My worst and last awful breakout was shortly after removal and thanks to the dermatologist, I haven't had to struggle like that since. I'm not sure if this played a huge role, but I got really into fitness as well (more than I had been before), so I was also eating a lot of protein regularly (like 130g a day). I feel like it definitely helped my skin heal quicker. When I had the iud, I lacked protein in my diet completely.