What I learned from post-pill acne

Chinese herbs, prescriptions + pore clogger checkers

Hi, I hope everyone is having a nice week.

Firstly, last week I sent a piece about the Olsen Twins’ hair and I think it’s my most-read Substack — my people.

This week is different but something I’ve been working on for the last few weeks, I hope it’s helpful.

Back in February I got this email from a stranger —

I emailed back, and got this reply —

The good news — we are still in contact, and their skin is starting to improve! Thank god.

I’ve written about post-pill acne a few times based on personal experience. It is a horrible thing to go through, and my heart goes out to anyone in the thick of it.

The first time I went off the pill my skin quickly turned to shit — oily, rough and bumpy (small spots all the way through to giant cysts that would take weeks to heal). By the time one breakout faded, another had arrived. For context on the pill my skin was perfect — smooth, poreless, literally like a baby.

It majorly stressed me out, so I just gave up and got another prescription. A couple of years later armed with more knowledge and the safety blanket of the pandemic I decided to go through the motions again. I did break out but it was a lot less severe and it passed with time. Now, five-ish years on, I rarely get pimples. I do think it’s combination of getting older (I’m 31), but also understanding my skin and skincare better.

I am not a doctor or a derm, I just know what I know. This article is based on my experience and the expertise I’ve gleaned from professionals but please keep in mind my formal *qualifications* are nil.

With that being said, an exhaustive guide — 

What’s post pill acne? Why does it happen?

In order to break out or experience acne, there must be a perfect storm of acne-causing bacteria (called P.acnes), excess skin cells and sebum.

This is an extremely simplified explanation, but basically most contraceptive pills suppress androgens (hormones like testosterone), decreasing sebum production. So when you are on the pill, your sebaceous glands are on vacanza. They’re doing the bare minimum.

This is why the pill is often a GODSEND for oily, acneic skin; it slows down sebum production, reducing the likelihood of breakouts.

As you probably guessed, when you quit the pill, your hormones fluctuate. The pendulum swings, and your sebaceous glands are suddenly working HARD. Overtime, in fact. Couple this with the bacteria, poor exfoliation, maybe some inflammation, and you are suddenly in the throes of mild, moderate or severe post-pill acne. It is truly like having different skin (at least, such was the case for me).

I will caveat this by saying the above is generalised — some people will have no issues whatsoever (bless them). Post-pill acne usually only happens to those of use who were a little bit oily/pimple-prone BEFORE we went on the pill. But there’s always exceptions to the rule.

What do to

Without being dramatic, having a bit of a plan is probably my best advice. Also, give yourself grace. Breakouts are so common and most of the time, other people don’t care. But I also don’t want to minimise anyone who finds acne emotionally taxing because I get it. Beauty standards, etc etc. When I was in my acne phase, I would wake up in the morning and immediately run my hands over my face while still in bed to see if the topography of my skin had changed overnight. I refused to leave the house without concealer. So literally who the fuck am I to judge.

In terms of treatment, I personally had the best results combining standard skincare with holistic methods. I could tell my hormones were not right because my period would show up twice in one month and then literally disappear. I figured there must be something off and that was probably a contributing factor. I worked out my skincare, and combined it with acupuncture, Chinese herbs and a few other lifestyle habits. I did facials and regular extractions (I think they helped, but probably not worth the thousands of dollars I spent). Within 12-ish months, my skin was 90% clear. Not the same, but clear.

Please leave a comment or message me if I’ve missed anything but I thought the easiest format was a list of key learnings that will hopefully, above anything else, help you to make informed decisions if you’re in the same position.

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