Acne is physically and emotionally traumatic. I know that first-hand. I remember I would have done just about anything to clear my skin, so I understand why women take the birth control pill to get rid of acne. Desperation. But the truth is that the pill is only a short-term fix that does nothing to address the underlying cause of acne. In addition, acne can come back worse than ever once the pill has been stopped, and the side effects of the pill can be fatal. So what should a desperate woman with acne do? For more understanding, let me answer some questions my patients often ask me about this very topic. How does the pill affect my natural hormones? The birth control pill contains two synthetic hormones: an estrogen-like hormone (ethinyl estradiol) and a progesterone-like hormone called a progestin (likely drosperinone if the pill is being prescribed for acne). These hormones shut down ovarian function completely, which means that natural estrogen and progesterone are no longer being produced in the body. Effectively, chemical castration. Are the synthetic estrogens and progestins in the pill similar to natural hormones? The synthetic estrogen and progestins that are in the pill are not at all like the natural estrogen and progesterone that our body produces. Natural estrogen and progesterone calm the nervous system, support pregnancy, and protect the body. Synthetic estrogen can lead to breast cancer and cardiovascular disease if not administered with a progestin. And the effect of synthetic progestins on the body is almost the exact opposite of natural progesterone and can cause some alarming side effects. Synthetic progesterone can cause depression, anxiety, hair loss, abortion, a decreased sex drive and fatal blood clots. In fact, drosperinone, the synthetic progestin that is in the pill often prescribed for acne, increases the risk of a fatal blood clot by 290%. Some sources say this risk is even higher. So how does the birth control pill stop acne? The ethinyl estradiol suppresses skin oils and the drospirenone blocks androgens (hormones that cause acne) from being active in the body. What will happen to my acne when I go off the birth control pill? If you have been prescribed the birth control pill to control acne you may experience post-pill acne. Remember how ethinyl estradiol suppresses skin oil? While on the pill the body will compensate for this by producing more oil so when you stop the birth control pill your skin will be oilier than before you started the pill. In addition, the drospirenone will no longer be blocking the androgens. This combination can lead to some serious acne break-outs. How long does post-pill acne last? Post-pill acne will peak 3-6 months after stopping the pill, and will generally resolve within a year. The body needs time to recalibrate its oil production. Is there a way to come off the birth control pill and avoid post-pill acne? The effects of the birth control pill on the body are strong, and there is always an adjustment period. That being said, addressing the root cause of acne will help minimize post-pill acne. This includes removing dairy from the diet, balancing insulin levels by avoiding sugar, and including supplements such as berberine, zinc and DIM (diindolymethane). This work should be started a few months before stopping the pill. If I don’t go on the pill to control my acne, what should I do? Curing acne from the inside out takes some effort and lifestyle changes, but the results are life-changing. The first step is to discover the imbalance in your body that may be causing acne, and the second step is to treat the root cause. Imbalances that can lead to acne include insulin resistance, sluggish liver detoxification, inflammation in the gut, hormone dysregulation and stress. Restoring the balance in the body will lead to clear, glowing skin – with no side effects other than excellent health!