Naturally, there’s a lot that goes into the decision to get on birth control. How it affects your skin, for better or worse, may not be top of mind until you notice the changes. Several factors, including age, health history, and the type of contraception you choose, can result in clear skin, breakouts, excessive dryness, and a range of other skin shifts. Experts explain some of the more visible changes your skin may experience—and more importantly, how to care for and keep it healthy and glowing while on birth control.
What happens to your skin when on birth control?
Birth control can have a pretty significant impact on the skin, particularly when it comes to acne, oil production, and pigmentation. Dr. Chelsea Hoffman, MD, MSc, FAAD, a board-certified dermatologist at Hudson Dermatology and Laser Surgery, explains that the changes vary between combination birth control, which contains estrogen and progestin (OCPs), and progestin-only methods. “Combination pills often improve acne because they work to counteract the effect of androgens—a type of hormone that stimulates oil glands and triggers acne,” Hoffman explains to ELLE. The result, especially for those with oily or acne-prone skin, is less oil production and fewer breakouts. Conversely, Dr. Jennifer Choe, an OB/GYN at Montefiore Einstein Advanced Care, says that while the breakout may subside, this type of birth control can trigger hyperpigmentation like melasma, particularly for those already susceptible to it.
On the other hand, Choe says that some progestin-only methods such as Depo-Provera shots or a Mirena IUD can trigger or worsen acne in some patients. Hoffman agrees, noting that acne is one of the most common reasons people discontinue these birth control methods.
What are some ways to properly care for skin while on birth control?
It’s a step that should already be ingrained into your routine, but Choe stresses how crucial regular sunscreen use is while on birth control—especially since melasma and hyperpigmentation can worsen with sun exposure. “Additionally, acne scars can become permanent if they are exposed to the sun,” says Choe.
This last layer is essential, but Hoffman says the rest of your routine doesn’t necessarily need an overhaul. “You generally don’t need an entirely different skincare routine just because you’re on birth control. I recommend keeping the basics consistent: a gentle cleanser, a non-comedogenic moisturizer, and daily broad-spectrum sunscreen with at least SPF 30,” Hoffman suggests.
Additionally, Hoffman says that tinted sunscreens containing iron oxides are especially important for patients dealing with melasma because they also help protect against visible light, which contributes to the condition. Beyond that, she recommends tailoring your routine to what your skin is actually doing. “If your birth control is improving your acne, a simple maintenance routine may be all you need. If you’re experiencing new breakouts, a topical retinoid, benzoyl peroxide, or another targeted acne treatment may help,” Hoffman says. “I always tell my patients to let me know about any persistent or sudden changes, so that we can work with the prescribing clinician to alter birth control if needed, rather than trying to correct everything by adding more products.”
Should you switch up your skin care routine if you cycle on and off birth control?
If you do happen to cycle off birth control for any stretch of time, Choe says you may notice some skin changes or the occasional pimple, but you don’t necessarily need to change your skin care routine to follow. “If you notice that you break out during your period, you can opt to skip your menses using birth control pills. Furthermore, topical acne medications are perfectly safe to use alongside birth control,” says Choe.
Talk to your doctor before adding or subtracting products from your regimen. “When you stop a combination birth control pill, you lose its ongoing sebum and acne-suppressing effects, so oily skin and breakouts can return. If you’re prone to hormonal acne, it’s helpful to have a maintenance or treatment plan in place before going off,” says Hoffman. With her patients, she adds that “Sometimes, we will use other anti-androgenic meds to do the work OCPs once did, for example, Winlevi or spironolactone.” One important point Hoffman also notes is that pigmentation doesn’t necessarily resolve when you stop birth control. “If you’ve developed melasma, treating it and consistent sun protection is still super important,” says Hoffman.
Are skin care actives like retinol safe to use while on birth control?
Choe says yes; most antiaging-focused ingredients such as retinol are safe to use with birth control. And Hoffman concurs, adding that being on birth control is not a reason to avoid topical retinoids or acids like AHAs. “However, because oral combined pills might be slightly suppressing oil production already, just make sure to start low and go slow when it comes to retinoids to reduce risk of causing irritation and disrupting the skin barrier,” Hoffman advises. She recommends this to everyone, even patients who aren’t on OCPs.
Are there any skin treatments that you shouldn’t do while on birth control?
Both experts agree that most treatments are safe while you are on birth control, including Botox, fillers, and many lasers. However, Choe says to be careful with aggressive heat- or light-based procedures like certain lasers, because they can provoke or worsen melasma. Always consult a dermatologist before undergoing any treatments.