Birth Control Pills And Acne

If you suffer from acne, birth control pills can help to treat it. This is because the synthetic hormones found in birth control pills can reduce breakouts by decreasing the secretion of oil from your glands. Birth control pills contain either one or two hormones – progestin (a synthetic form of progesterone) – or progestin and oestrogen. The latter is the best combination to use when it comes to tackling acne – pills containing just progestin can make acne worse.

What causes acne?

The cause of acne is not clear-cut and there are multiple different pathological changes involved. Treatment for acne is based on correcting the underlying cause. One such cause is an excess production of sebum, an oil made by your skin to help protect it and keep it moisturised. Excess sebum can clog pores and promote the growth of bacteria that can then go on to cause acne that so many of us experience. Other factors that influence the development of acne include hormones, medication and stress levels.

How do hormones influence my skin?

Androgens are a group of hormones (which includes testosterone) that stimulate the production of sebum. Androgens are commonly referred to as ‘male hormones’ but women produce androgens too. Fluctuating hormone levels may result in excess sebum production and hence your pores in your skin fill with extra sebum, combining with dead skin cells and bacteria, and forming acne pimples.

Birth control pills and acne

A woman’s ovaries and adrenals (glands located just above the kidneys) normally produce low levels of androgens. Contraceptive pills can suppress the effects of androgens in the body which has multiple effects on acne including a decrease in sebaceous gland numbers and activity. This consequently improves your acne. This is why you may have heard from your friends that their acne improved when they started taking oral contraception pills (OCPs).

Oestrogen has many functions within a woman’s body, including playing a large role in regulating their menstrual cycle. Birth control pills that contain oestrogen can be helpful in controlling acne because they help suppress the production of androgens (which are the cause of sebum production). Progestins are synthetic progesterones that can either improve or worsen acne as they have varying levels of androgenic effects on the skin.

Which birth control pill should I take?

Several clinical trials involving thousands of women have shown that taking combination birth control pills suppresses the effects of androgens and can result in decreased acne flare-ups, reduced inflammation, less severe acne, and fewer pimples. However, it is essential you take the right type of contraceptive to help improve your skin.

Studies have found that co-cyprindiol, brand name Dianette, combining cyproterone acetate (an anti-androgen) with ethinylestradiol (an oestrogen), has the benefit of improving acne in addition to providing effective contraception. It is thought to do so by reducing sebum secretion which is under the control of androgens.

Women with moderate to severe acne who have trialled oral antibiotics and a topical treatment and found them ineffective should consider taking Dianette. It is important to note that despite the Mirena Coil and the Implanon implant containing both oestrogen and progesterone, these options do not have any anti-acne benefits. Also, the progesterone-only pill, also known as the mini pill, can cause oily skin as a side effect and can actually worsen acne for some women. That’s why it is very important that your doctor chooses the right contraception option where the combination of hormones have low androgenicity and help to improve your acne.

Are there any risks of oral contraceptive pills?

As with all medications, there are potential side-effects and risks. A positive side effect of oral contraceptives is a potential improvement to your acne.

However, there is a very small increased risk of heart attack, stroke, and blood clots in the leg (deep vein thrombosis – DVT) or lungs (pulmonary embolus-PE). In most people, the benefits of contraception and improved acne symptoms outweigh the very small associated risks. Your doctor will consider this and take into account your medical history before prescribing a combined oral contraceptive.

Can everyone take contraceptive pills?

Certain oral contraceptives are also not advised for some groups of people with pre-existing medical conditions, such as:

– History of heart disease, hypertension, blood clots
– Blood clotting disorders
– History of hormonal-sensitive cancers such as breast or ovarian cancer
– Liver disease
– Migraines

Your doctor will make an assessment based on your medical history whether a contraceptive such as co-cyprindiol would be a suitable treatment option for you.

How do I start treatment?

So now that you know how and why acne develops, and why oral contraceptive pills may help achieve clearer skin, what should you do? If you do not fall into the categories mentioned above, then you should speak to your doctor about getting a prescription if this is the right option for you.

Remember, there are several types of acne management options available, and you may need to use a combination of creams, antibiotics, and a contraceptive pill to achieve clearer, healthier, beautiful skin. Here at Dermatica, we offer personalised prescriptions that can help combat acne – so contact one of our friendly team for more information.

Charlotte D'Souza
Originally published July 02 2018, updated June 27 2019

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