Struggling With Acne and Thinking About Treating It With Birth Control? Dermatologists Suggest These Types
There’s a ton of mixed messages surrounding birth control and acne. Some
people will say it cleared their skin right up, while others actually find that their skin breaks out as a result of it.
This is due to the fact that birth control affects everyone differently, and certain types may be better than others when it comes to eliminating acne. That’s why we’ve spoken to dermatologists to find out what works and what doesn’t—here’s everything you should know.
How does birth control work?
The hormones in birth control work by suppressing ovulation . “A birth control pill or an oral contraceptive is a prescription medication used to prevent pregnancy,” says Dr. Anna Chacon, MD, a board-certified dermatologist. “It contains two hormones—estrogen and progestin—or a single hormone, normally progestin. The estrogen component usually contains ethinyl estradiol. The progestin component usually contains several progestins. The way birth control works is by suppressing ovulation and thickening cervical mucous that prevents sperm from entering the womb.”
How birth control can improve acne
“Hormones in combination birth control pills can improve and reduce acne,” Dr. Annie Gonzalez, MD, a board-certified Miami-based dermatologist of Riverchase Dermatology, explains. “Birth control affects an individual’s hormones, and hormones play a crucial role in acne.”
More specifically, the hormones you need to pay attention to are androgens. “Androgens (a group of hormones that contribute to reproduction and growth in women) promote the production of sebum, an oil made by your skin. Pills that
contain both progestin and estrogen decrease the circulation of androgens, thus decreasing the production of sebum and acne,” Dr. Gonzalez adds.
Excess testosterone can lead to breakouts, and in those cases, birth control can be extremely effective. “Birth control can help ameliorate acne by treating signs of hyperandrogenism (excess male hormones such as testosterone) in women,” says Dr. Chacon. “In this manner it helps to treat forms of acne such as comedonal acne and hormonal acne.”
Underlying medical conditions may also be responsible for acne.
“There can be a number of medical conditions that contribute to an increase in acne breakout, but these conditions are usually related to hormonal imbalances,” Dr. Michele Green, cosmetic dermatologist, explains. “Some females have a condition called PCOS (Polycystic Ovarian Syndrome) which can lead to severe acne breakout and excess hair growth.”
The best types of birth control for acne
Dermatologists agree the ideal birth control for acne is one where the effects of estrogen outweigh the effects of progestin.
“There are different combinations of the estrogen-progestin balance,” Dr. Chacon explains. “Progestins are weak androgens that help to control acne. Estrogens can also help to reduce acne, while androgens make it worse.”
Dr. Chacon recommends newer types of birth control, norgestimate, and drosperinone.“In a combined oral contraceptive, the ideal one is where the
effects of estrogen outweigh the effects of progestin, decreasing overall androgen levels,” Dr. Chacon stats. “Newer ones such as norgestimate and drosperinone are the ones I typically recommend. Older first and second generation progestins often make acne worse.”
If you’re breaking out, pills that only contain progestin won’t be helpful.“The ‘mini pill’ or progestin-only birth control like Micronor or Camila does not work against acne,” says Dr. Gonzalez.
She recommends combination birth control pills, which are FDA-approved to treat acne, such as:
- Estrostep Fe
- Ortho Tri-cyclen
Is one better than another? Research shows the above pills have similar abilities when it comes to fighting acne.
In some cases, a blood test can be helpful to find the source of the acne.
“A routine blood test is usually performed to test hormone levels to determine the best birth control for your acne. While there are many births control pills available on the market, there are only three approved for treating acne: Yaz, Orth-Tri-Cyclen, and Estroste.”
So, what makes these birth control pills better than the rest? Dr. Green dives deeper into the science behind it.
“Yaz contains drospirenone, which is a synthetic form of progesterone. Each type of birth control mentioned contains estrogen and a variation of progesterone,” Dr. Green explains. “Orth-Tri-Cyclen, contains a synthetic form of progesterone called norgestimate. Estrostep contains norethindrone and Ethinyl estradiol, which lowers testosterone levels.”
It’s worth noting that many women have reported a handful of negative side effects associated with Yaz in particular, so be sure to talk with your doctor about that—and any form of birth control you choose to use, for that matter Finding out the best birth control for you requires sharing any and all underlying health conditions.
“You should speak to your dermatologist and gynecologist about your preexisting conditions and other medications you are taking to determine which birth control pill is right for you,” Dr. Gonzalez explains.
What types of acne can birth control treat?
“The main types of acne that birth control can address include hormonal acne, or acne that typically worsens in menstruation and also typically presents around the chin/jawline after the third decade,” Dr. Chacon states. “It also
helps to treat comedonal acne, or acne characterized by whiteheads and blackheads.
Thankfully, the signs of hormonal acne are easy to spot. First, pay attention to the timing of the breakout. “You can identify hormonal acne based upon when you break out (usually around your menstrual cycle) or if your breakout is triggered by stress. While stress doesn’t cause acne directly, it is a contributing factor as stress causes a rise in cortisol which affects hormone levels and can trigger breakouts,” says Dr. Green.
Second, notice where the acne is popping up. That’s also a strong indicator.
For example, “if your breakout is along your jaw and chin area it is a sign of hormonal acne,” Dr. Green explains. “These breakouts are usually cystic, painful and a result in overproduction of sebum along the jawline. The sebaceous gland is responsible for producing sebum. Sebum is the waxy like substance responsible for keeping your skin moisturized. If you produce too much sebum your pore become clogged from bacteria, and excess dead skin cells resulting in pimples.”
How long does it take to see results when you take birth control for acne? “It may take anywhere from a few weeks to a couple months—two to three months to see results from birth control being used to treat acne,” says Dr. Chacon. The good news is, “all forms of acne are treatable,” Dr. Green states. “However, some forms take longer to treat than others.”
Potential side effects of taking birth control for acne
Dr. Chacon lists the possible side effects of taking birth control for acne. They include:
- Stomach cramps
- Increased weight gain or weight loss
- Increase or decrease in appetite
- Constipation or diarrhea
Related: What Causes Bloating? How to Get Rid of a Bloated Stomach
Who can prescribe birth control for acne?
If you’re hoping to use birth control to clear up your acne, it’s typically prescribed by a dermatologist or gynecologist, specialists who are comfortable prescribing this treatment option for acne and other conditions, Dr. Chacon explains.
When should you talk to your doctor about birth control for acne? If acne is interfering with your quality of life, you should consult a healthcare professional. “It is always a good idea to see your dermatologist or gynecologist if the problem is becoming significant enough to interfere with your quality of life and livelihood,” says Dr. Chacon. “If you think birth control can help resolve your acne issues, it’s important to bring it up with your dermatologist.”