What is the world’s most common skin condition? If your answer is acne vulgaris, then you are right! Millions of people, teenagers, and adults suffer from frequent acne outbreaks, inflamed pimples, and blemished skin.
Ever wondered why is acne vulgaris so widespread?
Mostly because it’s a multifactorial skin disease. This means there are many reasons for developing acne and as many solutions. Birth control pills for acne is one solution for acne caused by hormonal fluctuations in the body. 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, here you will get all the information you need to find out whether birth control pills for acne is your answer.
Breaking down the most common skin condition in the USA is not an easy task, nor a short one. But, I’m sure you’ve already read thousands of texts about acne, so I’ll make this quick. Just in case you do want to go into detail about acne vulgaris, we have that covered for you here with this ultimate guide!
Most likely, your first encounter with acne was 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 at least minor acne. Now you know you are not alone in this!
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 skin’s sebum production in one way or another, clog the pores, creating a perfect environment for acne-causing bacteria to develop, and ultimately result in pimples.
Hormones are the number one culprit behind acne. This is why sometimes hormonal acne is used as a synonym for acne, or acne vulgaris. In this article, we are not going to do that, but rather try to give you an idea of how hormonal acne are different from other acne types, so you can understand how birth control pills might work in one case, but not another. So, let’s take a closer look.
Hormonal acne, just as the name suggests, is the type of acne that develops when there are hormonal fluctuations and imbalances in the body, for example, during puberty and later in life during menstruation and menopause. Because of these reasons, women are a lot more affected than men.
According to experts, the changes between estrogen and progesterone are making the skin more acne-prone. Just think - do you get more pimples several days before getting your period, or while you’re on it? If yes, you might be dealing with hormonal acne. The hormonal fluctuations influence the skin by increasing the overall inflammation in the body, which then worsens acne.
Another way to tell if you’re dealing with hormonal acne is to look where they appear. The pimples of this type of acne are typically distributed on the lower parts of the face, such as around the mouth, on the jawline and neck.
Finally, we get down to - how to treat hormonal acne? Unfortunately, conventional treatment options like creams, gels, peels, retinoid creams, salicylic acid or benzoyl peroxide, usually don’t work. You might see improvement, and they might help you alleviate acne symptoms, but they won’t stop acne breakouts from happening next time you’re in a state of hormonal disbalance. And, this is where birth control pills come into play.
Oral medications as a solution seem to work best for hormonal acne. Dermatologists usually prescribe birth control pills for females who suffer from hormonal imbalances because they balance out your hormones and irregular periods.
Most birth control pills contain synthetic forms of the hormones estrogen and progesterone (or only progestin) which prevent the sperm from fertilizing the egg. The ratio of the hormones differs in different brands and they can work in several ways. For example, birth control pills can stop the ovaries from releasing an egg, change the consistency of the cervical mucus to make it difficult for the sperm to fertilize the egg, оr alter the lining of the uterus to prevent implantation.
The synthetic hormones in the pills, besides changing the reproductive process, have additional effects on the body. One such effect is decreasing the circulation of androgen hormones. Androgens stimulate sebum production, so when they have decreased the influence they have on the sebum production is also reduced. Less sebum equals to less oil on the face, meaning your face will be less prone to acne. Another effect is increasing the synthesis of sex-hormone-binding globulin (SHBG), thereby reducing blood levels of free testosterone.
You should be careful! Not all brands and formulas are approved by the FDA, and additionally not all birth control pills are effective for acne. The pill must contain both hormones, estrogen, and progestin, to be effective for acne.
A study in 2016, published in the Journal Of Drug In Dermathology, examined the role of hormonal contraceptives on acne, on 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 took into consideration the progestin-only contraceptives, and combined contraceptives containing both - an estrogen component and a progestin component. 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 combined oral contraceptives (COCs). The results showed that progestin-only contraceptives were inferior to COCs and did not have a significant effect on acne. Combined oral contraceptives, on the other hand, were found to be most effective - drospirenone was most helpful, norgestimate and desogestrel were somewhat less effective, and levonorgestrel and norethindrone were found to be least helpful.
The following pills are approved by the FDA for use in the treatment of acne:
Beyaz is a combination of drospirenone, ethinyl estradiol, and levomefolate calcium. It’s an FDA-approved contraceptive to treat moderate 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 is a combination of 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 the sebum secretion and acne breakouts.
Yaz is a combination of drospirenone (progestin) and a low dose of ethinyl estradiol (estrogen). Yaz birth control pills are approved for the prevention of pregnancy, and acne treatment in women above 14 years of age and premenstrual dysphoric disorder (PMDD). A study from 2013, found that Yaz can help in reducing acne by blocking the acne-causing hormones - androgens. It works by increasing the levels of sex hormone binding globulin (SHBG) in the blood, which reduces acne because SHBG can deactivate androgens like testosterone.
Ortho Tri-Cyclen is a combination of norgestimate and ethinyl estradiol. In one study from 1997, published in the Journal of the American Academy of Dermatology, the researchers examined the effectiveness of Ortho Tri-Cyclen contraceptive pill against acne vulgaris and 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 vulgaris in women.
When it comes to hormonal acne, besides the birth control pill, another option available is oral medication, like some anti-androgen drugs. The most often prescribed drug with 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.
Accutane, or isotretinoin, is also a common option, but only prescribed for more severe conditions of acne vulgaris. This drug works by killing the bacteria that causes acne and permanently shrinking your oil glands, which reduces the amount of sebum. It’s said to be a very effective option but accompanied 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 that you trust.
The long list of side-effects of oral medications is not something you should take lightly. Trust me, I 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.
Several studies have clearly shown that taking birth control pills can be beneficial for reducing your acne, so here are the benefits of birth control pills when taken as prevention for acne:
Let’s keep in mind that while taking birth control pills for acne can help you with your problem, you must know that your acne is, in fact, hormonal. If it’s not, this is not the way to approach your problem.
If your acne problem isn’t hormonal, taking these birth control pills won’t help you at all, it may make your problem even worse, so make sure you know your acne isn’t a consequence of the wrong use of skin products or a result of some kind of allergic reaction to some products, makeup, etc.
It’s best to get advice from your doctor before taking these pills, and good to know that they should be recommended as a solution to your acne problem by your dermatologist.
It’s commonly known that every pill has its side effects, and you have to have this in mind if you want to start using birth control pills as an acne treatment.
These pills can be associated with: breast tenderness, headaches, bloating, nausea, fatigue - they can even make you have mood swings more often. Additionally, they can cause changes in your libido and in some cases, even make you gain weight. It’s best to read the back of the product you’re consuming because some side-effects can vary whether you are a smoker or not, whether you are over or underweight, have higher blood pressure, etc.
Always consult your doctor and make sure that birth control pills are a necessary method for your acne treatment. Never give yourself the liberty to take pills that are not prescribed by your doctor.
Make sure to always take the prescribed dose, never play with the dosage! Even the slightest tweak might stop you from getting the desired effects and cause some serious harm to your health.
And last, but not least, make sure you tell your doctor your health history, and whether you are taking some other medications or not. Mixing birth control pills with some other medication can also have harmful effects.
Acne vulgaris is a multifactorial disease with diverse epidemiology, which only makes finding treatment more complex. So don’t forget - you will only get rid of your acne if you are attacking the cause, not treating the consequences.
This is why sometimes and for some people taking birth control pills can really help with their acne. You have to be absolutely sure that your acne is hormonal in order for it to work as a treatment. So, before you take action, just schedule a doctor’s appointment. Maybe they will say that these pills aren’t the best option for you.
Additionally, have in mind that even though there are a lot of studies which have shown that birth control pills can really make acne less severe, it may take up to 3 months before you really notice it.
It’s good to always know that you are not the only one with a hormonal acne problem, so take your time, be patient and you will see the results that you have always wanted.