Birth Control For Acne: Best Options, Side Effects, and More

• Acne can lead to low self-esteem, social anxiety, permanent scars, and even reduced employment opportunities for some women.
• For decades now, dermatologists have prescribed specific hormonal birth control pills to address acne in women.
• As a general rule, birth control as an acne treatment is recommended to women in good health who are also in need of contraception.

The relationship between hormones and acne is well studied, as hormonal fluctuations are one of the most common causes of acne. While some women experience acne flare-ups as their hormones fluctuate throughout their cycle, for some acne persists even after menopause.

While it is normal for a woman’s ovaries and adrenal glands to produce a low level of androgens or ‘male’ sex hormones (such as testosterone), higher levels lead to excess sebum (an oily substance secreted by your glands to moisturize skin), which can clog pores and promote the growth of acne-causing bacteria. The synthetic hormones found in some oral birth control can lessen sebum and the breakouts which accompany it.

Can Birth Control Treat Acne? 

Yes, birth control can be an effective acne treatment for women coping with hormonal acne. Birth control pills will not, however, help treat acne triggered by other factors like the use of certain medications, wearing makeup, or placing too much pressure on the skin, however, so it’s important to first determine the cause of your acne with a doctor. 

If you take birth control pills to improve acne, it is worth noting that it can take anywhere from a few weeks to 3 months before you notice a visible improvement because the hormones take time to work their way into your system and take effect.

How does it work?

Combination birth control pills which contain both estrogen and progestin (synthetic progesterone) can balance your hormones, decreasing the circulation of androgens. In turn, this decreases the production of sebum and minimizes acne. 

Best Birth Control Options for Acne Prone Skin

Hormonal contraceptives can come in the form of pills, the patch, the ring, the injection, or the implant. However, combination oral contraceptives in the form of pills are the most commonly prescribed and effective type of birth control for treating acne, and some women also find success with the vaginal ring (a soft plastic ring inserted into the vagina which releases estrogen and progestin). 

Three types of combination oral contraceptives have been approved by the FDA for treating acne. While each type contains a low dose of the same form of estrogen, different forms of progesterone are used. 

Ortho Tri-Cyclen uses estrogen combined with a progestin known as norgestimate, and is available in different doses dependent on the severity of your acne and your doctor’s judgement.

Estrostep contains estrogen combined with a progestin known as norethindrone, and is also available in different doses dependent on your needs. 

YAZ combines estrogen with a synthetic form of progestin known as drospirenone, which may present an increased risk for blood clots compared to pills containing other progestins. 

Studies have not shown a major difference among these three formulations in terms of how effectively they treat acne. 

Can Birth Control Cause Acne? 

Yes, in certain cases, taking birth control pills can actually cause or worsen existing acne. However these cases are rare, and almost solely limited to those who have just switched birth control methods or are taking birth control pills containing progestin-only, also known as “mini-pills.” 

At times, these no-estrogen birth control pills can cause androgen levels to shift, triggering an increase of hormonal acne. Doctors do not typically prescribe the mini-pill for acne, however.

How to treat acne caused by birth control

If you find that the birth control your are taking is causing or worsening your hormonal acne, discontinuing its use with the guidance of your doctor may be the best option. 

If you have started taking birth control or switched types of birth control within the last 3 months, however, it may be best to wait it out, as it can be normal for acne to persist for a few months, eventually clearing up as your body becomes accustomed to it.

Other Side Effects of Birth Control

Modern birth control pills contain lower doses of estrogen and progesterone than birth control pills of past generations, which has significantly lowered their medical risks. Still, if you are prescribed birth control pills to treat your acne, it’s important to be aware of the possible side effects.

Common side effects of oral contraceptives include nausea, vomiting, stomach cramps, bloating, weight gain, weight loss, changes in your period, headaches, breast tenderness, dizziness, lowered libido, and even fainting. Serious side effects of birth control include heart attack, stroke, liver and gallbladder disease, migraines, dangerous blood clots in the legs or lungs, and depression or mood swings. 

For people with certain medical conditions, taking hormonal birth control is typically not advised. This includes those with a history of heart disease, high blood pressure, blood clots or clotting disorders, cancer, liver disease, diabetes, or migraines.

It’s also best not to take birth control if you’re over 35, a smoker, obese, or are physically immobile, as the risk factors for cardiovascular disease or other severe side effects are higher. Those who are pregnant or breastfeeding cannot take birth control either.

Alternative Acne Treatments

In certain cases it is simply better to try alternative treatments (OTC topicals) for acne than it is to use the birth control pill. For instance, if you have persistent or serious side effects from using the pill, or have a high risk medical history. 

It may also be better to use topical treatments if you have no need for contraceptive protection, or if your acne is mild. Most of the alternatives work best for mild acne. 

Among the most effective topical OTC acne treatments available are the following ingredients, all of which are easily found in products sold at pharmacies: 

Benzoyl peroxide 

An OTC topical acne treatment containing benzoyl peroxide is effective at addressing cases of mild acne. Benzoyl peroxide is available in many forms, including lotions, washes and gels. It removes the layer of dead cells on the surface of your skin, clearing sebum from your pores and preventing clogging, at the same time destroying acne-causing bacteria. 

It takes about a month for results to become apparent, however, and since it won’t affect your body’s sebum production, your product must be used continuously to remain effective. 

Salicylic acid

Topical products containing salicylic acid include lotions, creams, and pads. In cases of mild acne, it works preventatively by helping to unclog pores and thus reduce acne. Salicylic acid doesn’t have an effect on sebum production, nor does it kill bacteria. 

Like benzoyl peroxide, it has to be used continuously to be effective, because when you discontinue use, the pores simply clog up again and the acne returns. 

Topical retinol 

Retinol gels and creams accelerate skin cell turnover, helping you to shed dead skin and reveal new skin more quickly, while also having an antiinflammatory effect. This in turn works to unblock pores and keep acne from forming. Retinol has been shown to both reduce existing acne and prevent new acne. 

Your acne may appear worse before it improves however, because retinol works on acne that has already begun forming beneath your skin. Retinol typically takes 8-12 weeks for visible results, and must be used continuously. 

Antibiotics

Some people have seen success treating their severe acne with antibiotics, particularly amoxicillin, when taken for several weeks or months. 

Antibiotics are only recommended for moderate to severe cases of acne, as oral antibiotics can have side effects such as dizziness, digestive problems and rashes and topical antibiotics run the risk of bacteria becoming resistant to treatment over time.

Diet

Although the relationship between acne and diet remains tenuous and controversial, research has shown a link between the consumption of dairy products and acne. It has also been shown that foods with a high glycemic index, such as soda, white bread, candy, sugary cereals, and ice cream may cause blood sugar fluctuations which can worsen acne. 

Cutting these foods out may reduce the severity of your acne.

Takeaway

The synthetic estrogen and progestin found in some oral birth control can lessen sebum and the acne associated with its overproduction. Typically, birth control is only recommended as an acne treatment for healthy women who are also looking for a mode of contraception.

Several types of combination oral contraceptives have been FDA-approved for treating acne. It is important to remain patient, however, as it can take up to 3 months before you notice a visible improvement.

Taking hormonal birth control is not advised for people with certain high risk medical histories. If you have persistent or serious side effects from using the pill, it may be better to opt for topical treatments, particularly if you have no need for contraceptive protection, or if your acne is relatively mild.