Did you try and come off the oral contraceptive pill and your acne was out of control? Or perhaps you haven’t had acne before but you did after coming off the pill. Let’s discuss why this happens & what you can do to help reduce the outbreak. In our topic today: Acne worse after coming off the pill.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


Why were you prescribed the pill?

There are many different reasons you may have been prescribed the pill. One of the reasons may have been to control your acne and then when you came off the pill it came back, only worse. Or perhaps you were prescribed the pill for something other than acne, but when you tried to come off the pill you ended up getting it even though you have never had it before. Then you end up freaking out and going back on the pill.


Why am I getting acne after stopping the pill?

The pill contains synthetic hormones, synthetic oestrogen (Yasmin, Brenda or Diane) for instance will suppress adult sebum production to that of a child. But naturally if you are an adult you need to have more sebum than a child. Sebum is a naturally oily substance produced by the sebaceous glands found on your skin. Sebum has a special’s job is to lubricate your skin and prevent it from going dry. While you are on the pill your sebum is suppressed. Once you stop taking the pill there is a surge and overproduction of sebum because your body senses that there is not enough sebum there to lubricate and protect your skin. This can last for 3-6 months (and be at its worst then) or can sometimes last up to a year if left untreated.

Another thing that happens is that your brain can now communicate with your ovaries to tell it to produce hormones again. It needs to learn how to ride a bike again so to speak and so that is why it can take a while for your hormones to balance. Initially your ovaries produce too much testosterone > over production of sebum > acne. Too much sebum & androgens like testosterone contribute to your pores being blocked > acne.


How does the pill prevent acne?

There are three ways that that oral contraceptive pill suppresses sebum:

  1. Sebum production is also androgen dependent so if you have high androgens you will have too much sebum. Synthetic oestrogen found in the oral contraceptive pill decreases the activity of androgens.

  2. The anterior pituitary gland in your brain is told to stop producing LH and FSH which decreases your ovaries production of the androgen, testosterone.

  3. Increases sex hormone binding globulin levels (SHBG) which decreases the amount of free testosterone gloating around available to bind to an androgen receptor.

 The thing is the pill doesn’t treat acne or the causative factors it simply suppresses hormone production & sebum production. So, of course when you stop the pill it is going to come back with avengence, because the issue as to why you have acne in the first place has not been addressed.


How can I prevent post pill acne?

One very important thing you can do is to support your organs of elimination: liver & bowels because if the toxins and synthetic hormones have no where to go they will come out through your skin. Also, any residual synthetic hormones will disrupt your skin as well.

Start on this a couple of months prior to stopping the pill

Support your gut health:

The pill will impact your gut microbiota, or the good bacteria found there and reduce the diversity of strains of bacteria found there. There are specific types of good bacteria involved in detoxifying excess hormones from the body and that is important for hormone balance.

Probiotic food / drinks: water kefir, miso, tempeh, kombucha

Healing foods: bone broth to heal the gut lining making it desirable for good bacteria

Support your liver health:

The liver is involved in detoxifying excess hormones from the body including synthetic hormones from the pill.

Liver loving foods: spinach, grapefruit, beetroot, green tea, turmeric, lemon juice, garlic, cruciferous vegetables – broccoli, brussels sprouts, cabbage & cauliflower

Support your bowels:

Doing a poo daily (at least one per day) is essential in clearing out excess hormones both natural & synthetic. If you are not going daily this can lead to reabsorption of those hormones causing hormonal imbalance.

Bowel love: The big things are fibre, water & exercise.



Found in nuts, vegetables (particularly in the skin) and whole grains such as quinoa and buckwheat, peas, oats, apples, avocado, asparagus and legumes (lentils, chickpeas etc.)


Things like:

Flaxseed oil & chia pudding (chia seeds soaked in dairy free milk with some toppings like berries & LSA – linseed sunflower & almonds)

Boo to the moo!

Stop eating cow’s dairy because this increases the hormone IGF-1 (insulin like growth factor) similar structure to insulin. If you have high insulin & insulin like growth factor this increases inflammation & increases sebum production which worsens acne.

Furthermore, cow’s dairy results in further inflammation from the A1 casein protein. This is a big protein molecule and difficult to digest and break down.

And if that wasn’t already bad enough for you, it increases mTOR which is an enzyme that stimulates keratin, sebum production & inflammation. Switch to goats or sheep’s dairy products instead because they have A2 casein which is easier for your body to digest, and it is not inflammatory. If you are intolerant to lactose though you would need to avoid them.

Ultimately though, it is all about finding what the causative factors are for you whether it is:

  • Stress

  • Hormone imbalance

  • Poor digestive function (liver, bowels, lack of good bacteria & too much bad bacteria)

  • Inflammatory foods

  • Sugary foods

  • Lack of nutrients (for e.g. zinc is depleted on the pill) which is important for skin integrity (anti-inflammatory, antibacterial, assists liver detoxification & heals the skin)

This is what I do in my clinic. Look for causative factors and help put into place a treatment plan with herbal medicine, nutritional medicine, diet & lifestyle advice for 2-3 months before coming off the pill to try and prevent your skin breaking out.

If you would like some support before coming off the pill or you are off the pill now and experiencing issues. I would love to help you, go ahead and book a FREE 15 min discovery call to find out more.

If you have any questions or comments, please pop it in the box below