Can Birth Control Cause Acne?
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Ever had a friend mention that her skin cleared up as soon as she started taking birth control? Maybe you’ve talked to someone whose skin broke out terribly after they started a new contraceptive.
You’ve likely heard both sides of the story, but numerous studies have found that birth control can actually be a great option, especially for women with acne that hasn’t improved with topical acne applications alone.
Birth Control and Acne
Birth control can affect the frequency and severity of acne breakouts. Under normal conditions, a woman’s adrenal glands and ovaries produce low levels of androgens. A lower amount of androgens leads to a decrease in the production of sebum, which can result in fewer and less severe breakouts. Taking birth control pills that contain both progesterone and estrogen can decrease the amount of androgens produced. Therefore, birth control can decrease the occurrence of acne.
Does Birth Control Cause Acne?
Generally, birth control helps alleviate acne breakouts. Birth control pills that contain both estrogen and progesterone help decrease the amount of androgen in the body. The less androgen present, the less sebum the body produces, which can help cut down on breakouts. However, certain birth control pills can cause acne. Those that contain progestin can promote acne and worsen breakouts.
It’s important to understand what causes acne in order to understand the role birth control plays in clear skin. Acne is caused by a fluctuation in hormone levels, which may occur during puberty, pregnancy, menstruation, or menopause. Stress and acne often go hand-in-hand as the aforementioned periods of your life can often be rife with anxiety and uncertainty.
This fluctuation results in a rise in androgens, hormones that are found in both men and women. When the adrenal glands are stimulated, more sebum is produced in the skin’s follicles. As pores fill up with excess sebum, this oily substance may combine with dead skin cells, debris, and P. acnes bacteria, and begin the formation of a pimple. There is a high correlation between oily skin and acne: the more sebum produced by the skin, the higher the chances pores will become clogged.
A woman’s ovaries and adrenal glands generally produce a low level of androgens, but higher levels of androgens can lead to excess production of sebum. So is birth control a necessary step for clear skin and how does it work?
The Lowdown on Birth Control
To determine how birth control helps (and sometimes hinders) our skin, it’s important to learn exactly how it affects the body.
Oral contraceptives, most commonly referred to as birth control, are medications designed to prevent pregnancy. Birth control pills often contain both progestin and estrogen. These hormones prevent ovulation, the process in which the ovaries release an egg. They also lower the amount of androgens in the body, which results in decreased sebum.
The less oil your skin produces, the fewer clogged pores you’ll have—cue clear skin.
Every birth control pill uses some type of progestin, which is a synthetic form of progesterone. There are numerous variations of progestin, but it’s important to choose a birth control pill that uses a progestin low in androgens.
Most birth control pills contain estradiol, which is the synthetic form of estrogen. Generally, skin clears up faster with a birth control pill that contains a moderate to high level of estrogen. Low-dose birth control pills often contain low amounts of estrogen; while still an effective contraception option, this type of birth control can mean bad news for breakouts.
What Type of Birth Control Combats Acne Best?
Dermatologists and healthcare professionals have been prescribing birth control pills for the treatment of acne for many decades, and there are numerous brands and types available. There is no foolproof guide to acne causes, but many health professionals tout the benefits of contraception for female acne patients.
It can be difficult to know which to choose, but if you’re looking to use contraception to help clear your skin, there are only three specific pills that have been approved by the FDA for acne treatment: Ortho Tri-Cyclen, Estrostep, and YAZ.
All three of these pills are considered combination oral contraceptives, which means they contain both estrogen and progesterone.
1. Ortho Tri-Cyclen
This birth control pill combines estrogen with a progestin known as norgestimate. This pill is intended for use as a contraceptive but provides the additional benefit of acne prevention and control.
In a study performed in 1997, the Journal of the American Academy of Dermatology found that in a group of 247 women, 93.7% of women who took Ortho Tri Cyclen saw improvements in their skin, while only 65.4% of the placebo group saw the same type of results.
This birth control pill combines estrogen with a progestin called norethindrone. These pills may also contain iron, and come in varied levels of estrogen.
This was the first oral contraceptive approved in a new class of birth control called Estrophasic. It increases doses over a woman’s cycles, providing gradually increasing amounts of estrogen.
You’ve likely heard of YAZ. Introduced in 2006, YAZ was at one time the top-selling, most popular oral contraceptive in the U.S. It uses a combination of estrogen and synthetic progestin known as drospirenone.
Concerns were raised however when some health professionals noticed that this progestin may raise the risk of blood clots. Numerous side effects came to light, including the drug’s ability to lower potassium levels and cause strokes or embolisms. It has not been recalled, but many lawsuits have been filed against the company because of its side effects.
Studies so far haven’t shown a difference in effectiveness between these three pills. These are just the three oral contraceptives that have been approved by the FDA, but dermatologists will describe a host of other brands to help patients struggling with acne.
Those who need birth control for contraceptive purposes often must try different pills in order to find one that also helps clear up the skin.
Birth Control versus Antibiotics
Many dermatologists and health care professionals will prescribe antibiotics for acne, but there can be downsides to this form of treatment. These antibiotics are available in topical applications, tablets, capsules, and elixirs.
To utilize antibiotics for acne treatment, you must often obtain a doctor’s prescription. The most common oral antibiotics prescribed for acne include tetracycline, doxycycline, erythromycin, and clindamycin.
Many have found that antibiotics are an effective method of controlling breakouts, offering two main acne-fighting effects:
- Antibiotics reduce bacteria on the skin’s surface and within the pores, including acnes bacterium.
- Antibiotics serve as an anti-inflammatory agent, easing irritation and inflammation often associated with breakouts.
Both of these benefits have made antibiotics a popular choice for acne treatment. However, antibiotics do come with their risks.
Side Effect of Topical Antibiotics
- Topical antibiotics can create skin irritation that ranges from mild dryness to scaly, itching skin
- Intermittent use of topical antibiotics can result in bacterial resistance, making it harder to treat acne with antibiotics down the road
- The skin may develop contact dermatitis
Side Effects of Oral Antibiotics
- Taking a regular dose of antibiotics can result in bacterial resistance, but this is more commonly seen with topical applications
- Certain antibiotics can result in photosensitivity, especially doxycycline
- Antibiotics can result in yeast overgrowth
- May cause a variety of rashes
So what do antibiotics have to do with birth control and acne treatment? It turns out that birth control might be more effective than these popular treatment methods, and result in fewer side effects.
In a study published in the Journal of the American Academy of Dermatology, research showed that during a six-month period, oral contraceptives reduced acne by 55 percent, while antibiotics improved the skin by only 53 percent.
Numerous studies have shown that antibiotics and birth control pills have shown similar success in improving acne symptoms, but the pill is a great alternative for avoiding the drawbacks of antibiotics.
Is Birth Control Safe?
While birth control is widely prescribed for contraception and acne control purposes, there are a few things to be aware of before beginning an oral birth control regimen. Women who smoke, have high blood pressure, or are older than 35 are advised against taking oral contraceptives.
There are a variety of side effects associated with oral contraceptives, including:
- Vomiting and nausea
- Bloating and cramping
- Changes in menstruation cycle
- Soreness in breasts
- Vision loss
- Feeling faint
- Increased risk of blood clots, stroke, heart attack, and tumors
Always speak with your doctor before taking oral contraceptives and work with your dermatologist to determine if birth control is a necessary method for your acne treatment.
So My Birth Control Won’t Cause Acne?
While many women have found birth control methods to be effective in reducing their acne breakouts, some have found birth control can have the opposite effect on their skin. This is highly dependent on the type of contraceptive they take.
Birth control pills that contain only progesterone can actually make breakouts worse and more frequent because it can stimulate the production of sebum. These types of birth control pills are what is known as the mini-pill. Avoid these types of oral contraception, and try a different variety (always under the care of a physician) if you notice your acne worsens after a few months of use.
A Team Effort
Oral contraceptives are generally used in conjunction with topical acne treatments. A dermatologist usually only prescribes birth control to patients who have a need for contraception and have exhausted all other methods to manage their acne. Birth control is generally only used for moderate to severe cases of acne when other options won’t cut it.
While the right birth control pills can reduce the amount of sebum produced in the pores and cut down on acne blemishes, it’s important to use topical treatments designed to soothe the skin and keep it looking radiant and vibrant.
- Birth control pills that contain both progesterone and estrogen can help clear the skin
- Using antibiotics for acne treatment can result in the body developing bacterial resistance, meaning the antibiotics may stop working down the line.
- Birth control that contains only progesterone can make acne worse.
- Birth control for acne control and prevention should be used in conjunction with topical treatments to help the skin look and feel its best.