The Wellness Library

Can Coming Off the Pill Make My Acne Worse?

by | Sep 1, 2021 | Hormones, Women's Health

A woman in a gray seater blazer holds two small pills in her open hand.

Whether you have experienced acne worsening after coming off birth control or you’re hesitant about coming off birth control for fear of acne, this post is for YOU! Being in the know can help you understand what your body may be undergoing with discontinuation of hormonal birth control and how to strategize your exit plan for easier transition.

There’s a whole list of things to consider when coming off of hormonal birth control. Possible skin flare-ups and an increase of acne are just one of the possible side effects. Why? Let’s dig a bit deeper.

Why Does Post-Pill Acne Happen?

There are a few reasons coming off of hormonal birth control can contribute to an increase in acne.

Microbiome Disruption

Studies have shown that birth control causes change to the oral, vaginal and gut flora. The impacts on your microbiome can predispose your intestinal lining to increased permeability (or, what is often coined “leaky gut”).

This disruption in gut permeability predisposes the gut lining to increased inflammation and food sensitivities, as well as increased susceptibility for exposure to other pathogens and illness. With changes to good gut flora, this ultimately can negatively impact the making and clearance of hormones. 

Nutrient Depletion

Hormonal birth control pills deplete nutrients. Medical research has discovered that oral contraceptive agents have been shown to deplete the levels of riboflavin, pyridoxine, folic acid, B12, C, and zinc. It just so happens that zinc is necessary in using vitamin A, a well-known skin nutrient that helps with speedy healing recovery, preventing breakouts, and supporting the immune system of the skin.

Zinc is also highly recognized for its immune function and its ability to inhibit bacteria from inhabiting sweat glands—yay for less acne formation! 

Androgen Rebound

The pill is known for blocking your natural hormone production. This includes testosterone production (often also why women also experience lower libido while on the pill). With the discontinuation of the pill, the body can experience what is called an “androgenic rebound”—basically meaning your body starts over-producing testosterone to compensate for the lack of testosterone prior.

Unfortunately, the immense change in testosterone levels can increase sebum production and acne formation—hello acne flare!

Terrified? Don’t be. These can all be dealt with by informing yourself and creating an action plan (plus, accepting that it will take some time and patience to regulate!).

How to Help Heal Acne Post-Pill

Support Gut Health

As we discussed the pill can cause a negative impact on the gut, so for us to effectively treat the acne we have to look at the underlying cause. (More resources on gut health here.)

Fiber is your friend: I can’t stress this enough! Fiber is the key to balanced blood sugar and healthy bowel movements, is a superb food source for your healthy gut bugs to thrive, and can help move estrogen clearance, all of which in turn can help reduce blemishes.

Balance Your Blood Sugar

A diet high in sugar can lead to insulin insensitivity, which can ultimately lead to requiring the pancreas to overproduce insulin. Why do high insulin and high sugar matter? They’re capable of further increasing testosterone production and simultaneously reducing sex hormone binding globulin concentrations. And all of that can mess with your skin.

Go Pro(biotic)

Consider adding in a medical-grade probiotic to help support the repopulation of healthy gut microbes. With a little help from your naturopathic doctor, you can consider what formulations are best for you. 

Ditch the Dairy

Dairy can be a huge skin irritant, as the lactose can often be poorly broken down by the gut, which can further exacerbate imbalances in the gut microbiome. Dairy can also be laden with exogenous hormones, which your body doesn’t need and won’t know what to do with.

Replete Lost Nutrients

Build a food plan for your week that is dense in nutrients. A good rule of thumb—each meal should contain at least 2 servings of fruits and vegetables. Not there yet? Start by adding it in slowly. 

A medical grade multivitamin can also help restore lost nutrients. Working with your naturopathic doctor can allow you to test specific nutrients and devise a nutrient strategy in optimizing depleted nutrients. 

Replenish Your Zinc

Zinc is key to healthy skin. Add chick peas, lentils, black beans, hemp seeds, pumpkin seeds, or sesame seeds into your meal plan to help increase your body’s zinc reserves.

Keep an Eye on Your Hormones

Three months after you’ve discontinued your hormonal birth control, after you’ve made positive updates to your diet and lifestyle (see above!) is the perfect time to meet with your naturopathic doctor to test your hormones (don’t waste your money—skip hormone testing while you’re on hormonal birth control!). This will allow us to understand your biochemistry and hormone pathways to start addressing better estrogen, progesterone and testosterone levels. 

How Long Does It Take to Reduce Post-Pill Acne?

Every person’s journey is different and can vary in time, but in my clinical experience, for those who are actively working to heal and navigate their total health find positive improvements in 4-6 months post-birth control.

Looking for support? We can help. Give us a call or book your first appointment online today. Wondering what other birth control options there are? Check out our breakdown of the pill vs. IUDs and the family planning method.


  1. Insulin regulates testosterone and sex hormone-binding globulin concentrations in adult normal weight and obese men. PMID: 785253
  2. The Role of Vitamin A in Wound Healing PMID: 31389093
  3. Influence of hormonal contraceptives on microbial flora of gingival sulcus PMID: 9693397
  4. Association Between Long-term Oral Contraceptive Use and Risk of Crohn’s Disease Complications in a Nationwide Study. Gastroenterology. 2016. 150(7). 1561-1567.


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