Which Birth Control is Best For Your Skin?
It’s well-known that birth control can impact your skin—some may say it’s a godsend to clear up acne, while others may tell you it’s wreaked havoc. So how you do know what you should be taking?
Let’s start from the beginning.
The types of birth control that may affect your skin are lumped under the broad category of “hormonal birth control,” meaning they use certain hormones to prevent you from getting pregnant, but these hormones may also effect your skin. Players in this arena include birth control pills, patches, vaginal rings, injections, a sub-dermal implant, and the hormone-impregnated IUD.
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Birth control pills (BCPs) are a combination of two synthetic analogs of the female hormones estrogen and progesterone. Though they are usually administered orally, “pill” ingredients can also be time-released from a vaginally-inserted plastic polymer (NuvaRing) or from a Band-Aid-like skin patch.
One percent of “pill” prescriptions are for the progesterone-only mini-pill, prescribed for patients who can’t take or tolerate estrogen. The birth control injection (most commonly Depo-Provera) is a long-lasting progesterone-only derivative injected every twelve weeks. But, whether “pill” or “mini-pill,” they both work by inhibiting ovulation.
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The hormonal intrauterine device (IUD), known better by its brand name Mirena, contains the progesterone analogue levonorgestrel. The manufacturers of Mirena claim a variety of reasons the contraceptive is effective. Most likely, it works the same way that other IUDs work—either by acting to prevent the ovum from implanting into the uterus, interfering with sperm, or both–but not by stopping ovulation. And, it’s worth mentioning, that the added levonorgestrel affects bleeding and may lighten a heavy flow.
Can the pill really cure acne?
Certain combination birth control pills can decrease the appearance or severity of acne. They do this by lowering androgen levels (the male hormone androgen can negatively impact the skin) or by decreasing sebum production. Sebum is the oily, lipid-based substance that can give your face a greasy appearance in acne-prone areas. Birth control pills that are FDA-approved to lower the incidence of acne include Ortho Tri-Cyclen, Estrostep, and Yaz. But, this doesn’t mean that other pills are ineffective. For example, Alesse, Yasmin and others are highly regarded, but not FDA-approved for treating acne. Unfortunately, there is no one best pill. Remember that heredity is a major factor in skin complexion. Where a certain pill brand may help one person, it may not work for another; so sometimes trial and error is needed.
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So which types of birth control upset your skin?
When it comes to progesterone-only birth control (the mini-pill, Depo-Provera, the Implanon implant, and the medicated IUD) the news is not so good. Progesterone-dominant delivery systems have actually been linked to acne in certain people. Even more rare, but still a concern, is the occurrence of melasma, which causes facial skin discoloration, or hyperpigmentation. Most commonly, this condition occurs during pregnancy, but it has been proven as an unusual side-effect of progesterone dominant contraceptives. So, if your main concern is clear skin, it would be best to steer clear of these methods.
How do you know which birth control is right for you?
When selecting a method of hormonal birth control, is your main consideration contraceptive effectiveness, skin appearance, possible side-effects, or a little of each? It’s best to consult with both your dermatologist and your gynecologist about all risks and benefits before making a final decision. Consider that birth control pills are only one part of a multi-faceted approach to clearing acne that includes topicals, antibiotics, and other therapies.
By David Shobin, MD
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