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  • Post Pill Acne | with Emily Bathgate

    January 17, 2023 7 min read

    So, you’re reconsidering your relationship with your oral contraceptive pill (OCP), but have heard all of the post-pill acne horror stories? Or maybe you’re living your post-pill acne horror story right now? You’re in the right place.

    Post-pill acne is something I see incredibly often in the clinic. It's an issue that impacts a really large percentage of my client base.

    Let me fill you in on what exactly post-pill acne is, and – most importantly – what you (and we!) can do about it.

    Acne + The Pill

    Many women are prescribed the pill for their skin in the first place. And there's a method to the madness. In theory, it’s a 'Band-Aid' fix (because it’s not addressing or treating the root cause of the acne), but the synthetic hormones in the pill (I explain these hormones in this episode of my podcast: The Pill Explained) work to crack down on sebum production - one part of the reason acne develops in the first place.

    In fact, the pill shuts down sebum production to the equivalent of that in our younger, pre-pubescent years (back when acne had never even entered our imaginations!).

    But that sebum your pill is quashing? Your skin needs it.

    Especially in adulthood, sebum, in the right quantity + quality helps to moisturise and protect our skin. So, our skin works double-time to increase sebum levels, just to keep that basic biological balance.

    Now, what happens when the pill exits the picture?

    The skin, which has been working hard to keep sebum supplies up to prevent the pill’s sebum-quashing effect, has no idea what's hit it and keeps playing along. In turn, we end up with some serious sebum over-production, and we've suddenly got more now than ever before.

    On top of this, your ovaries – for the first time since you started on the pill – are rebounding and kicking back into action. And, as a result, they (plus your adrenals) are making plenty of androgens like testosterone. With more androgens comes even more sebum production… and more sebum-clogged pores (hello, bacterial breeding grounds!) – and, inevitably, acne – as a result.

    The elevated androgen level and acne link might be a relationship you’ve heard about before.

    Polycystic ovary syndrome (PCOS) is a hormonal disorder that is characterised by an overproduction of androgens, and acne is a really common symptom of this disorder. PCOS and post-pill syndrome can look incredibly similar from both an androgen excess and symptom perspective. However, the post-pill syndrome should only ever be a short-lived issue (and, with support, can have very minimal impact symptomatically). You might notice post-pill acne not only facially, but it might appear on other body parts too, including your back and chest.

    Now that we understand it, here’s…

    What To Do About Post-Pill Acne:

    Start with the Gut

    Post-pill or not, acne is a surprisingly common symptom of digestive disharmony, so it's time to get your gut health on track - particularly if you already experience other symptoms, like bloating, regularly.

    Pill use has been shown to alter the gut's microbiome, as well as contribute to a 'leaky gut' (aka a damaged, gappy gastrointestinal lining that is allowing toxins and wastes to ‘leak’ through accidentally). In turn, this can lead to issues like constipation, bloating, diarrhoea, gassiness, nutrient malabsorption and deficiencies, and food intolerances.

    As the gut and skin (and, really, every one of the body’s organs and systems!) are so closely linked, poor gut health = poor skin health.

    As well as repairing the lining of the gut, and therefore improving an unhappy gut’s symptom picture and increasing absorption + tolerance of foods, it’s also important to support your microbiome with prebiotics and probiotics.

    While supplements containing glutamine and PHGG, and even quality products, can be helpful here, you'll also want to work on increasing your dietary intake of both pre- and probiotic-rich foods like:

  • onion
  • garlic
  • leeks
  • asparagus
  • banana
  • oats
  • apple
  • artichoke
  • chia, hemp & flaxseeds
  • small, regular serves of sauerkraut, kimchi, coconut kefir, kombucha and miso

    (Temporarily) Ditch Dairy

    Dairy products contain the hormone, Insulin-like Growth Factor, which promotes androgen production. Therefore, androgen levels tend to rise with dairy consumption. And, as we know, elevated androgen levels are already an issue in the case of post-pill acne.

    Insulin-like growth factors, like our androgens, can be another trigger for accelerated sebum production, too.

    Ditching dairy will help to reduce inflammation, minimise insulin-like-growth factor – and, in turn, androgen – levels, and therefore the incidence of acne.

    However (good news!), you shouldn’t need to ditch dairy forever. By improving the health of the gut, and therefore the ability of your gut to tolerate potential acne-triggering foods like dairy, you should – in time – be able to eat small amounts of quality dairy products from time to time without the hormonal acne blow-up!

    Time For A Nutrient Top-Up

    The skin is an organ, and, just like all the other organs and systems in the body, it requires certain nutrients for its health. Our skin is also our largest organ: so, it’s going to want a lot of them, too!

    Unfortunately, the pill depletes us of several nutrients. Especially zinc, B12, B6, vitamin C, vitamin E, magnesium, and selenium.

    Many of these nutrients are essential to the health of not only our skin and immune system (remembering that our skin is our first physical line of defence, and therefore a huge part of our immune system) but our entire body.

    Now is an as important time as any to up the ante on your nutrient-packed meals! Following an anti-inflammatory, whole-food diet is a great first step, and ensuring that you eat mindfully (chewing your food plenty and avoiding multi-tasking while eating) will help support the digestion of all the goodness. You also want to make sure that you're eating regularly, and not skipping any meals.

    You’ll find lots of skin-loving nutrients in foods like:

  • oily, wild caught fish
  • walnuts
  • almonds
  • sunflower seeds
  • sesame seeds & tahini
  • eggs
  • broccoli, cauliflower & brussel sprouts (brassicas)
  • turkey
  • leafy green vegetables
  • chicken or beef liver
  • oats
  • mushrooms

    If you’re working with a qualified health practitioner, like a naturopath, they might also prescribe quality multi-nutrient supplement/s to help combat any specific deficiencies (as well as analyse blood and other testing to assess these deficiencies).

    Meet Zinc!

    Zinc is an incredibly helpful nutrient when it comes to treating any type of acne, as it will bust acne-causing bacteria, balance androgen levels, reduce inflammation (throughout the body as well as in the skin: goodbye, big angry breakouts!), and keep pores healthy, happy, and unclogged.

    It does matter which type of zinc you use, though. As a qualified health practitioner, I work only with practitioner-strength and high-quality zinc supplements.

    You'll also find zinc in foods like:

  • oysters
  • almonds, cashews, pecans and walnuts
  • sesame seeds & tahini
  • sunflower seeds
  • poultry
  • eggs
  • garlic
  • broad & butter beans
  • spinach
  • mushrooms
  • fresh herbs, like basil & parsley

    Balance Blood Sugar Levels

    Keeping your blood sugar levels steady will help to ensure that your ovaries and adrenals don’t end up riding a blood sugar rollercoaster and overdoing it on the androgen production.

    Eating regular, macronutrient (protein, complex carb + healthy fat)-packed meals and ensuring you’re regularly exercising are paramount here.

    I like to remind my clients of how important it is to start your morning with a protein-packed, slow-paced breakfast (i.e. not a coffee on the go!) by 9 am to kickstart a steady blood sugar day. No fasting or meal skipping here, please!

    Give Your Liver Some Love

    As your major detoxification organ, your liver is constantly processing and clearing toxins, wastes and leftovers. Including excess hormones (both natural and synthetic) and medications.

    It’s not a surprise, then, that your liver might need some extra TLC when you’re on and breaking up with the pill.

    As well as the liver, the skin also plays a role in detoxification and elimination (alongside your gut, kidneys and lungs).

    So, it’s also not a surprise that, when our elimination and detoxification organs are overworked or inflamed, it’s going to show in the skin!

    I encourage all of my clients suffering from any kind of skin complaint to incorporate more bitter foods into their diet to protect their liver and encourage healthy detoxification + elimination.

    As the name implies, bitter foods have a naturally bitter taste. Incorporate more of these for a bitter, liver-loving boost:

  • grapefruit, lime & lemon
  • cruciferous veggies (broccoli, cauliflower, cabbage, kale, brussel & broccoli sprouts)
  • artichoke
  • rocket
  • radish
  • dill
  • cumin
  • turmeric
  • green & nettle teas

    Stay Calm

    Firstly, it's important to remember that post-pill acne isn't forever. It's also important to remember that the pill isn't a forever fix – so, although it may be tempting to jump back on when your skin hits the pits, you can't put post-pill acne off permanently.

    You should also know that your adrenals are responsible for producing adrenal androgens, testosterone and DHEA (and we already know the impact that these androgens have on acne!).

    Your adrenals play an important role in reacting to stress. When your body and nervous system perceive stress (mental, emotional, environmental, or physical), it produces stress hormones, like cortisol, accordingly.

    Cortisol levels that are too high for too long can cause us to produce even more androgens (especially testosterone), cause inflammation (in the skin and throughout the entire body), and cause an imbalance in sebum production too. It can also cause the quality and consistency of your sebum to change – because your bodies believe you’re at threat, it will thicken your sebum to protect you and your skin… which isn’t ideal for keeping pores clean, clear, and healthy!

    High stress can also impact the health and regularity of your menstrual cycle – something we want to be getting back on track post-pill, and NOT interrupting further!

    Commonly, acne can peak around 6 months post-pill. While it can be incredibly frustrating, and so often makes women hop straight back onto the pill, your ovaries should almost be back on track and familiar again with a healthy hormonal picture, so things should start to improve from here.

    But what if they don't/aren't?!

    If your ovaries still aren’t back to doing the right thing androgen-wise, or oestrogen and progesterone (both hormones are vital for healthy skin!) production-wise, it might be time to look more closely at why your hormones are out of whack.

    Feeling like things are just out of whack hormonally? Why not book a one-on-one consult with me, to start to uncover what and why as well as how to get back to hormonal harmony?

    I love to help my clients prepare to break up with their pill. I recommend spending at least 3 months getting gut, liver and blood sugar health back on track, and nutrient levels restored, before saying “sayonara”.

    Looking to ditch your Pill and maintain radiant skin? You can book an initial consultation with Emily here.
    Naturopath Emily Bathgate, offers natural, holistic and evidence-based treatments for a range of skin + general health condition, addressing underlying causes and setting you up for ongoing skin health + wellness. 

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