, your body can process glucose more efficiently, preventing excess sugar from building up in your blood. Leafy greens such as spinach and kale are rich in magnesium, as are nuts (such as almonds and cashews), seeds (like pumpkin, sunflower, and chia seeds) and organic cacao. By including these magnesium-rich foods in your diet, you help support better blood sugar control, which can help prevent the crashes that can contribute to cravings, fatigue, and hormonal acne flare-ups.

2. Enhance Liver Detox Pathways

Your liver plays a crucial role in breaking down and eliminating excess hormones. When coming off the pill, your body may struggle to clear synthetic hormones, leading to acne. Supporting liver detoxification can help regulate hormone levels more efficiently.

How to Support Liver Health:

• Increase cruciferous vegetables (broccoli, cauliflower, kale):
  Cruciferous vegetables contain compounds known as indoles and glucosinolates, which are known to support the liver's detoxification processes. The liver is responsible for metabolizing and eliminating excess hormones, including estrogen and androgens. When the liver is functioning efficiently, it can better break down these hormones, preventing an imbalance that may lead to issues like acne, particularly post-pill acne.
  

• Enhance Bile Production:
  Including bitter foods like dandelion, rocket, lemon water, and apple cider vinegar in your diet can support healthy bile flow, improve liver detoxification, and balance hormone levels, all of which are important for preventing and managing acne. Bile is a digestive fluid produced by the liver that helps break down and emulsify fat-soluble vitamins (Vitamin A, Vitamin D and Omega-3s), which are necessary for skin health and integrity.
  

• Liver Supporting Herbs:
  When working alongside a Clinical Naturopath, we can prescribe herbs that are profound for liver health and detoxification pathways, such as St Mary’s thistle. St. Mary's thistle supports liver health by enhancing detoxification processes, particularly the breakdown and elimination of excess androgens. Additionally, its anti-inflammatory and antioxidant properties further contribute to clearer skin. When used in conjunction with other herbs such as dandelion root and turmeric, St. Mary's thistle can be a powerful tool in managing acne through holistic liver support and hormonal regulation.

3. Support Gut-Health

The gut and skin are closely interconnected, and disruptions in the gut microbiome are a common factor in post-pill acne. The contraceptive pill can significantly alter the gut microbiome, reducing the population of beneficial bacteria and affecting gut health. This can impair the body's ability to properly metabolise and eliminate excess hormones, including androgens and oestrogen, leading to hormonal imbalances that may trigger acne flare-ups

• Eat Probiotic-Rich Foods:
  Probiotics are live microorganisms that can help restore a healthy balance of gut bacteria. Include fermented foods like sauerkraut, kimchi, kefir, and miso in your diet to introduce beneficial bacteria that can help restore gut balance. These foods can support the growth of good bacteria that aid in hormone metabolism and improve digestion. Probiotic-rich foods also help promote the healthy balance of gut flora, which can influence estrogen metabolism and improve its clearance from the body.
  

• Include Fibre-Rich Foods:
  Fibre is crucial for supporting healthy digestion and hormone elimination. Specifically, flaxseeds, chia seeds, Kiwifruit, and a variety of vegetables (like broccoli, Brussels sprouts, and spinach) provide both soluble and insoluble fibre. These fibres help bind excess hormones in the digestive tract, facilitating its elimination through bowel movements. Adequate fibre intake supports regular bowel movements, preventing hormones from being reabsorbed into the bloodstream, which can otherwise contribute to hormonal imbalances and acne.
  

• Avoid Inflammatory Foods:
  Certain foods can really ramp up inflammation in the body, and for some people, this can lead to acne flare-ups. Dairy products and processed fats are particularly known for being pro-inflammatory, especially if you're sensitive to them.
  
  Take dairy, for example. It contains growth factors that can increase androgen production, which in turn stimulates the sebaceous glands in your skin. On top of that, dairy can trigger mast cell activation. Mast cells are immune cells that play a role in allergic reactions and inflammation, and they’re found in places like the skin. When you consume dairy, especially milk and cheese, the proteins (like casein and whey) can prompt your mast cells to release inflammatory substances. Your body might recognise these proteins as potential threats, causing the mast cells to kick into action.
  
  Once these mast cells are activated, they release histamine, a chemical that contributes to inflammation. Histamine increases blood flow and makes blood vessels more permeable, which can cause redness, swelling, and itching on your skin. Histamine is also linked to flare-ups, itching, and even hives, things that can worsen inflammatory skin conditions such acne or eczema. (Interestingly, this histamine response can also make PMS symptoms and period pain worse, which is something often seen in women who are transitioning off the pill.) So, cutting back on dairy and processed oils can help reduce the inflammatory triggers in your body, potentially giving your skin a much-needed break.

4. Prepare for a Smooth Transition with Herbal Support

If you're considering coming off the pill, preparing your body in advance can help ease the transition and support hormone balance. A Naturopath can prescribe specific hormone-modulating herbs that not only regulate hormones but also address underlying causes of post-pill acne. These herbs can work synergistically to reduce excess androgens, support the adrenal glands, and enhance overall reproductive health.

Key Herbs for Hormone Balance:

• Peony:
  Peony is a powerful herb known for its ability to support progesterone production while simultaneously helping to reduce androgens, the hormones often linked to acne. Peony contains compounds that can inhibit the effects of androgens on the skin, such as testosterone, which can lead to excessive sebum production and clogged pores. This makes peony especially helpful for those struggling with post-pill acne, where hormonal fluctuations can trigger excess oil production and breakouts. When combined with liquorice, peony's ability to reduce androgens is enhanced, making this combination a potent tool for managing acne and balancing hormones.

• Liquorice:
  Liquorice is another key herb in managing hormonal acne, particularly when it comes to reducing androgens. It works by inhibiting the enzyme 5-alpha-reductase, which is responsible for converting testosterone into its more potent form, dihydrotestosterone (DHT). DHT is strongly associated with increased sebum production and acne. Liquorice also supports the adrenal glands, which are crucial for managing stress. In times of stress, the adrenal glands produce cortisol, which can contribute to hormonal imbalances. By helping to reduce excess cortisol and DHEA (another hormone related to androgens, which I will touch on soon), liquorice can help reduce the overall androgen load in the body, ultimately preventing acne flare-ups caused by hormonal spikes.

• Vitex (Chaste Tree):
  Vitex is well-known for its ability to support progesterone production, which can help regulate the menstrual cycle. By balancing progesterone levels, it can help reduce symptoms common post-pill symptoms such as PMS and hormone-related acne. Vitex works by influencing the pituitary gland, which release follicle stimulating hormone and luteinising hormone, which in turn helps balance hormones such oestrogen and testosterone, making it particularly beneficial for those dealing with hormonal acne.
  

• Burdock Root:
  Burdock is an excellent herb for skin health. It works as a natural blood purifier, helping to clear toxins from the body that could contribute to skin issues like acne. It has anti-inflammatory properties that can soothe the skin and reduce the appearance of blemishes. Burdock is especially useful for people experiencing post-pill acne, as it helps detoxify the body and support healthy skin from the inside out.
  

• Raspberry Leaf:
  Raspberry leaf is a gentle uterine tonic that can help regulate hormone levels by supporting the reproductive system. It’s especially helpful for women who have irregular cycles after coming off the pill, as it can promote healthy menstruation and hormone balance. By supporting overall hormone regulation, raspberry leaf can indirectly help keep acne at bay.
  

• The Power of Herbal Support:
  These herbs can be potent allies in supporting hormone balance and reducing hormonal acne when transitioning off the pill. Peony and liquorice are excellent for addressing excess androgens, which is one of the primary causes of acne post-pill. However, it’s important to work with a qualified naturopath who can tailor a plan specifically for you, ensuring you choose the right herbs and dosages to support your unique needs.

5. Manage Stress & Anxiety to Prevent Breakouts

Stress is a major trigger for acne because it increases cortisol, which can lead to excess androgens and oil production. The post-pill transition can be emotionally and physically stressful, so supporting your nervous system is key. Your adrenal glands play a crucial role in hormone regulation, especially when it comes to post-pill acne. They produce cortisol (the stress hormone) and another androgen called DHEA, both of which can exacerbate and cause acne. If your adrenals are overworked due to chronic stress, they may produce excess DHEA and cortisol, leading to increased oil production, clogged pores, and breakouts.

Stress-Reducing Practices for Clearer Skin

Managing stress is essential for balancing hormones and promoting skin healing, especially when dealing with post-pill acne. Here are some specific stress-reducing practices that can support your skin’s recovery:

• Prioritise Sleep: Aim for 7-9 hours of restful sleep each night. Sleep is crucial for regulating cortisol, the stress hormone, which in turn supports the body’s natural healing processes. During deep sleep, your body repairs itself, including your skin, making it a vital part of the acne recovery process.
  

• Practice Mindfulness and Deep Breathing: Incorporate daily mindfulness practices such as deep breathing exercises, guided meditation, or even simple moments of reflection. These techniques can help lower cortisol levels, calm the nervous system, and reduce the inflammation that contributes to acne flare-ups.
  

• Seek Psychological Guidance: Working with a trained therapist or counselor can help you identify and address anxious thought patterns. Cognitive Behavioral Therapy (CBT) can be particularly effective for learning how to manage stress and anxiety, which can have a direct impact on skin health. Reducing mental stress can ease hormonal fluctuations that may worsen acne.
  

• Utilise Adaptogen Herbs: Adaptogens like Withania (Ashwagandha), Rhodiola, and Rehmannia help the body adapt to stress, support the adrenal glands, and balance cortisol levels. These herbs can reduce the impact of stress on your skin, and when prescribed by a qualified naturopath, they can be part of a holistic plan to support hormone balance and acne healing.
  

• Engage in Gentle Movement: Incorporating low-impact activities like Pilates, swimming, or restorative yoga into your routine can help reduce stress without overloading your body. These activities promote relaxation, improve circulation, and reduce tension, all of which support both your mental and physical well-being.

By integrating these stress-reducing practices into your daily routine, you’ll help balance hormones, regulate inflammation, and support your skin’s ability to heal naturally.

Final Thoughts

I know that healing post-pill acne can feel like a slow process, but with the right focus on balancing blood sugar, supporting liver detoxification, nurturing gut health, using herbal remedies, and managing stress, you can achieve clear, healthy skin naturally. If you’re feeling frustrated by post-pill acne and would love some personalised support, I’d be honoured to guide you through this journey.

Book a session now, I’m here to help!

With love,

Bell.