While birth control can be an effective treatment for certain types of acne, it’s not appropriate for all acneic skin types nor is it typically the first recommendation for treating acne. If you’re struggling with acne, talk to your doctor about various treatment options, and ask if birth control could be your route to clear skin.
Birth Control for Acne: How It Works, Options, and More Uses
Acne is a source of skin irritation that can range from mild to severe. It’s often caused by an increase in androgens, which are male sex hormones.
Androgens are also present in people assigned female at birth (AFAB). They become active in the teenage years for everyone and cause sebaceous glands to produce more sebum, or oil.
If you’re AFAB and you have acne, birth control may help treat it. The synthetic hormones found in some birth control pills can help decrease the secretion of oil from your glands. This can actually lessen breakouts.
The ingredients in birth control pills can vary, so you should make sure your medication contains the right mix of hormones.
The birth control pill contains synthetic (human-made) hormones that prevent the sperm from fertilizing an egg. It does this by:
- stopping the ovaries from releasing an egg
- changing the consistency of cervical mucus to make it harder for sperm to reach the egg
- altering the lining of the uterus to prevent implantation
Several birth control pills contain synthetic forms of the hormones estrogen and progesterone. These types of pills are known as combination pills. The ratio of the hormones differs in each form of the combination pill.
Other birth control pills only contain progestin, the synthetic form of progesterone. They’re sometimes referred to as minipills.
The birth control pill can offer a variety of benefits. Those on birth control may experience:
- lighter, more regular periods
- fewer menstrual cramps
- reduced risk of certain cancers, including ovarian, uterine, and colon cancers
- improved acne
Birth control pills don’t protect you from sexually transmitted infections (STIs), however. You should consider using a barrier method, such as a condom, to protect against STIs.
The hormones in combination birth control pills can help reduce acne. The pills decrease the circulation of androgens, which decreases the production of sebum.
The pills must contain both estrogen and progestin to be effective against acne. The minipill only contains progestin, so it doesn’t help improve acne.
Many combination birth control pill brands are available. Each contains its own variation of hormones. Pills prescribed for acne should contain progestin with low androgenic possibility. This means the progestin has less androgenic side effects, such as oily skin and acne.
The Food and Drug Administration (FDA) has approved the following pills for the treatment of acne:
Beyaz
Beyaz combines drospirenone, ethinyl estradiol, and levomefolate calcium.
Each package contains 28 pills:
- 24 pink tablets containing:
- 3 mg drospirenone
- 0.02 mg ethinyl estradiol
- 0.451 mg levomefolate calcium
Potential side effects include:
- headaches or migraine episodes
- irregular menstrual cycles
- nausea and vomiting
- tender breasts
- fatigue
- irritability
- low libido
- weight gain
Estrostep Fe
Estrostep Fe combines norethindrone acetate, ethinyl estradiol, and ferrous fumarate.
Each package contains 28 pills with 21 hormonal contraceptive tablets and 7 nonhormonal tablets.
Potential side effects include:
- nausea and vomiting
- cramps and bloating
- changes in the menstrual cycle
- spotting or breakthrough bleeding
- migraine episodes or headaches
- weight changes
- breast tenderness
- rash
- yeast infection
- increased risk of blood clots
Ortho Tri-cyclen
Ortho Tri-Cyclen combines norgestimate and ethinyl estradiol. Each package contains 28 pills.
There are 21 hormonal tablets with:
- 0.250 mg of norgestimate
- 0.035 mg of estrogenic compound
- ethynyl estradiol
The 7 light green tablets are nonhormonal.
Potential side effects include:
- nausea and vomiting
- cramps and bloating
- rash
- breast tenderness or enlargement
- swelling
- changes in the menstrual cycle
- spotting or breakthrough bleeding
- yeast infections
- migraine episodes and headaches
- depression
- increased risk of blood clots
Yaz
Yaz combines drospirenone and ethinyl estradiol. Each package contains 28 pills. Of these, 24 tablets have 3 mg drospirenone and 0.02 mg of ethinyl estradiol, and 4 tablets are nonhormonal.
Potential side effects include:
- nausea and vomiting
- headaches and migraine episodes
- spotting and breakthrough bleeding
- cramps and bloating
- period changes
- changes in weight and appetite
- mood changes, like irritability or depression
- vaginal infections
- increased risk of blood clots
Other
Other combination pills that aren’t on this list may still help improve acne. Talk with your healthcare professional to fully explore which option is best for you.
Most combination birth control pills are equally effective in helping improve acne.
A 2012 review looked at 31 trials involving the use of birth control as an acne treatment. After looking at six new trials, the authors concluded that all combination birth control pills treated noninflammatory and inflammatory acne.
The study also suggested that combination birth control pills containing drospirenone were more effective than those that contained norgestimate or nomegestrol acetate plus 17 beta-estradiol.
Combination pills containing drospirenone were then found to be less effective than those containing cyproterone acetate. This distinction isn’t significant enough to favor one type of combined birth control over another, though.
In a summary of this study, the Institute for Quality and Efficiency in Health Care concluded that any claims of one pill leading to better skin should be taken with caution.
A 2018 review confirmed that all the different hormones in combination birth control pills are effective at reducing inflammation of acne.
A 2021 review also reports that oral antibiotics are the first choice to treat acne that’s resistant to topical treatments, and that adding on oral contraceptives that contain both estrogen and progesterone (combination pills) works even more efficiently.
Acne can manifest in a variety of forms, including:
Acne can develop from:
- hormonal changes during puberty and adulthood
- medications
- makeup
- rubbing or placing pressure on the skin
Having a family history of acne can also make you more prone to getting acne.
Dermatologists Say This Is the Best Birth Control for Acne
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Julia A. Siegel, MD is a board-certified dermatologist based in Boston, Massachusetts. She is a member of the American Academy of Dermatology and has authored several peer-reviewed journal articles and book chapters.
Board-Certified Dermatologist
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In This Article
How Birth Control Works How Birth Control Can Improve Acne The Best Types of Birth Control for Acne Types of Acne That Birth Control Can Treat How Long It Takes to See Results
Potential Side Effects of Taking Birth Control for Acne Who Can Prescribe Birth Control for Acne When to Talk to Your Doctor About Birth Control The Takeaway
For some people, acne isn’t just a pesky skin issue that appears every so often; it’s a chronic condition. Instead of dealing with the occasional breakout or two, the skin is consistently red, inflamed, and sometimes even painful to the touch. It’s at this point that many look to birth control as a way to treat and control flare-ups.
But just like taking any other prescribed medication, you need to do your research and talk to a doctor before using birth control for acneic skin. That’s because not all birth control works the same or provides the same skin-clearing results. A 2016 Journal of Drugs in Dermatology study found that combination birth control pills, or those that contain versions of both estrogen and progesterone, are generally best at clearing skin, while hormonal injections, implants, and intrauterine devices (IUD’s) tend to worsen acne.
Below, six experts explain how certain birth control methods may improve acne.
How Birth Control Works
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Combination hormonal birth control, or the main type of oral contraceptive prescribed for acne, contains two hormones: estrogen and progesterone. Together, these hormones suppress ovulation. A typical menstrual cycle includes menstruation (a period), a follicular phase, ovulation, and a luteal phase, which are all driven by fluctuations in hormones from the brain and ovaries. The pill stops these fluctuations and in turn, stops ovulation.
How Birth Control Can Improve Acne
Birth control works by affecting your body’s hormone levels, which is how, along with preventing unwanted pregnancy, it can also impact other hormonal-related issues like acne.
“When women’s hormone levels shift from a more female profile, for example, with estrogen and progesterone, to a more male profile, for example, testosterone, during our cycles, this has an effect on oil production and acne,” says Melissa Kanchanapoomi Levin, MD, a board-certified dermatologist and the founder of Entière Dermatology in NYC.
“When the hormone profile is more male dominant, a couple of skin changes occur: The sebaceous glands (the glands that make oil) become more active, there is an increase in dead skin cells, and the skin cells become stickier. This environment is perfect for acne flares. Some women are more sensitive to circulating testosterone and develop hormonal acne,” says Levin. Taking birth control pills can stabilize these hormones and decrease the amount of testosterone in your body.
The Best Types of Birth Control for Acne
Levin, who also works as a faculty member at NYU Langone, says Ortho Tri-Cyclen, a popular brand of birth control, has been cleared by the Food and Drug Administration (FDA) for the treatment of acneic skin. Along with Ortho Tri-Cyclen, Estrostep, and Yaz are two other brands of birth control cleared by the FDA for acne treatment. Yaz contains the hormone progestin drospirenone that is known to be especially effective in the reduction of hormonal acne.
While certain brands of birth control carry the FDA’s approval as an acne treatment, others are still prescribed off-label with some success. Other times, people who are prescribed oral contraceptives for other indications may find that a bonus “side effect” is an overall reduction in their acne symptoms. OB/GYN Sara Twogood, MD, notes that all oral contraceptive pills can have the effect of being anti-androgenic, meaning that they can lower the level of androgens like testosterone in the body. Androgens are one factor that leads to the development of hormonal acne, so blocking them can help to improve acne over time.
“There are no set requirements or parameters for starting birth control pills for acne. The decision about when or if starting the pill to help control acne should be individualized,” says Twogood.
Nava Greenfield, MD, of Schweiger Dermatology Group, agrees: “Each person may respond differently to different forms of oral contraception, so finding the one that works for you is important.”
Types of Acne That Birth Control Can Treat
Acne can take the form of a blackhead, whitehead, a small mark, or even a cyst, but it’s the underlying cause of your acne that determines whether birth control might be an effective treatment. According to Levin, teenage or inflammatory acne can be treated with oral antibiotics, but hormonal acne is not usually successfully treated by antibiotics.
That’s where hormonal medication, such as birth control, can come into play. If home treatment doesn’t help your breakouts, or if you’re finding yourself with large, hard, or pus-filled bumps, you may want to consult your doctor to learn if you’re experiencing hormonal or cystic acne—both of which may be treated with birth control. Other signs that you’re dealing with hormonal acne rather than good old-fashioned inflammatory acne include breakouts that follow a cyclical pattern with your menstrual cycle and acne that pops up mainly along your jawline or chin.
How Long It Takes to See Results
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While it can take as little as a month to notice an improvement, says Twogood, “in most studies, it took three to six months to show a reduction of acne due to birth control use.” Of course, oral contraceptives are considered long-term treatment, and acne may flare back up with discontinued use of the medication.
Potential Side Effects of Taking Birth Control for Acne
Side effects of taking birth control pills for acne are the same as those of someone who takes the pill for contraception or any other indication. The most common short-term side effects of birth control are nausea, breast tenderness, and bloating. You may also experience longer-term mood changes and changes in libido. You should speak with your doctor about whether you’re a good candidate for this medication given your medical history and to get more information about other possible side effects.
“If a person has a history of a blood clotting disorder, is a smoker, or suffers from migraine headaches, they are not good candidates for a birth control pill,” warns Birmingham-based dermatologist Julie C. Harper, MD.
Who Can Prescribe Birth Control for Acne
While any physician can write the script, “dermatologists, OB/GYNs, and primary care doctors are the usual prescribers,” Twogood says.
When to Talk to Your Doctor About Birth Control
If your acne is getting especially bad and isn’t responding to other treatments, consider speaking with a specialist or your primary care physician. Your doctor can help identify the underlying cause of your breakouts and suggest a treatment plan.
While there is no harm in asking your doctor about taking birth control for your acne, particularly if you believe your breakouts are hormone-related, be prepared to follow a suggested treatment plan, even if it doesn’t include the pill. While birth control may be incredibly effective against certain types of acne, it’s important to note that it’s not usually intended to be the first line of defense.
Usually, dermatologists will first recommend a topical retinoid. “Topically, my feeling is everyone and their mother should be on a retinoid,” says board-certified dermatologist Adam Friedman, MD, FAAD. “This first-line medication can be difficult to get covered in our current healthcare climate, so fortunately, there is an over-the-counter form available called Differin Gel ($15).”
Levin agrees: “In addition to clearing existing acne, Differin Gel will also help to prevent future breakouts from forming by increasing skin cell turnover to minimize clogging of pores.”
And while being on birth control can help manage hormonal acne, you still need a solid skincare routine and diet. “As acne is an inflammatory disorder, foods that cause inflammation may also contribute to acne,” board-certified dermatologic surgeon Dendy Engelman, MD, FACMS, FAAD, says. According to Engelman, high-glycemic index foods and dairy have been linked to acne.
Foods that are high in sugar or contain dairy are known to cause acne. To establish a diet conducive to fighting acne, look for foods with anti-inflammatory properties, such as those packed with essential fatty acids and antioxidants, to try to help get acne under control.
As for your skincare routine, Friedman says it should take on a “less-is-more approach” as opposed to loading up on anti-acne products. “Many believe overwashing, exfoliating, [and] scrubbing will improve acne, but, in fact, it will only make it worse. The inflammation that causes the visible pimple disrupts the skin barrier, impacting its ability to keep water in and harmful things out. Overwashing or using harsh cleansers can further disrupt the skin barrier, which can, in turn, create more inflammation and even more acne.”
Friedman recommends a gentle wash, like Cerave Foaming Facial Cleanser ($14).
The Takeaway
While birth control can be an effective treatment for certain types of acne, it’s not appropriate for all acneic skin types nor is it typically the first recommendation for treating acne. If you’re struggling with acne, talk to your doctor about various treatment options, and ask if birth control could be your route to clear skin.
Article Sources
Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.
- Lortscher D, Admani S, Satur N, Eichenfield LF. Hormonal contraceptives and acne: a retrospective analysis of 2147 Patients. J Drugs Dermatol. 2016;15(6):670-674.
- Trivedi MK, Shinkai K, Murase JE. A review of hormone-based therapies to treat adult acne vulgaris in women. Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018
- Słopień R, Milewska E, Rynio P, Męczekalski B. Use of oral contraceptives for management of acne vulgaris and hirsutism in women of reproductive and late reproductive age. Prz Menopauzalny. 2018;17(1):1-4. doi:10.5114/pm.2018.74895
- Cleveland Clinic. Birth control: the pill. Updated July 21, 2020.
- Veith WB, Silverberg NB. The association of acne vulgaris with diet. Cutis. 2011;88(2):84-91.
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