What’s the short answer?
“Hormonal IUDs can actually cause acne,” says cosmetic dermatologist Dr. Michele Green.
In fact, acne is a known side effect of IUDs like Mirena, Liletta, and Skyla.
You may be more affected if you’re already prone to hormonal breakouts — particularly if you experience breakouts before your period.
Cystic acne around the jawline and on the chin is commonly reported.
What type of IUD are we talking about?
Five brands of IUD are approved by the Food and Drug Administration (FDA):
Only one, Paragard, is of the nonhormonal type. Paragard is a copper IUD, while hormonal types release varying amounts of a synthetic hormone called progestin.
These hormonal types can cause acne breakouts, explains Green.
Progestin, she says, “can send your body in a frenzy, throwing off [its] hormonal balance.”
Is it the IUD itself or is it a mix of factors?
Acne can be caused solely by an IUD or by a combination of things.
When progestin —the synthetic version of progesterone found in IUDs — is released into the body, it can stimulate androgenic activity.
“If the body’s level of androgen hormones (the male sex hormones, such as testosterone) increases, it can cause an overstimulation of the sebaceous glands,” says Green.
“When this occurs, the skin can become oily, which can clog the pores and cause an acne breakout.”
Sometimes, acne can be caused by switching from the combined pill to an IUD.
This is because some pills contain estrogen and progestin: a mixture of hormones that can reduce testosterone levels and therefore help combat acne.
When those hormones are replaced with just progestin (in the form of a hormonal IUD), or no hormones (in the form of a copper IUD), acne may ensue.
In some cases, acne breakouts may have little to do with birth control.
Some people experience acne for the first time as an adult, and everything from stress to new skin care regimens can prompt a flare-up.
What if you already have an IUD?
If you’ve already been fitted with an IUD, there’s no need to panic. It can take some time for your body to adjust to any form of birth control.
In the meantime though, there are things you can do to reduce or treat acne breakouts.
Is there anything your doctor can prescribe?
“Oral medication such as Accutane (isotretinoin) is a great choice for patients who have tried everything without success to control their acne,” notes Green.
Severe cases may also be given oral antibiotics or topical retinoids, she adds. “These prescriptions work by reducing bacteria, excess oil, and inflammation which results in fewer breakouts.”
Another option is spironolactone. It blocks the hormones that can cause acne.
What about changing diet and skin care?
If you believe your acne is linked to your IUD, changing up your skin care routine may be beneficial.
Some recommendations include exfoliating a few times a week with the likes of salicylic acid to help clear clogged pores.
Adding ingredients like retinol to your regime can help encourage the turnover of skin cells.
It’s also important to thoroughly cleanse your skin at least once a day and avoid picking or squeezing pimples.
The link between diet and hormonal acne is still unclear, but certain dietary changes may help control breakouts, too.
Try following a low-glycemic diet involving plenty of fresh vegetables and beans.
Try to cut back on — not necessarily eliminate — foods and drinks that quickly raise your blood sugar, such as:
- white bread
- potato chips
- sugary drinks
When should you consider getting the IUD removed?
Any IUD-related side effects may improve over the course of a few months as your body adjusts.
Unless you’re experiencing severe side effects or discomfort, most experts recommend leaving the IUD in place for at least 6 months before considering removal.
What if you don’t have an IUD yet?
If you’re still deciding whether to get an IUD, it can be pretty difficult to predict the effect it’ll have on your skin. Here are a few things to consider:
Is one IUD better than another if you’re predisposed to acne?
According to Green, “copper IUDs are best since they are hormone-free and will not further exacerbate your acne.”
As mentioned, the only copper type currently on the market is Paragard.
Is there anything you can start at the same time to minimize your risk of acne flare-ups?
Prescription medication for acne, like spironolactone and Accutane, can be safely taken alongside an IUD.
You shouldn’t dismiss the importance of a good skin care routine.
“Start with the basics,” says Green. “A cleanser to clean the skin and remove all traces of makeup and bacteria.”
Acne-prone types should opt for a gel-based cleanser.
After cleansing, apply a toner to open the pores and allow other products to fully absorb, she adds.
Formulas containing salicylic or glycolic acid are best for people prone to acne.
Follow this up with a lightweight moisturizer that replenishes the skin and hydrates your skin cells, says Green.
The final step is skin-protecting sunscreen.
Once you’ve got the basics down, you can begin to add in other products, like exfoliators and serums.
At what point should you consider using another contraceptive entirely?
If you’re already dealing with acne or are particularly prone to hormonal breakouts, you may want to consider another form of birth control.
Weigh the pros and cons of each method before making your final decision.
Remember: It isn’t a given that a hormonal IUD will lead to or worsen existing hormonal acne.
A doctor or dermatologist can help determine the cause of your acne.
“If your acne is due to a hormonal imbalance, an oral contraceptive may work best,” states Green.
Pills that contain both estrogen and progestin can help manage acne by reducing elevated testosterone levels. The pill isn’t the only form of birth control to contain these two hormones. They’re also found in the patch and the ring.
The bottom line
While a hormonal IUD may cause breakouts in one person, another may experience zero skin-related side effects.
If you can, make an appointment with a physician or dermatologist. They’ll listen to your concerns and guide you in the right direction.
If acne does flare up, know that there are ways to combat it. Just remember to seek professional advice first before trying the DIY route.
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