In the aftermath of stopping birth control—or entering early perimenopause—many women are blindsided by skin chaos. Breakouts, oiliness, and cystic acne along the jawline. Most are told, “It’s just acne,” and handed a prescription for antibiotics or benzoyl peroxide. But this skin story runs deeper. One of my biggest eye openers when leaving primary care for aesthetics was seeing how aestheticians treated acne with actives and lifestyle support. As a physician, I learned in school to use mainly antibiotics, birth control, and benzoyl peroxide, which strip the skin, alter the microbiome, and destroy our skin barrier.
May 2025 L+A Report
Why Feminine Health Matters to Medical + Spa Aesthetic Professionals
For decades, menopause was spoken about in hushed tones—if at all. Referred to simply as “the change,” it often carried a vague, almost mysterious connotation. We grew up hearing about hot flashes on sitcoms, where menopause was portrayed as a punchline or a dreaded life event. I can still remember episodes where characters treated it like the end of youth, the end of beauty, or even the end of relevance.
But things are changing.
Thanks to mainstream advocates—yes, even Oprah—the conversation around menopause and feminine health is shifting into the spotlight. We’re finally seeing more open, honest discussions about how hormonal transitions impact the entire body, not just fertility.
As a young woman growing up in the early 2000s, many of my friends and I went on birth control very early on in life, and stayed on them for a decade through college and professional school. In residency, I once had an attending scold me for not getting a young woman to commit to some type of hormonal contraception, as if I had failed as a provider. Now, Generation Z is trending away from hormones, alcohol, and heavy chemicals, thought to be influenced by the wellness culture online.
Here’s the controversial truth: getting off birth control is a shock to the body and being awoken after chronic suppression. You’re detoxing years—sometimes decades—of hormonal suppression. This isn’t a random breakout; it’s a communication breakthrough. Your body is speaking up after being muted for too long.
Androgen Aftershock: What Really Happens When You Stop Birth Control
Hormonal birth control doesn’t just prevent pregnancy—it suppresses your natural hormonal rhythm. When you stop taking it, your endocrine system suddenly wakes up and starts recalibrating. One major player in this transition? Androgens.
Androgens, such as testosterone, stimulate sebum (oil) production. When birth control is removed, your body may experience a temporary androgen surge. This spike often leads to oily skin, clogged pores, and acne flare-ups, especially in androgen-sensitive areas like the chin, jawline, and upper back. Thankfully, this should be temporary, but it can start a cascade, leading to scarring and post-inflammatory hyperpigmentation.
But there’s more. Hormonal birth control has also been shown to deplete essential nutrients over time—particularly vitamin D, B12, and B6 [1]. These deficiencies can impair hormone balance, immune regulation, and skin repair mechanisms, making post-pill breakouts more severe and longer-lasting. Keep reading for natural ways to rebalance your hormones.
Contribution By Dr. Chantal Lunderville, L+A Medical Editor
Dr. Chantal Lunderville is a board-certified physician specializing in skin health, aesthetic medicine, and Women’s health. She attended medical school at UCLA School of Medicine, followed by a residency at UCSF Family Medicine, and on graduating opened her own concierge aesthetics practice in the San Francisco Bay Area focusing on hormone health, skincare, and longevity.
Since then Dr. Lunderville has grown her practice to include overseeing nurses and aestheticians as medical director to over 15 practices across California, and through Dr. C’s Academy helps to launch new practices across the US and Canada through consulting and online courses in business, compliance, aesthetic procedures including neurotoxin, fillers, lasers, microneedling, and lasers. Read Full Bio
Perimenopause and the Skin Shift
Similarly, during early perimenopause, hormone levels begin fluctuating unpredictably. Estrogen drops faster than androgens, creating a relative androgen dominance. This imbalance can cause breakouts in women who never struggled with acne before. Add in slower collagen turnover, a shifting skin microbiome, and reduced detox capacity—and it’s a perfect storm.
Your Skin Is a Detox Organ, Not Just a Canvas
As I explain to patients, your skin health is also largely determined by your gut, liver, and lymphatic systems. These all play a role in the microbiomes and elimination, as well as where your hormones get flushed and cleared. Lymphatic massage, exercise, antioxidant supplements, and in food, warm water, fermented foods, are among some ways to support detoxification. Warm water with lemon in the morning with my glutathione, prebiotic, and gua sha are my go-to jump start for the day.
Why Topicals Alone Won’t Cut It
Benzoyl peroxide, antibiotics, and other common acne treatments target symptoms—not causes. They dry the surface but leave internal imbalances unaddressed. In fact, overuse can further disrupt the skin barrier and microbiome, making long-term healing harder. I recommend these traditional treatments temporarily to my patients while we work on addressing their lifestyle, starting on actives for long-term control, and restoring the barrier with lipids, ceramides, or peptides.
Dr. Chantal Lunderville, L+A Medical Editor
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Support, Don’t Suppress: A Root-Cause Protocol
True skin healing happens when you work with your body, not against it. Instead of trying to silence symptoms, support the detoxification systems your skin is working overtime to compensate for.
Here’s where to start:
- Liver Support: The liver processes excess hormones. Feed it cruciferous vegetables, bitter greens, and antioxidants. Supplements like glutathione, milk thistle, NAC, and calcium-D-glucarate can assist with hormone metabolism and phase II detox.
- Lymphatic Activation: The lymphatic system moves waste and immune cells throughout the body. Support it with dry brushing, gua sha, rebounding, sauna, or lymphatic drainage massage.
- Gut Rebalancing: A healthy gut regulates hormones and inflammation. Reintroduce prebiotics, fiber, zinc, and glutamine to support the intestinal lining and microbial balance. Avoid ice-cold drinks and stick with warm water.
- Micronutrient Repletion: After birth control, supplement with B12, B6, and vitamin D, as well as eat ideal protein for your body weight. These are critical for hormonal balance, skin healing, and mood regulation.
- Androgen Modulation: Nutrients like DIM (from cruciferous vegetables), saw palmetto, and spearmint tea may help lower excess androgens naturally, as well as supplementation with Inositol (myo- & D-chiro-inositol) and Berberine.
This Is a Message, Not a Malfunction
The breakouts you see now are a delayed conversation your body is finally having with you. It’s not rebellion—it’s revelation. It’s detox, recalibration, and expression.
Rather than panic or fight it, pause and listen. Support your body’s natural detox and hormone pathways. Don’t suppress the signal—decode it. Because what’s surfacing isn’t just inflammation… it’s intelligence.
Let’s help our female patients at every stage of their hormone shifts, and particularly at these junctures to rebalance and realign with our natural hormone states and detox systems.
[1] Endocrine Society. (2016, March 5). Vitamin D levels may drop when women stop using birth control. https://www.endocrine.org/news-and-advocacy/news-room/2016/vitamin-d-levels-may-drop-when-women-stop-using-birth-control