Medically reviewed by Sophia Yen, MD, MPH
IUDs have long been a popular form of birth control for women. However, one potential side effect of using a hormonal IUD is acne. While not a common side effect, some women have reported experiencing breakouts after getting a hormonal IUD. This can be frustrating and uncomfortable for those who experience it, but some strategies can be used to manage and prevent IUD acne. In this article, we will explore the relationship between hormonal IUDs and acne, including possible causes and treatments.
What is an IUD?
Intrauterine devices (IUDs) are small, T-shaped devices that are inserted into the uterus by a doctor or NP/PA and can provide 5-12 years of effective contraception.
There are two main types: Copper IUDs and hormonal IUDs. As of 2023, US Hormonal IUDs include Liletta, Mirena, Kylena, and Skyla.
The hormonal intrauterine devices release a synthetic progesterone called progestin, specifically Levonorgestrel, which causes the mucus in the cervix to become so thick that sperm can’t penetrate the mucus to get through to the egg. This prevents conception from occurring. The hormonal IUD also keeps the lining of the uterus too thin to support pregnancy if the sperm were to get through and fertilize the egg and the egg tries to implant.
30% of the time, a hormonal IUD may prevent ovulation from occurring, making hormonal IUDs highly effective contraceptive devices (they beat tubal ligation aka having your tubes tied if you have ovaries and tubes). Some IUDs (Liletta/Mirena) can stay and work in the uterus for up to 8 years.
Do IUDs Cause Acne?
Yes, in some instances, hormonal IUDs can cause acne. This is because in some people, the progestin in the IUD increases the production of androgenic hormones (hormones that cause male characteristics e.g. hairnes, acne). One side effect of this can be unwanted hair growth. Another potential issue is the increased risk of acne. Jawline acne is one form of acne sometimes caused by hormonal IUDs, as is chin acne. However, a hormonal IUD may trigger acne anywhere on the body.
It’s important to note that just because you have an acne breakout while using an IUD doesn’t automatically mean the IUD is the cause. If you’re already prone to acne breakouts, you might find they happen more frequently or become more severe. Or, you may simply have an acne breakout for a completely different reason. Other common causes of acne include bacterial infection, new skincare products, or other hormonal changes—even stress could contribute to acne. More recent research has shown that 35% of new hormonal IUD users reported worsened acne.
A copper IUD works by releasing copper into the uterus, which causes an inflammatory reaction which is toxic to egg and sperm. Studies suggest that there’s no link between copper IUDs and acne. However, some copper IUD users report other side effects, especially heavier menstrual flow, increased cramping, or longer periods.
Hormonal IUDs and Acne
All U.S. hormonal IUDs contain a type of progestin called levonorgestrel. This is the same hormone that some emergency birth control pills contain, as well as certain daily contraceptive pills and birth control patches. However, IUDs have a much lower dose of levonorgestrel and slowly release the hormone to provide ongoing birth control. IUDs also come in different “levels,” which provide larger or smaller volumes of levonorgestrel. The amount of levonorgestrel determines how long the IUD lasts and the likelihood of monthly periods and ovulation.
Some contraceptive options can help with hormonal acne e.g. research shows that any birth control pill, patch, or ring helps with acne. However, some research shows that levonorgestrel could actually be associated with acne flare-ups or worsen acne that’s already present.
4 Effective Treatments for IUD Acne
Acne is a potential side effect of using a hormonal IUD, but there are several effective ways to try to prevent it from occurring. Whether you’re considering getting a hormonal IUD or already have one and want to avoid acne breakouts, these preventative measures can help you try to maintain clear and healthy skin.
1. Drink water
Keeping your skin hydrated could help reduce the impact of hormonal acne flare-ups. The drier your skin is, the more likely it is to produce sebum, the oil that contributes to acne. Drinking at least 8 glasses of water every day helps keep your skin hydrated and healthy and could even boost your immune system.
2. Wash your skin twice a day
Consider altering your daily skincare routine to help manage acne flare-ups. Unless you have very dry skin, wash your face twice a day with a gentle, unscented cleanser to remove any excess oil or dirt from the skin. Do not wash more than twice a day, otherwise your skin will make more/extra oil. When washing your face, avoid over-scrubbing, because this can irritate your skin and increase inflammation, making IUD acne worse.
3. Level up with prescription acne medications from Pandia Health
While salicylic acid and benzoyl peroxide are effective acne treatments, both can cause side effects such as dryness and irritation. If you’ve been using these products for a while and your acne isn’t going away, consider getting prescription-strength topical acne treatment.
Adult acne is usually managed with medication as well as lifestyle changes and/or new skincare routines. However, it can occur at any time, so understanding what treatments are available could help you deal with flare-ups better. Prescription acne treatments include benzoyl peroxide, tretinoin cream, and clindamycin phosphate lotion (a topical antibiotic). Spironolactone is one potential treatment. It’s a daily tablet that can help with cystic acne and other types of acne flare-ups by slowing your body’s production of androgenic hormones. It should not be used by people with kidney problems and is best if you can drink at least 8 glasses of water a day, or else you risk getting headaches from it.
Get Acne Treatment Online
Our expert acne doctors can prescribe the right acne treatment for your needs, including tretinoin cream, spironolactone, and more, right from the comfort of your home. With or without a prescription, we can help you!
4. Last resort: Ask your doctor about removing your IUD
If your hormonal IUD acne persists despite benzoyl peroxide, tretinoin, topical antibiotics, and spironolactone, you could talk to your doctor about getting your IUD removed and switching to an alternative form of contraception. Remember, it’s your body, your choice, so always do what feels right for you. You have to weigh the benefits of a birth control method with only a 1/1000 failure rate against the difficulties caused by it e.g. acne.
Alternative contraceptive options
Hormonal breakouts due to your IUD might lead you to switch to oral contraceptives, also known as birth control pills. These are less invasive than an IUD and have been known to correct hormonal acne breakouts.
Another option is the Twirla birth control patch, which lasts for seven days and is often worn three weeks out of every four. Most users experience withdrawal bleeding in the fourth week. You can skip this week of bleeding but only for 12 weeks in a row, after that the estrogen builds up and puts you at risk of blood clots and death!
The NuvaRing birth control ring is another possibility. This is a small ring you put inside the vagina, which stays there for three weeks to 35 days (you choose!). Withdrawal bleeding occurs in week four (if you take it out after 3 weeks) or you can just use it continuously = changing it every 4 weeks-35 days which results in no withdrawal bleeds.
There is less likelihood of acne if you keep the hormones continuous vs. dropping the level (by taking out the ring, stopping active birth control pills, taking a week off the patch).
It’s clear that each contraceptive option has pros and cons, and because these are all hormonal options, they all still carry the risk of causing acne flare-ups, depending on how your body responds to the progesterone. Always discuss your options with your doctor, including potential side effects, and best not to try to remove your IUD yourself!
Consult Doctor About Your Acne Treatment Options
Thankfully, no one needs to suffer alone when it comes to dealing with hormonal IUD acne. Here at Pandia Health, we have board-certified expert doctors that can assess your situation, help diagnose what’s happening, and recommend an acne treatment that could work for you. Best of all, you’ll get acne treatment straight to your door with free shipping ! Acne caused by your IUD or other hormonal contraceptive isn’t always easy to handle, but it’s good to know there are plenty of treatment options to help you on your way to clearer skin. Learn more about how Pandia Health’s acne treatment services work, and get started with Pandia Health today!
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Disclaimer: This article is for general informational purposes and is NOT a substitute for professional medical advice. Always seek the advice of your healthcare provider before starting or changing acne treatment.