The Simple Skin Care Routine That Cleared My Post-Pill Acne

During the peak of 10-step routines, finding a skin care starting lineup that worked felt like a major accomplishment — and then I stopped taking birth control. After five years of being on The Pill, I decided enough was enough. I constantly would forget to take the medication at the same time every day despite alarms and reminders, and the stress of doubling up or remembering to pack the monthly set whenever I went on a trip began to grate on me. After moving to a new neighborhood, I finished the pack I started, ignored reminders from my old pharmacy for refills, and embarked on a new, hormone-free journey. And then came the post-pill acne.

My friends warned me about the side effects I might experience when I started taking hormonal birth control, but no one really tells you about what to expect when you go off of it. When my period came back, I let out a sigh of resignation, but I wasn’t prepared for the breakouts that followed. In addition to hormonal acne, an increase in menstrual bleeding, ovarian cysts, and PMS symptoms during periods can occur at any point up to three months after you stop taking The Pill, especially if these were issues you encountered prior. Five years of perfectly clear and smooth skin came to a grinding halt as painful pimples dotted my chin, cheeks and forehead every month. I started being more diligent about washing my face and adhering to the skin care lineup I routinely used — to no avail.

After months of trying (and failing) to improve my adult acne on my own, I decided it was time to rethink everything I thought I knew about my skin — and call a professional. Ahead, the steps I took and products I used to rebalance my complexion post-pill.

Step One: See A Dermatologist

There wasn’t a cleanser or toner in my possession that did anything to help the clusters of cysts and dark marks unfolding on my face. After doing some research, I made an appointment with Dr. Michelle Henry, M.D., a board-certified dermatologist based in New York City. We went over the products I was using, and decided a total overhaul of my routine was necessary to address the current issues I was facing with my skin.

“The estrogen component of combined birth control (pills, patches, and rings containing estrogen and progestin) is responsible for suppressing the production of hormones in the ovaries that contribute to acne,” says Dr. Kelly Culwell, M.D., a board-certified OB-GYN also known as Dr. Lady Doctor. “When you stop hormonal birth control, the ovaries start producing all of their hormones again, including androgens like testosterone.” Due to the sharp increase in hormones in my body, the products I was using were far too mild to really tackle the influx of pimples and ensuing acne scars dotting my face.

Henry prescribed Winlevi (also known as clascoterone), a prescription specifically designed to tackle hormonal acne. Unlike spironolactone (a diuretic that’s commonly prescribed off-label to fight hormonal acne), Winlevi is topical, not oral. She breaks down how the two work, and how Winlevi is different: “Winlevi and Spironolactone are both androgen-receptors, although Winlevi works directly on the oil glands of the skin so that effects from androgens, such as testosterone, are blocked,” Henry explains. “Spironolactone is only taken orally and requires more intense monitoring to ensure it doesn't cause systemic side effects such as altered blood pressure or potassium levels.” As someone who already had difficulty remembering to take pills, choosing to apply some lotion out of a tube was an easy choice. Because there isn’t a guaranteed cure for acne, there’s no telling how long I’ll be using Winlevi to keep my skin clear.

Step Two: Protect Your (Healing) Skin

I was also prescribed tretinoin to apply before bed, a commonly prescribed retinoid that would help with the dark marks left behind. As a retinol virgin, I didn’t use nearly enough moisturizer afterwards. Big mistake. Retinol burn (technically known as retinoid dermatitis) is REAL, and my skin was painful and sensitive to the touch. “Retinol derivatives essentially cause downregulation of your sebaceous glands, which causes the skin to dry out and feel chapped,” cosmetic dermatologist Dr. Karan Lal, M.D., a board-certified dermatologist in Scottsdale, Ariz. shares. This is also typically followed by some sensitivity and breakouts, commonly referred to as the “purge” phase of using retinol.

After taking a couple days off, I resumed using tretinoin with the sandwich method to soothe my face after the intense irritation. Thayers’ Bestie Barrier Ultra Whip Cream was a miracle saver in terms of restoring my skin, and as someone with a naturally dry complexion, my face felt soft to the touch after application.

Sunscreen is also a major factor in keeping dark marks at bay. Because my skin was so sensitive in this healing process, it was imperative that I protect my face from the sun with SPF products before heading out for the day. Bubble’s Solar Mate mineral sunscreen became my go-to product before leaving the house; not only does the SPF 40 keep my skin protected, but I can count on an effortless blend into my dark tone — no weird white or purple cast left behind.

Step Three: Go Easy On Active Ingredients

When it comes to rebuilding my routine, less is truly more. Gentle cleansers such as Bubble’s Fresh Start Gel Cleanser are what I reach for now, followed by EADEM’s Cashmere Peel exfoliating toner. After applying a pea-sized amount of Winlevi, I’ll do a couple drops of a light face oil (I like Lancer’s) in the mornings. Cutting down the steps in my skin care routine has not only saved me time, but my complexion has never looked smoother and clearer.

Several months into my new routine, I’m now enjoying (mostly) blemish-free skin. Every couple of weeks, I might still get a pimple or two — usually if I get lazy with the prescribed topicals. One tube of Winlevi lasts me at least half the year, and my simplified skin care lineup means a little goes a long, long way.