Hailey Bieber Opened Up About Having "Painful" Hormonal Acne After Getting an IUD
If you can relate, here's what you need to know about the link between acne and IUDs.
If you've ever gotten the adult acne blues after starting a new method of birth control, you're not alone. Hailey Bieber recently opened up about developing acne for the first time as an adult, sharing that she began experiencing breakouts after getting an IUD.
The 23-year-old model talked about her acne in an episode of The Biebers on Watch, her Facebook Watch series with husband Justin Bieber. "Within the last year, I started getting a little bit of acne from my IUD because I'd never been on birth control before, so my hormones were a little out of balance," she recalled, explaining the pimples on her forehead were often "painful."
"I hid it really well," she added, admitting it impacted her self-image at times. (Related: Why You're Breaking Out, According to a Derm)
Even if you're not on BC, you're probably aware that acne is a common birth control side effect. But how, exactly, can the IUD lead to acne—and what can you do to prevent it? Here's what you need to know.
The Link Between IUDs and Acne
There are two types of IUDs: hormonal and non-hormonal (the non-hormonal is made of copper). While Bieber didn't specify which type she has, hormonal IUDs can indeed cause acne, even if someone has never battled breakouts before, says ob-gyn Felice Gersh, M.D., founder/director of the Integrative Medical Group and author of PCOS SOS Fertility Fast Track. (Related: Is an IUD the Best Birth Control Option for You?)
Hormonal IUDs prevent pregnancy by releasing a very small amount of levonorgestrel—a chemical similar to progestin, which is a synthetic form of the sex hormone progesterone—each day, explains Dr. Gersh. She describes levonorgestrel as an "endocrine disruptor," meaning it changes the natural production and function of your body's hormones to prevent egg fertilization, she says.
So, how can that lead to breakouts? "By altering the levels of your hormones, these IUDs can change how the body works in a multitude of ways, including creating a state of inflammation. Acne is an outward manifestation of inflammation," explains Dr. Gersh. Essentially, the hormones in these IUDs can mimic the production of androgen sex hormones such as testosterone, potentially "leading to increased oil [or sebum] production, which may lead to breakouts," says Marisa Garshick, M.D., F.A.A.D., a board-certified dermatologist in New York City. (Related: 6 Surprising Things Making Your Acne Flare Up)
"In general, there are few other skin issues that are linked to the [hormonal] IUD," adds Dr. Garshick, noting that the change in hormone levels has, in some cases, been linked to hair loss, too. "Mirena (one of the four types of hormonal IUDs) lists hair loss as one of the side effects occurring in less than 5 percent of women. There's also a rash that can rarely appear with exposure to progesterone called autoimmune progesterone dermatitis." (Related: What You Know About IUDs May Be All Wrong)
Still, it's important to note that hormonal IUDs are generally considered safe and that these side effects are rare. "Not everyone on an IUD will experience breakouts," adds Dr. Garshick. If you notice an increase in breakouts after IUD insertion, the best thing to do is talk to your gynecologist and/or dermatologist about it. (Related: What Is Telemedicine, Exactly?)
Side note: If you're switching to a hormonal IUD from a different type of hormonal birth control (such as the pill), you might still experience breakouts due to the general shift in hormones. "If a patient was on oral contraception with both estrogen and progestin and they switch to a [hormonal] IUD [with levonogestrel], they may notice their skin is worse because the estrogen in the pill [was helping] to bind testosterone and prevent acne," explains Yvonne Bohn, M.D., ob-gyn at Los Angeles Obstetricians and Gynecologists and Cystex spokesperson. (Related: Everything You Need to Know About Going Off the Pill)
BTW, the copper (non-hormonal) IUD isn't typically linked to acne—but if you switch to the copper IUD from a hormonal birth control pill, which may have been keeping breakouts at bay, that change, in itself, may also lead to breakouts, explains Dr. Garshick. So, if acne is a concern, and your doc feels the pill is otherwise the right birth control method for you, Dr. Bohn notes that ultimately "the best acne control or prevention might be with a combined estrogen/progestin pill." (Related: How to Find the Best Birth Control for You)
How to Treat Hormonal Acne Caused By an IUD
To be clear, if you have an IUD (or are considering getting one), all hope for clear skin is not lost. Hailey Bieber, for instance, mentioned in The Biebers on Watch that she saw improvement in her skin after taking spironolactone, a blood pressure medication commonly prescribed to help treat acne. "[Spironolactone] helps to block the acne-causing hormones for patients with hormonally-driven breakouts," explains Dr. Garshick.
Spiro is generally considered safe for women (but not men, due to the difference in sex hormone levels), and Dr. Garshick says she finds anecdotally that spironolactone and birth control "work well together" for those dealing with hormonal acne. That said, the medication isn't without potential side effects; for instance, spironolactone should not be used by pregnant women (or women trying to get pregnant), as the medication can harm the fetus, says Dr. Gersh.
Another common prescription acne medication: Clindamycin, a topical or oral antibiotic. There's also Accutane (isotretinoin), adds Dr. Garshick. Of course, these medications come with their own laundry list of possible side effects, so consulting your doctor is the best way to make a decision. (Related: How Dietary Supplements Can Interact with Your Prescription Drugs)
If you want to start with OTC treatments before considering a prescription, Dr. Bohn recommends topical acne products with benzoyl peroxide or salicylic acid as a frontline treatment. Dr. Garshick suggests cleansing with PanOxyl Acne Creamy Wash (Buy It, $12, cvs.com), formulated with 4 percent benzoyl peroxide, and using La Roche-Posay Effaclar Duo Dual Acne Treatment (Buy It, $30, target.com) as a follow-up spot treatment.
Another option with salicylic acid: Dr. Loretta Micro-Exfoliating Cleanser (Buy It, $35, dermstore.com), a sulfate-free cleanser that combines 2 percent salicylic acid with cold-pressed, extra-virgin organic coconut oil. Dr. Garshick also likes Dove Gentle Exfoliating Nourishing Body Wash (Buy It, $6, target.com) for body breakouts. (These are the best drugstore acne products, according to dermatologists.)
Bottom line: Acne isn't the end of the world—and, again, IUDs won't always lead to acne. Because many factors can contribute to acne, "it's often hard to know if it's is specifically related to an IUD or not, so it isn't necessarily a reason to not get an IUD if you and your doctor think it is the best form of contraception for you," notes Dr. Garshick.
"I would recommend that all women speak to their doctor if they have new-onset acne," adds Dr. Bohn. "Many times, the acne will decrease as the body adjusts to the new hormonal environment, so an adjustment period of three months is usually recommended" before exploring other options.