If you have tried various acne treatments and you're still struggling to keep a clear complexion, you may want to ask your doctor if birth control may be an option to treat your acne. While birth control pills can't guarantee clear skin, they may be helpful for some women.
Using Birth Control to Help With Acne
The typical cause of acne is hormone-related and can actually happen at any age. Acne can occur when you're a teenager, during your reproductive years (especially at premenstrual time) and even after menopause.
Acne Problems
Birth control pills work best on controlling acne that is caused by an excess of androgens or 'male hormones' that include testosterone. All women have some androgens in their body. The problem occurs when too many androgens cause the sebaceous glands to produce an excess of oil (sebum), thus clogging pores and causing bacteria to grow. This leads to the redness, swelling, and pus-like fluid that makes blemishes so bothersome to women.
Signs of Hormonal Acne
You may have this type of acne if:
- You have adult acne.
- You have irregular menstrual cycles.
- Your acne seems to be worse before you get your period.
- You also suffer from excessive hair growth.
Taking birth control pills can be helpful because you can use this medication in combination with skin care products that contain salicylic acid or benzoyl peroxide.
What to Look For
When looking for a birth control pill that helps treat acne, you should be prescribed one of the 'combination oral contraceptives' that contain both estrogen and progesterone. This will help decrease the amount of androgens in your body and in turn reduce the amount of sebum (oil) produced.
Pills That Help Acne
Keep in mind that all combination birth control pills aren't created equal and the composition of each pill is slightly different. The relationship between birth control and acne can be very complex. Currently, there are four brands of birth control pills currently approved by the FDA to treat acne:
Ortho Tri-Cyclen (Ethinyl Estradiol and Norgestimate)
The FDA has approved Ortho Tri-Cyclen and generic norgestimate/ethinyl estradiol for acne treatment. The FDA believes these low-dosage birth control pills are an effective treatment for mild-to-moderate acne. One clinical study showed that over 90 percent of women who took Ortho Tri-Cyclen noticed an improvement in their skin.
Estrostep Fe (Ethinyl Estradiol, Norethindrone and Ferrous Fumarate)
The Estrostep Fe brand of birth control pill has also been approved by the FDA for the treatment of moderate acne in women age 15 and older. This pill is prescribed for women who have not gotten results with topical acne medications. These pills may come in varied estrogen levels and may contain iron as well. This type of pill gradually increases the amount of estrogen over the course of a woman's cycle.
Yaz (Ethinyl Estradiol and Drospirenone)
Yaz has been approved in the treatment of moderate acne as well in women older than 14 years of age. However, this form of birth control has a higher risk of blood clots, so remember to discuss this issue with your doctor if you decide to use this medication.
Beyaz (Ethinyl Estradiol, Drospirenone and Levomefolate Calcium)
Beyaz and Yaz are very similar in their treatment of moderate acne in women ages 14 and older. The side effects are also similar. The one difference is that Beyaz contains folic acid (folate) which is important during child-bearing years. Folic acid can help prevent birth defects if/when you do decide to get pregnant.
Do Other Pills Help Acne?
Other combination birth control pills are also thought to improve acne in most women. These include Desogen, Demulen, Brevicon, Nelova 1/35, Ovcon 35, and Ortho Novum 7/7/7. However, there is some evidence to suggest these pills are more effective in younger women who have fluctuating hormone levels that are the primary cause of their acne. The pills, Yasmin and Alesse, have also been shown to improve acne but these medications have not been approved by the FDA.
Problems With Some Pills
Older brands of birth control pills that contain estrogen and progestin hormones with higher androgen levels may make your acne worse. This includes birth control pills such as Loestrin1.5/30, Loestrin1/20 Fe, Levlen, Ovral, and Norlestrin1/50. Progestin-only birth control pills (the mini-pill) -- like Micronor or Nor-QD -- may also worsen your acne.
Speak With Your Doctor
If you are interested in using birth control pills to help treat acne, talk to your dermatologist or healthcare provider about your plans. Based on your medical history, he can recommend which brand of birth control pill is most likely to be effective in helping your acne.
Starting Birth Control Pills
When taking birth control pills to help treat acne, patience is key. You may not see results for two or three months. Birth control pills, like other acne treatment products, work to help prevent new blemishes from forming. Your existing blemishes must be allowed to heal on their own.
Side Effects to Keep in Mind
Also, if you are switching from a different type of pill or trying birth control for the first time, you may notice some side effects. Most side effects are relatively mild and disappear as your body adjusts to the medication, but reactions can vary. When deciding whether birth control pills should be part of your acne treatment, keep the following side effects in mind:
- Breast tenderness
- Nausea
- Vomiting
- Headaches
- Change in menstrual flow
- Decreased sex drive
- Depression
- Slight weight gain
Potential Risks
Birth control pills may not be the right type of acne treatment for certain women who can be at risk of serious complications. Birth control pills also slightly increase the risk of heart disease, high blood pressure, high potassium levels, and blood clots. Combination estrogen-progestin pills are not recommended for women who smoke, women who are over age 35, or women with a history of cardiovascular disease.
A Word of Caution
When using birth control pills for contraception and for treatment of acne, keep in mind that the pill does not protect against STDs such as genital warts, herpes, hepatitis, and syphilis. If you're having sex and you're not in a monogamous relationship where both partners have been tested, you need to be using condoms to protect yourself.
Antibiotic Use
At one time it was believed that if antibiotics are taken, it would affect the efficacy of the birth control pill. However, this is only true if you are prescribed rifampin or another rifamycin antibiotic. If you have been prescribed rifampin, then you may want to use an additional form of birth control such as a condom. If you are taking a non-rifamycin antibiotic, it will not decrease the effectiveness of your hormonal birth control.
Talk to Your Physician
Birth control pills may solve two issues at once for some women - birth control and acne relief. Your physician will be able to tell you if you are a good candidate depending on your health history. After an evaluation, he will then prescribe the correct dosage, strength and birth control brand specific for you and your needs.
