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So I've been reading through the forums on birth control pills for hormonal acne, and it seems that this is the only option!

I am fine with this at the moment, as Juliet 35ED is working for me [4 years now], but looking at the long-term (say 10+ years) what are my options there? Has anyone come off birth control and noticed that their acne is actually okay?

The thought of taking a drug long-term really scares me, yet is seems from most posts, that coming off birth control causes huge breakouts. What have people done after deciding birth control is not the best way, and that they want something natural?

Is it possible for your hormones to have settled down anyway while you're taking birth control, so when you come off it, it has 'fixed' itself naturally?

I am just stuck at the moment, in my head I'm thinking 'I can't have acne FOREVER!' but I guess I can, right? What can I do about it without taking drugs?

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So I've been reading through the forums on birth control pills for hormonal acne, and it seems that this is the only option!

I am fine with this at the moment, as Juliet 35ED is working for me [4 years now], but looking at the long-term (say 10+ years) what are my options there? Has anyone come off birth control and noticed that their acne is actually okay?

The thought of taking a drug long-term really scares me, yet is seems from most posts, that coming off birth control causes huge breakouts. What have people done after deciding birth control is not the best way, and that they want something natural?

Birth control is not the only way to systemically treat hormonal acne... Juliet35 can improve acne because it is an antiandrogen... even normal levels of testosterone in women can cause acne and oily skin, so antiandrogens can have great success with clearing "hormonal" acne. If you have success with Juliet35, chances are you could also successfully use spironolactone. Spiro is a more direct antiandrogen, and it is not a contraceptive (so it contains no estrogen or progestin, just spironolactone, which blocks certain androgen receptors). Spiro is actually a component of Yaz birth control pills, which are FDA approved for treating acne. Yasmin contains a similar compound.

Spiro can be used with or without birth control pills, and is pretty much the most effective treatment for acne in women caused by androgens. So far, it also seems to be relatively safe to use long term.

If you do not want to take any synthetic drugs, there are natural supplements that can have antiandrogenic effects. However, none of these will be as direct as spiro.... saw palmetto is one I've read about... I've also read a few posts about spearmint tea being antiandrogenic... and peony and licorice...

Before messing with hormone levels on your own, it's a good idea to talk to your doctor, though...

Is it possible for your hormones to have settled down anyway while you're taking birth control, so when you come off it, it has 'fixed' itself naturally?

It is not possible for your own hormones to be normal or "settled down" while on birth control pills. This is because the artificial hormones change your entire menstrual cycle to prevent ovulation by preventing your body's production of the hormones which begin ovulation.

Thus, when you discontinue birth control pills, your body will once again begin to produce its own hormones... this natural pattern of hormone production is much different than the constant supply of hormones you were getting from the birth control pills... much of your natural cycle involves various feedback systems, where your hormones are consistently rising and lowering, which triggers the rising and lowering of other hormones, until menstruation occurs, and the cycle begins all over again.

So, if your normal, natural hormone levels cause your acne, then discontinuing birth control will certainly cause your acne to come back.

When I discontinued birth control pills, I didn't get any huge break outs or anything, but my skin went back to the way it was before I began birth control... (there was hardly any improvement from the pill anyway though).

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thanks! that makes a bit more sense I guess, after stopping bcp your 'normal, natural hormone' levels come back which originally caused the acne. However, how do people then 'outgrow' acne? Do you mean that hormones can never settle down? Or do you mean that they'll never settle down while you're on birth control? I have a picture in my head of my actual hormones which might slowly fix themselves over time, and over the top of this is my bcp hormones which is masking the effects of the natural ones. In my head when I remove the 'mask' i might be okay. Obviously this is crazy lol.

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thanks! that makes a bit more sense I guess, after stopping bcp your 'normal, natural hormone' levels come back which originally caused the acne. However, how do people then 'outgrow' acne? Do you mean that hormones can never settle down? Or do you mean that they'll never settle down while you're on birth control? I have a picture in my head of my actual hormones which might slowly fix themselves over time, and over the top of this is my bcp hormones which is masking the effects of the natural ones. In my head when I remove the 'mask' i might be okay. Obviously this is crazy lol.

The birth control pills do mask your natural hormones, in a way... but when I said that your hormones won't "settle," I meant that your natural hormones won't get "fixed" just because you're on birth control... so if your acne was caused by your body's sex hormones, you won't remain clear when you discontinue the pill.

People's acne is caused by different things. Men whose teen acne is caused by increases of testosterone (puberty) might outgrow it once their androgens level out. Women whose acne is caused by our sex hormones are often just out of luck... after puberty, we experience monthly and lifelong fluctuations of our hormones. It's not often we can "outgrow" acne caused by these fluctuations :cry: If anything, we are more often surprised with it in our 20s.

Since testosterone (imbalances or sensitivity to it) is not the only thing that causes acne, it's not surprising that not everyone is able to get clear on birth control (or on spiro). Other hormone imbalances can cause acne, as does diet, genetic predisposition, and even other factors... and all of these factors can be interrelated.

This is why it's so hard to get clear... but once you figure out what's causing your acne, it's easier to find an effective way to stay clear.

Because my acne is caused largely by PCOS (an endocrine disorder), I'm having more success working with a knowledgeable internal medicine specialist at my gyno's office (and an esthetician there as well) instead of a derm.

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thanks! that makes a bit more sense I guess, after stopping bcp your 'normal, natural hormone' levels come back which originally caused the acne. However, how do people then 'outgrow' acne? Do you mean that hormones can never settle down? Or do you mean that they'll never settle down while you're on birth control? I have a picture in my head of my actual hormones which might slowly fix themselves over time, and over the top of this is my bcp hormones which is masking the effects of the natural ones. In my head when I remove the 'mask' i might be okay. Obviously this is crazy lol.

The birth control pills do mask your natural hormones, in a way... but when I said that your hormones won't "settle," I meant that your natural hormones won't get "fixed" just because you're on birth control... so if your acne was caused by your body's sex hormones, you won't remain clear when you discontinue the pill.

People's acne is caused by different things. Men whose teen acne is caused by increases of testosterone (puberty) might outgrow it once their androgens level out. Women whose acne is caused by our sex hormones are often just out of luck... after puberty, we experience monthly and lifelong fluctuations of our hormones. It's not often we can "outgrow" acne caused by these fluctuations :cry: If anything, we are more often surprised with it in our 20s.

Since testosterone (imbalances or sensitivity to it) is not the only thing that causes acne, it's not surprising that not everyone is able to get clear on birth control (or on spiro). Other hormone imbalances can cause acne, as does diet, genetic predisposition, and even other factors... and all of these factors can be interrelated.

This is why it's so hard to get clear... but once you figure out what's causing your acne, it's easier to find an effective way to stay clear.

Because my acne is caused largely by PCOS (an endocrine disorder), I'm having more success working with a knowledgeable internal medicine specialist at my gyno's office (and an esthetician there as well) instead of a derm.

Comfy Cat, how much spiro do you take, how long have you been on it, and what side effects have you encountered? I am considering spiro for my acne. I took BCPs years ago but stopped and had my tubes tied after having children. I never had bad problems with acne until after I tied my tubes. My skin got oiler and started to breakout more. The BCPs may have kept me clear the earlier years. I didn't start breaking out bad until I hit 30. I have even taken accutane at 80mg for 6 months and I stayed clear for a year then the acne returned but not as bad.

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Sonyah - have you considered taking Accutane again? I think one year's remission is impressive. Two years might just do it for you. My daughter got no relief at all from taking accutane and she was on the same dosage and as long as you. I am always impressed when I hear a success story. When you were done you could consider say Genesis laser treatments and Vi peels. I hear the combo works quite well to keep acne at bay. Just a thought...

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Sonyah - have you considered taking Accutane again? I think one year's remission is impressive. Two years might just do it for you. My daughter got no relief at all from taking accutane and she was on the same dosage and as long as you. I am always impressed when I hear a success story. When you were done you could consider say Genesis laser treatments and Vi peels. I hear the combo works quite well to keep acne at bay. Just a thought...

I have thought about it but I just feel like it didn't cure me the first time so taking it again may just give me a temporary remission again. Just don't know if it is worth the risks twice and it not be a cure.

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Sonyah - have you considered taking Accutane again? I think one year's remission is impressive. Two years might just do it for you. My daughter got no relief at all from taking accutane and she was on the same dosage and as long as you. I am always impressed when I hear a success story. When you were done you could consider say Genesis laser treatments and Vi peels. I hear the combo works quite well to keep acne at bay. Just a thought...

I have thought about it but I just feel like it didn't cure me the first time so taking it again may just give me a temporary remission again. Just don't know if it is worth the risks twice and it not be a cure.

I would not take it three times but twice yes. Especially since you got a year's remission out of it. I have a friend that once was not enough but twice cured him. Do you think males have more success with accutane? I suppose you could hang out at the accutane forum to see the success rate of the 2nd go rounders. At any rate I wish you well with whatever you decide.

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Comfy Cat, how much spiro do you take, how long have you been on it, and what side effects have you encountered? I am considering spiro for my acne. I took BCPs years ago but stopped and had my tubes tied after having children. I never had bad problems with acne until after I tied my tubes. My skin got oiler and started to breakout more. The BCPs may have kept me clear the earlier years. I didn't start breaking out bad until I hit 30. I have even taken accutane at 80mg for 6 months and I stayed clear for a year then the acne returned but not as bad.

I so far have not experienced any side effects from spiro. I've been taking 50mg twice per day for about three weeks.

If birth control pills were keeping you clear, it's possible that spiro will help you. Hormonal changes after your surgery might also be playing a role... it's hard to say ;)

But if you're not interested in taking more accutane, as Boston suggested, then spiro might be a good alternative for you.

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