You chose a hormonal IUD because it was convenient, effective, low-maintenance, or whatever combination of reasons. Then a few months later, your skin started breaking out. Maybe it was along your jawline. Maybe it was your cheeks, chest, or back. Maybe your acne returned after years of having relatively clear skin.


Naturally, you started wondering: Could my IUD be causing this?


The short answer is: yes, it's possible.


Not everyone with a hormonal IUD develops acne, but for some people, hormonal IUDs can contribute to breakouts. Understanding why can help you decide what steps to take next.

How Hormonal IUDs Work

Hormonal IUDs release a synthetic progesterone-like hormone called levonorgestrel.


Common hormonal IUD brands include:

  • Mirena
  • Kyleena


The primary purpose of levonorgestrel is to prevent pregnancy by thickening cervical mucus, thinning the uterine lining, and sometimes suppressing ovulation. Although most of the hormone acts locally within the uterus, a portion is absorbed into the bloodstream. This means it can still influence other tissues in the body—including your skin.

Woman looking at her reflection in a fogged bathroom mirror, leaning on the sink with a contemplative expression.

Why Acne Can Happen After Getting a Hormonal IUD

Acne development is complicated and rarely caused by a single factor. However, hormonal IUDs can create conditions that make acne more likely in susceptible individuals.


Levonorgestrel belongs to a group of progestins that have relatively androgenic properties. Androgens are hormones that stimulate:

  • Oil production
  • Sebaceous gland activity
  • Pore clogging
  • Acne formation


This does not mean the IUD dramatically increases testosterone levels. Instead, the hormone may create an environment where the skin behaves as though it is receiving a stronger androgen signal, leading to increased oil production and breakouts. This is one reason why acne associated with hormonal IUDs often appears along the chin, jawline, and neck. These areas tend to be particularly sensitive to hormonal influences.

Does Everyone Get Acne From a Hormonal IUD?

Absolutely not. Many people use hormonal IUDs and never experience any skin changes. 


Others notice:

  • Mild increases in oiliness
  • A temporary flare after insertion
  • Persistent hormonal acne


Individual responses depend on many factors, including:

  • Genetics
  • Hormone receptor sensitivity
  • Existing acne history
  • Stress levels
  • Sleep quality
  • Diet
  • Gut health
  • Blood sugar regulation


The IUD may be one piece of the puzzle rather than the entire puzzle itself.

Doctor with gray hair and glasses consulting a patient in a medical office, discussing health information.

Should You Have Your IUD Removed?

Not necessarily.


One mistake many people make is focusing exclusively on the IUD while ignoring the factors that determine how resilient their skin is overall. This is where many people jump straight to an all-or-nothing decision. If your IUD is working well for contraception and you are otherwise happy with it, removal may not be the first step.


Instead, it can be helpful to evaluate:

  • When the acne started
  • Whether you recently stopped the birth control pill
  • Other hormonal symptoms
  • Stress levels
  • Dietary factors
  • Digestive health
  • Sleep quality
  • Blood sugar regulation


For some people, addressing these factors significantly improves acne while allowing them to keep their IUD. 

How I Can Help

If you're wondering whether your hormonal IUD is contributing to your acne, it can be difficult to determine on your own.


As a naturopathic doctor, I can help you evaluate the timing of your breakouts, assess whether the issue may be related to discontinuing the birth control pill, identify other contributing factors, and determine whether further hormone testing is appropriate. Most importantly, I can help you understand whether removing the IUD is likely to make a meaningful difference or whether other root causes should be addressed first.


The goal isn't necessarily to convince you to keep or remove your IUD—it's to help you make an informed decision based on your unique situation.

Watch my free webinar

Understanding the bigger picture—including gut health, inflammation, blood sugar balance, stress, and hormone function—can help you identify what's really driving your breakouts.


If you're struggling with persistent acne and aren't sure where to start, watch my webinar "3 Reasons Your Acne Isn't Clearing (That Your Doctor Never Told You)" to learn more about the root causes of acne.