Medically reviewed by William Truswell, MD
Approximately 50 million people are affected by acne each year. In women, androgens (fluctuating hormones) are one cause of acne.
Certain types of birth control (oral contraceptive pills) like Yaz and Orth Tri-Cyclen have been shown to improve hormonal acne. It's important to discuss the benefits and risks of birth control with your healthcare provider before starting treatment for acne.
This article discusses the brands of birth control that may help improve acne caused by hormones.
Birth Control That Could Help Acne
Not all birth control brands are effective in treating acne. In fact, birth control pills that contain only progestin can make acne worse. Combination birth control with estrogen and progestin is best for improving female acne. The following birth control brands have been approved by the Food and Drug Administration (FDA) for treating mild to moderate acne in women.
Ortho Tri-Cyclen contains ethinyl estradiol and norgestimate (estrogen and progestin) and was the first birth control approved for acne. You must be at least 15 years old and have started your period before using this medication.
If you have risk factors for blood clots and are a smoker over age 35, you should not take Ortho Tri-Cyclen. Some benefits of taking this birth control are menstrual cycle regularity, decreased ovarian cysts, and decreased endometrial and ovarian cancer incidence.
The brand-name product Estrostep Fe is only available in generic forms such as Tilia Fe. Containing norethindrone acetate (progestin), ethinyl estradiol (estrogen), and ferrous fumarate (iron), Estrostep Fe is for females over 15 years old who have achieved menarche (the start of menstrual cycles) and whose acne is unresponsive to topical treatments.
You shouldn't take Estrostep Fe if you have contraindications to (reasons not to take) oral contraceptive pills (OCPs). The health benefits of taking Estrostep Fe are decreased dysmenorrhea (menstrual cramps), ectopic pregnancy, and acute pelvic inflammatory disease (PID).
Yaz contains ethinyl estradiol and drospirenone (progestin). For some people, drospirenone is more effective than norgestimate for treating acne.
You must be at least 14 years old, have achieved menarche, and have no contraindications to OCPs. An added benefit to taking drospirenone is treating premenstrual dysphoric disorder (PMDD).
Generic forms of Yaz include:
The newest oral birth control approved for acne, Beyaz, contains drospirenone, ethinyl estradiol, and levomefolate (increases folate levels). You must be at least 14 years old, have achieved menarche, and have no contraindications to OCPs to take this medication. Similar to Yaz, Beyaz also treats PMDD.
Birth Control That Worsens Acne
Progestin-only birth control pills can make acne worse. Progestin is the synthetic (human-made) form of testosterone; without estrogen, acne will not improve.
How Soon Birth Control for Acne Could Work?
It can take up to three months to see results from taking birth control for acne. If your skin responds and clears up, you can safely remain on birth control for a long time. You may also be able to stop other treatments if your acne improves with birth control pills.
Why Does Hormonal Birth Control Help Acne?
Androgens are a group of sex hormones that contribute to reproductive health. Although both females and males produce androgens, males make more of them. Testosterone is an example of an androgen.
Sebum, the oily substance that keeps skin moisturized, is produced by androgens. Excess sebum can lead to clogged pores, which cause acne. If the ovaries produce too much androgen, it can lead to excess sebum and worsening acne. Combining estrogen and progestin in birth control pills inhibits androgen production, decreasing sebum and acne.
Weighing the Benefits Against Side Effects
Treating acne is essential to improving the quality of life for many people. Birth control for acne doesn't come without risks, and the side effects must be weighed against the benefits. The following conditions can make taking birth control dangerous:
History or risk of blood clots
Heart disease and/or high blood pressure
Liver disease or tumors
Being on hepatitis C treatment
Abnormal uterine bleeding
Smoking cigarettes, especially after the age of 34
One fear of taking birth control is weight gain. Fortunately, there is no clear link between weight gain and taking oral contraceptives.
How to Get Birth Control for Acne
Your healthcare provider or dermatologist can prescribe birth control for acne. There are also several online resources that can help locate a medical professional and access to affordable birth control. Never take birth control pills without being evaluated by a healthcare provider first.
Alternatives If Birth Control Isn't Right for You
If birth control pills are not an option for you in treating hormonal acne, you might be prescribed spironolactone, which reduces androgen levels and is 50% to 100% effective. Caution should be taken as the medication is a diuretic (increases urine excretion) used to treat fluid retention and high blood pressure.
Spironolactone can also lead to increased potassium levels in your blood. Do not take potassium supplements while on spironolactone. Most people see less oily skin within just a few weeks, and taking it at the same time each day has the best results.
Other medications used for treating acne include:
Antibiotics: Doxycycline and erythromycin help decrease skin bacteria and reduce acne.
Isotretinoin (formerly Accutane): These medications help treat severe acne. It is unsafe to take isotretinoin without a prescription.
Additional alternatives to treating hormonal acne include:
Keeping appointments with your healthcare provider or dermatologist
Following your prescribed treatment regimen
Keep skin clean and dry using gentle products
Eating a healthy diet
Acne affects many people's quality of life. Birth control pills can help reduce acne caused by androgen hormones. Ortho Tri-Cylen, Yaz, Beyaz, and Estrstep FE are four birth control brands approved by the FDA for treating acne. If you are a female over 14 and menstruate, you could be eligible to try birth control for acne.
Birth control is not a safe choice for some people; therefore, you need to be evaluated by a healthcare provider for the risks and benefits before starting treatment. Spironolactone, antibiotics, isotretinoin, and topical treatments are alternatives to taking birth control for acne.
Read the original article on Verywell Health.