What is the world's most common skin condition? If your answer is acne vulgaris, then you are right! Millions of people, including teenagers and adults, suffer from persistent acne outbreaks, inflamed pimples, and blemished skin.
Ever wondered why acne vulgaris is so widespread?
It's a multifactorial skin disease. This means there are many reasons you might develop acne (with as many solutions for curing it, from amazing skincare products to medications.) Birth control is one solution for acne caused by hormonal fluctuations in the body. But will they work for you?
Well, think about it this way - it all starts with understanding the type of acne you have. If hormonal changes are the reason behind those nasty-looking pimples, we've got all the information you need to determine whether birth control pills are your answer.
Acne 101
Breaking down the most common skin condition in the USA is not an easy task, nor a short one. We're sure you've already read thousands of articles about acne, so we'll make this quick. (If you want more detail about acne vulgaris, check out our ultimate guide on acne types!)
Your first encounter with acne was most likely during puberty, although it can occur at any age. It's estimated that around 85% of people between the ages of 14 and 24 experience minor acne.
The severity of the condition varies and includes everything from mild pimples and whiteheads to inflamed cysts and scarring.
The reasons behind the condition and the risk factors (other than genetics and hormones) haven't been conclusively identified, but most experts agree on what can contribute to more pimple breakouts:
All these factors stimulate the sebaceous glands to increase the skin's sebum production in one way or another. This clogs the pores, making a perfect environment for acne-causing bacteria to develop and create pimples.
Hormonal Acne
Hormones are the number one culprit behind acne. This is why "hormonal acne" is sometimes used as a synonym for acne vulgaris. In this article, we'll give you an idea of how hormonal acne differs from other acne types, so you can understand how birth control might work in one case but not another.
Let's take a closer look.
Hormonal acne, as the name suggests, develops when there are hormonal fluctuations and imbalances in the body - for example, during puberty, menstruation, and the menopause. Because of these reasons, women are more affected than men.
According to experts, the changes between both estrogen and progesterone make the skin more prone to acne. Just think - do you suffer from acne flares several days before getting your period or while you're on it? If the answer is yes, you might be dealing with hormonal acne. Hormonal fluctuations during your menstrual cycle can influence the skin by increasing the overall inflammation in the body, which worsens acne.
Another way to tell if you're dealing with hormonal acne is to look where they appear. The pimples are typically found on the lower parts of the face, such as around the mouth, jawline, and neck.
Finally, how do we treat hormonal acne? Unfortunately, conventional treatment options like gels, peels, retinoid creams, salicylic acid, or benzoyl peroxide usually don't work. You might see some improvement, and they might alleviate some acne symptoms, but they won't stop acne breakouts from happening next time you're in a state of hormonal disbalance. This is where birth control comes into play.
Oral medications work best for hormonal acne. Dermatologists usually prescribe the birth control pill for females suffering from hormonal imbalances because they balance out hormones and irregular periods.
Understanding How Birth Control Methods Work For Acne
Most birth control medications contain synthetic forms of the hormones estrogen and progesterone (or only progesterone), which prevent the sperm from fertilizing the egg. The ratio of the hormones differs depending on the brand, and they can work in several ways.
For example, birth control pills work by stopping the ovaries from releasing an egg, changing the consistency of the cervical mucus to make it difficult for the sperm to fertilize the egg, оr altering the lining of the uterus to prevent implantation.
Besides changing the reproductive process, the synthetic hormones in the pills have additional effects on the body. One effect is reducing androgen production. Androgens stimulate sebum production. When androgen levels decrease, their influence on sebum production also decreases. Less sebum equals less oil, meaning your face will be less prone to mild, moderate, and severe acne.
Another effect is increasing the synthesis of sex hormone-binding globulin (SHBG), thereby reducing blood levels of free testosterone.
But you should be careful! There are many types of birth control out there. Not all brands and formulas are approved by the FDA, and additionally, not every birth control pill is effective for acne. To treat acne, it must be a combination birth control pill containing both hormones: estrogen and progestin.
Remember, the best birth control option for you depends on many factors.
Research on Birth Control For Acne
A study in 2016 published in the Journal Of Drugs In Dermatology examined the role of hormonal contraceptives for acne in 2147 patients. They categorized the different types of contraceptives by their efficiency in clearing acne based on the hormone type(s), the hormone dose(s), and the route of delivery.
The study considered progestin-only contraceptives and combined contraceptives containing both estrogen and progestin components. The progestin-only contraceptives included oral contraceptive pills, hormonal intrauterine devices (IUDs), depot injections, and subdermal implants.
The combined contraceptives included contraceptive patches, vaginal rings, and combination birth control pills (COCs). The results showed that progestin-only contraceptives were inferior to COCs and did not significantly improve acne.
On the other hand, combination birth control pills were found to be the most effective. Drospirenone was the most helpful, norgestimate and desogestrel were somewhat less effective, and levonorgestrel and norethindrone were found to be least helpful.
The U.S. Food and Drug Administration (FDA) Approved Birth Control For Acne Treatment
The following birth control options are approved by the FDA for treating acne.
Beyaz For Acne
Beyaz is a combination of drospirenone, ethinyl estradiol, and levomefolate calcium. It's an FDA-approved contraceptive to treat acne.
The drospirenone in Beyaz can block the androgens (hormones) that cause acne. Beyaz is also approved by the FDA to treat the emotional and physical symptoms associated with premenstrual dysphoric disorder (a severe form of PMS), which can negatively affect women's psychological well-being.
Estrostep Fe For Acne
These combination pills combine norethindrone acetate, ethinyl estradiol, and ferrous fumarate. The combination of norethindrone acetate and ethinyl estradiol increases sex hormone binding globulin (SHBG) and decreases free testosterone, which in turn can reduce sebum secretion, clogged pores, and acne breakouts.
Yaz For Acne
Yaz combines a progestin called drospirenone and a low dose of ethinyl estradiol (estrogen). Yaz combination birth control pills are approved to prevent unwanted pregnancy and treat acne in women above 14 years of age and premenstrual dysphoric disorder (PMDD).
A study from 2013 found that Yaz can help reduce acne by blocking the acne-causing hormones - androgens. This combination pill works by increasing the levels of sex hormone-binding globulin (SHBG) in the blood. Since SHBG can deactivate androgens like testosterone, this will reduce acne.
Ortho Tri-Cyclen For Acne
Ortho Tri-Cyclen is a combination of norgestimate and ethinyl estradiol. In one study from 1997, the researchers examined the effectiveness of the Ortho Tri-Cyclen contraceptive pill against acne. They concluded that an OC containing 0.035 mg of ethinyl estradiol combined with the triphasic regimen of norgestimate is a safe and effective treatment of moderate acne in women.
Medicaments Vs. Birth Control For Treating Acne
When it comes to hormonal acne, the birth control pill isn't the only form of treatment. You can also try oral medication, like some anti-androgen drugs. The most often prescribed drug for this purpose is spironolactone (Aldactone). Technically, spironolactone is used to treat high blood pressure, but it has anti-androgen effects and can also balance your hormones by preventing androgen production.
Isotretinoin (also known under the Accutane or Roaccutane brand names) is a common option as well but is only prescribed for more severe conditions of acne. This drug works by killing the bacteria that cause acne and permanently shrinking your oil glands, which reduces excess sebum. It's said to be a very effective option, but it comes with many side effects, which is why many dermatologists might not want to prescribe it.
Before deciding on taking Accutane, or any other type of oral drug, make sure you do your research and consult with a doctor you trust.
The long list of side effects of oral medications is not something you should take lightly. We know you're desperate to get rid of those annoying pimples, but sometimes rash decisions can cause more problems than solutions. And unfortunately, many doctors don't understand the mechanisms behind acne and instead will offer pills that cover up the problem rather than treating the root cause. So, choose wisely.
The Side Effects of Oral Medications and Antibiotics For Acne
- Bacterial Resistance - Taking oral antibiotics regularly might lead to bacterial resistance, and they can become less effective over time.
- Photosensitivity - Some antibiotics can make you sensitive to sunlight, triggering more severe immune system reactions.
- Yeast overgrowth - This can happen because antibiotics kill off the beneficial bacteria that prevent the overgrowth of yeast.
- Rashes - A rash is a common side effect of many antibiotics that treat acne. The good news is that it's harmless and will go away when you stop taking the antibiotics. In any case, if you notice any side effects, consult with your doctor.
- Birth defects - Spironolactone and Accutane are linked to teratogenicity. During pregnancy, these drugs can affect the fetus's cells and DNA, causing serious problems. This is why spironolactone and Accutane shouldn't be used by pregnant women under any circumstances!
- Liver problems - Accutane is mainly processed by the liver, and it can make it harder for the liver to deal with all the work.
Benefits of Birth Control Pills for Acne
Several studies have clearly shown that taking birth control pills can be beneficial if you suffer from acne. Here are the benefits of the pill when used to treat acne.
- You'll have less inflammation in your affected areas. Skin with acne is more easily inflamed. Hormonal control will take care of that. Your skin will retain its natural glow without you worrying about battling inflamed, red skin daily.
- You'll have clear-looking skin overall. No matter what type of acne you suffer from, you'll have fewer blackheads, whiteheads, smaller bumps, pimples, etc.
- Your acne pain will become less severe. This is because your acne flare-ups will be significantly decreased, and they'll also be less noticeable.
- While taking birth control to treat acne, you'll notice that your PMS (premenstrual syndrome) pain and all the inconvenience that comes with it will be less emphasized. You might not even have PMS problems at all.
- Your menstrual cycle will become more regular;
- Taking the pill can even reduce the risks of cancer, such as ovarian and uterine cancer.
Limitations of Using Oral Contraceptives for Treating Acne
While taking birth control for acne can help you with your problem, your acne must be, in fact, hormonal.
If it isn't hormonal, taking an oral contraceptive won't help improve acne. It may make your acne worse. Make sure your acne isn't a consequence of using the wrong skin products or isn't due to an allergic reaction from products and makeup. In this case, you may need to avoid birth control pills altogether.
Topical creams and other treatments may work better. This Complete Clear 3-Step System will remove dead skin cells and debris, kill acne-causing bacteria, reduce redness and inflammation, and soothe breakouts.
It's best to get advice from your doctor before taking oral contraceptives. They should be recommended as a solution to your acne problem by your dermatologist.
Side Effects of Birth Control Pills
Every pill has its side effects, and you must keep this in mind if you want to start using birth control pills as an acne treatment (or even to prevent pregnancy).
These pills can be associated with: breast tenderness, headaches, bloating, nausea, migraine headaches, breakthrough bleeding, and fatigue. They can even give you mood changes. Additionally, they can cause changes in your libido and, in some cases, cause weight gain.
It's best to read the back of the product you're consuming because some side effects can vary whether you are a smoker, over or underweight, or have higher blood pressure. In severe cases, some hormonal birth control pills can even lead to blood clots.
Precautions
Consult your doctor to make sure that oral contraceptives are a necessary method for your acne treatment. Never take pills that are not prescribed by your doctor.
Always take the prescribed dose, and never play with the dosage! Even the slightest tweak might stop the desired effects and cause serious harm to your health.
Last but not least, tell your doctor your medical history, including medications you're already taking. Taking birth control pills with other medications may also have harmful effects. They'll likely want to know your personal or family history, too, to flag up liver cancer, blood clots, and more.
If one option doesn't work for you, you may be able to try other birth control pills.
Final Thoughts
Acne is a multifactorial disease with diverse epidemiology, making acne treatment more complex. You will only get rid of your acne if you are attacking the cause, not treating the consequences.
You must be absolutely sure that your acne is hormonal for oral contraceptives to work as a treatment. Other forms of acne might respond better to topical treatments.
Before you take action, schedule a doctor's appointment. Even though many studies have shown that taking a birth control pill can make acne less severe, it may take up to 3 months before you notice a difference. There are many different types of birth control for acne out there. Whether you're suffering from mild or severe acne, a doctor can recommend the best birth control for you.
Take your time, be patient, and you'll get the results you've always wanted.
References
Effectiveness of norgestimate and ethinyl estradiol in treating moderate acne vulgaris
Hormonal Contraceptives and Acne: A Retrospective Analysis of 2147 Patients
