How I’m Managing My Post-Pill Acne The Second Time Round

Emily Algar
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I want to begin by clarifying that OTC Oral Contraceptives are neither good nor bad. Every person who menstruates is different, and there are many factors that influence how and why it’s used. It’s also a privilege to have (relatively) easy access to oral contraceptives in Australia — and this isn’t lost on me. Always chat with a medical professional to gauge what’s right for your body at any given point in time.
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I’ve been on the oral contraceptive pill for the greater part of eight years. Overall, my experience with the pill has been a good one. No mood swings, no abnormal weight gain, a more manageable cycle. I had control and freedom! It was fantastic. It was only as I got older that I started to feel disconnected from my 'natural' cycle (or lack thereof), and wondered if I’d be better off without it. 

The first time I quit the pill...

An overseas holiday where I forgot to bring an additional blister sheet presented as the perfect opportunity to quit. For a month everything was fine. Plus, I never had serious acne before I started taking it — just sporadic teenage spots. 
Emily Algar
My skin the first time I went off the pill.
But the smugness wore off 12 weeks in when my skin was in shambles. Inflamed pimples that took weeks to heal populated my cheeks and jawline, while my t-zone was beyond greasy. I tried a bunch of topical treatments (I was part girl, part Mario Badescu Drying Lotion) but nothing worked long-term. 
I had also just moved cities and started a new editorial job (entry-level + rent = no money) and the stress of it all plus hormonal acne was intense. I was a beauty writer who talked about skin health, and the irony of it all made me feel like a fraud. In hindsight, it was a vapid concern but still, my low self-esteem was leaching into every facet of my life. Eventually, I gave up and went back on the pill. I was frustrated but, whatever. Future me could deal with it. 
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Take two!

Some four years later, future me is just me. About six months ago I again decided — with trepidation — to stop taking the oral contraceptive pill. I figured my skin would go through a similar hell-ish phase as it did the first time around, however, I wanted to soften the blow. It’s also worth pointing out I still experienced breakouts on the pill, but on a lesser scale and they healed faster.
So where to begin? I fell down many Reddit rabbit holes and asked all my friends and colleagues for advice. Some had experienced post-pill acne, some had 0 issues and others were too anxious to stop taking the pill and find out (feels). 
I figured a good place to start was education. According to Dr Jo-Ann See, a Dermatologist at Central Sydney Dermatology, the pill works to decrease oil flow that’s hormonally triggered in the sebaceous gland. So when you stop taking it, that oil flow will increase, encouraging pre-existing acne to return or minor breakouts to worsen. The onset can be as early as a few weeks and up to three months, while duration varies from person to person — some complexions might level out in half a year, whereas others will experience acne long-term. 
As for managing my own face post-pill, I decided on a consistent routine, monthly facials (not the fluffy kind), expert-prescribed supplements and traditional Chinese medicine. Let me map out details... 
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The skincare routine I'm following now:

My skincare routine includes a gentle cleanser, antioxidant serum, light moisturiser and SPF during the day. At night I double cleanse, apply retinol (every second night) and the same moisturiser as before. Once a week, I’ll add in a chemical exfoliant. I also use a LED mask every second night and hydrocolloids on active spots. I do very occasionally try new things for work-related purposes, but I have a pretty good barometer on what will and won’t piss off my skin, so keep testing within these parameters. 
For facials, I see the team at Belemeres once a month. They do extractions, cold laser, and I always leave looking like a newborn baby. Plus, it’s a much safer alternative than picking my face at home, which can lead to scarring and post-inflammatory hyperpigmentation, as I‘ve learnt the hard way. 
I also take a probiotic, magnesium and zinc as prescribed by nutritionist and naturopath Georgia Forsyth from Cohere Studio. The idea is to balance gut health, support skin function and keep me zen (at least we try). 

The positive impact of Chinese Medicine

As for Chinese medicine, I was already seeing a doctor for other reasons so told them about my plan to quit the pill. My doc took this on board with my existing treatment plan (we do acupuncture every six or so weeks and I take herbs daily) and I’m certain it’s having a positive effect. 
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To give you some context, the guiding principle in Chinese medicine is balance within the internal body. When things are out of whack, health issues (including skin conditions) can arise.
Elizabeth Cullen, Principle Chinese Medicine Practitioner, Acupuncturist and founder of The Dao, explains that acne specifically is a “branch symptom whereby the root issue that needs to be addressed includes excess heat and yang, deficiency of yin, and supporting harmony of the internal organs including the lung, heart, kidneys, spleen and liver.” Of course, it’s a complex issue, and one that varies from person to person, but Cullen believes there is a strong connection between female hormones and skin health.
“Through the use of synthetic hormones, the connection of the Hypothalamic-Pituitary-Ovarian axis which supports a regular menstrual cycle is disturbed.” She explains this can lead to changes in gut health, nutritional deficiencies and altered liver function, which in turn can affect the complexion.
Treatment plans will vary based on the individual and their lifestyle, but Cullen explains that acupuncture, Chinese herbal medicine, Chinese dietary therapy including warming foods and professionally prescribed supplementation can all help restore balance, thus regulating oil and reducing the incidence of angry red spots. 
But she also makes a valid point that perfect skin isn’t always realistic. Period pimples are annoying, but they can also be seen as a lovely reminder that your bleed is on its way — something I’ll try and remember next time a volcano erupts on my chin. Cute. 
As for me, it’s been almost six months and while I have experienced bigger pores, stubborn AF blackheads, minor thinning of my hair and some breakouts on my jaw, my skin is faring significantly better than it did the first time. It could flip at any minute (because skin, like JLo, is wildly unpredictable) but for the most part, I think I’m on the right path. 
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Emily Algar
My skin this time round
It’s also been a reckoning of sorts. I am not complaining, but working in the beauty industry and experiencing skin freakouts can be a little unnerving. I also think it’s worth acknowledging that while social beauty standards are for lack of a better word, sh*t, the emotional implications of acne are no joke. Dr See puts it eloquently when she says that post-pill acne is a topic that’s often glossed over, but the effects can be severe: "Having been a dermatologist for over 25 years, I have seen a lot of women experience post-pill acne and it can be devastating for their wellbeing. They often feel cheated or lulled into a false sense of security because, for the first few months, their skin is clear. But then the pimples slowly start coming back. There really is no quick fix."

My tried & tested tips for managing post-pill acne:

What I’m trying to get at is that there is no cure — no magic cream or potion that’s guaranteed to work. It’s highly individual and can come down to patience. But I also get that this sucks, and speaking from personal experience, I think there are ways to mitigate its severity. So in the spirit of hope, I’ve put together some practical takeaways to (hopefully) help anyone in the same breakout-prone boat.

Don’t overdo it  

I (like many) have been guilty of applying countless products, but have come to learn less is often more. Stick to no more than three to four steps morning and night. As Dr See puts it, too many layers, occlusives or highly perfumed products can make inflammatory acne worse. Also, this is better for the planet and your wallet. 
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Use these:

Dr See suggests a cleanser, serum or moisturiser with both salicylic and glycolic acid to exfoliate the skin’s surface and within the pores. She also loves niacinamide as it’s anti-inflammatory and decreases sebum flow. *Adds to cart*
Dr See loves La Roche-Posay’s Effaclar Serum as an all-in-one targeted treatment. Personally, I’ve had huge success with Biologique Recherche P50 Lotion, Medik8 Clarity Peptides and Beaute Pacifique Clinical Super 3 Booster

Don't pick

My biggest beauty vice is picking my face. But do as I say, not as I do. 

Think about it holistically

Acne management is highly personal, but I’ve always found an inside-out approach to be effective in the context of skin. While the science isn’t bulletproof when linking diet, stress and acne, eating fresh, warming meals, cutting down on highly processed food and trying not to burn yourself out certainly doesn't hurt. If you’re wondering about dairy consumption and acne, Dr. See tells us there’s a single study that suggests a link for teenagers, so do with that information what you will. 

Enlist professional help

If you’re struggling and have the means, enlist the help of a professional, whether that’s your doctor, a dermatologist, trusted aesthetician or another health expert. They will guide you through it and can work with you on a management plan tailored to your skin and body. 

Remember, you’re not your skin 

Sappy I know, and easy to say when you're not in the thick of it, but you’re more than your acne. Hang in there — I’m hoping you come out the other end! 

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