Birth Control For Acne

This is a prescription drug with active ingredients that include norethindrone acetate and ethinyl estradiol. It has FDA approval to treat acne.

Birth Control for Acne

For women, acne, especially severe acne, can lead to embarrassment, anxiety, social isolation, and permanent skin scarring. Severe acne can even lower the chances of employment in some industries.

Dermatologists have been using birth control pills to treat acne in women for decades. However, only three pills have actually been approved by the FDA for treating acne.

In general, birth control to treat acne is often advised for healthy women who also need contraception. It is typically started after other acne treatments, such as topical creams and oral antibiotics, have failed to clear up the skin. Here is information about the risks and benefits of taking birth control pills for acne. It can help you make an informed decision about what’s right for you.

How Does Birth Control Treat Acne?

As every teenager knows, there’s a clear relationship between hormones and acne. Some women experience premenstrual flare-ups of acne as their hormone levels shift during their cycle. And for some, acne simply persists through the years, even after menopause.

Acne is triggered by an excess production of sebum. Sebum is an oil made by glands in your skin. Along with skin cells, sebum can clog pores and promote the growth of bacteria that contribute to acne. Androgens, a group of hormones that includes testosterone, stimulate your skin to produce sebum.

A woman’s ovaries and adrenal glands normally produce a low level of androgens. Higher levels of androgens can lead to excess sebum. Taking birth control pills that contain both estrogen and progesterone lowers the amount of androgens in your body. This results in less sebum and less severe acne.

Types of Birth Control to Treat Acne in Women

The last decade has seen an explosion in new types of birth control. But so far, only three types of birth control pills have been approved by the FDA for treating acne. All three are “combination” oral contraceptives that contain both estrogen and progesterone. In fact, birth control pills that contain only progesterone can actually make acne worse.

Each type of birth control pill used for acne contains a low dose of the same form of estrogen. But each one uses a different form of progesterone.

The FDA has approved the following types of birth control for acne:

Ortho Tri-Cyclen uses estrogen combined with a progestin called norgestimate. A progestin is a synthetic, or manmade, form of progesterone. The pill is available with different doses of progestin.
Estrostepuses estrogen combined with a progestin called norethindrone. The pill is available with different doses of estrogen.
YAZ uses estrogen combined with a manmade form of progestin called drospirenone. The FDA has concluded that birth control pills containing drospirenone may have increased risk for blood clots compared to pills containing other progestins. Other brands containing drospirenone include Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, and Zarah.

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

Treating Mild to Severe Acne

These three oral contraceptives have been approved for treating moderate acne in women who:

Are at least age 14 or 15 (depending on the brand)
Have already started menstruating
Need contraception

In actual practice, doctors prescribe birth control for the full spectrum of acne, from mild to severe.

In addition, doctors may prescribe additional birth control products for acne. For example, the oral contraceptives Yasmin and Alesse have both been clinically shown to improve acne. But neither one has been approved by the FDA for this use.

If you’re already taking an oral contraceptive that’s working well in treating acne, there’s no need to switch brands. But if you are taking birth control pills for acne for the first time, it’s best to use one of the three types now approved for acne treatment.

You may need to take an oral contraceptive for a few months before your skin starts to clear. And an initial flare-up of acne is common when a woman first starts taking birth control pills.

Birth control pills work on only one acne-related factor — excess sebum. Doctors often prescribe other forms of acne treatment — topical medications or antibiotics — to be used alongside them for best results in clearing the skin.

Benefits of Birth Control for Acne

Several clinical trials have shown that taking combination birth control pills can result in:

Decreased acne flare-ups
Fewer pimples
Less inflammation
Less severe acne

Many women with severe acne take oral contraceptives with other acne treatments. For women who also want contraception, taking birth control pills for acne also offers one of the most reliable forms of contraception, as long as the pills are taken on schedule as prescribed.

Risks of Oral Contraceptives

Today’s birth control pills contain lower doses of estrogen and progesterone than in the past. This has significantly lowered their medical risks. Still, women taking oral contraceptives do have a higher risk of side effects, including heart attack, stroke, and dangerous blood clots in the legs or lungs.

Other risks include:

Hypertension (high blood pressure) and other cardiovascular problems
Liver and gallbladder disease
Migraine headaches
Depression and mood changes

Who Should Avoid Birth Control Pills

A decision to take birth control pills needs to take into account your medical history. Certain medical conditions could become worse if you use an oral contraceptive. Birth control pills are usually not advised if you have any of the following conditions:

History of heart disease, hypertension, blood clots in your legs or lungs
Blood clotting disorder such as factor V Leiden deficiency
History of cancer, especially breast, uterine, or liver cancer
Liver disease, diabetes, or migraine headaches

You also shouldn’t take oral contraceptives if:

You’re a smoker over age 30
You’re currently pregnant or breastfeeding
You’re severely obese or physically immobilized

Tips for Maximum Benefit

Here are tips for getting the most benefit from your acne treatment:

Continue taking other acne treatment prescribed by your doctor. An oral contraceptive targets only part of the acne problem.
Be sure to precisely follow the schedule for taking birth control pills. Doing so provides the maximum benefit and safety.
Talk with your doctor about possible side effects of the birth control you’re considering. These can include breast tenderness, headaches, breakthrough bleeding, or an initial, temporary flare-up of acne. It’s important to know what to expect.
Tell your doctor about any other medications you’re taking. Some can interfere with the effectiveness of an oral contraceptive and lead to an unwanted pregnancy. Taking some types of birth control pill together with oral rifampin (an antibiotic) may make it necessary to use a back-up form of contraception.

Show Sources

Ebede T., Arch E, Berson D. Journal of Clinical and Aesthetic Dermatology, December 2009.

Tan J, Ediriweera C. International Journal of Women’s Health, August 2009.

O’Connell K., Westhoff, C. Cutis, January 2008.

Salvaggio H., Zaenglein, A. International Journal of Women’s Health, August 2010.

American Academy of Dermatology: “The Truth about Oral Contraceptives and Acne” and “Treating Severe Acne.”

George R., Clarke S., Thiboutot D. Seminars in Cutaneous Medicine and Surgery,September 2008.

James, W. New England Journal of Medicine, Apr 7, 2005.

5 of the best birth control options for acne

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Acne is a widespread skin condition that can affect anyone. Some people develop acne due to hormonal changes. Birth control pills influence hormones and could reduce acne in some people.

Acne is one of the most common skin conditions in the United States, affecting more than 70% of Americans at some point in their lives.

There are many ways to treat acne, and the American Academy of Dermatology states that anyone can experience clearer skin with effective acne treatment.

Birth control can be effective for treating acne in some people. This article provides information on how a person can find the best birth control for acne.

Combined hormonal contraceptives (CHCs) are a type of birth control pill containing the active ingredients estrogen and progestin. These hormones can prevent pregnancy by:

promoting thicker mucus around the cervix to keep sperm from reaching the egg
stopping ovulation, so there is no egg for sperm to fertilize
making the womb a less welcoming place for a fertilized egg

Hormonal acne is the result of hormonal changes in the body. This means it may occur at times when hormones fluctuate, such as puberty or menopause.

Clogged pores are one of the main reasons for the blackheads, whiteheads, and cysts of hormonal acne. Excessive levels of sebum oil on the skin are typically a cause of clogged pores. Changing hormone levels can lead to excess sebum production.

Birth control pills can stabilize hormones at levels that help reduce acne.

Birth control can benefit the skin by lowering androgen levels, which decreases sebum production and can reduce acne.

Along with reducing androgen production in the ovaries and adrenal glands, CHCs lower the amount of testosterone in the bloodstream. The estrogen in birth control pills also helps lower oil production by the sebaceous glands.

CHCs are effective at reducing inflammatory and noninflammatory acne.

The Food and Drug Administration (FDA) has approved three medications for treating acne vulgaris:

Ortho Tri-Cyclen
Estrostep
Yaz

In addition, Yasmin 28 and Alessa are alternative treatments for acne. However, they currently lack formal FDA approval.

According to some studies , pills that contain ethinyl estradiol and cyproterone may be more effective at reducing acne than others.

The following are CHCs, meaning they contain progestin and estrogen and can help a person reduce acne:

Ortho Tri-Cyclen

This prescription drug is made from a combination of norgestimate and ethinyl estradiol. The amount of these hormones present in each pill varies each week. The FDA has approved it to treat acne vulgaris in menstruating people at least 15 years old.

Estrostep

This is a prescription drug with active ingredients that include norethindrone acetate and ethinyl estradiol. It has FDA approval to treat acne.

Yaz

This is another prescription combination birth control pill with FDA approval for treating acne. Its active ingredients are drospirenone and ethinyl estradiol. In addition to preventing pregnancy and reducing acne, Yaz may help treat premenstrual dysphoric disorder.

Yasmin 28

The active ingredients in this prescription medication are drospirenone and ethinyl estradiol. People with a history of blood clotting problems should use caution if taking this medication. It currently lacks FDA approval for treating acne.

Alesse

Levonorgestrel and ethinyl estradiol are the active ingredients in this prescription combination birth control pill. It currently lacks FDA approval for treating acne.

The table below compares the five birth control medications listed above.

Ortho Tri-Cyclen	Estrostep	Yaz	Yasmin 28	Alesse
Ingredients	norgestimate and ethinyl estradiol	norethindrone acetate and ethinyl estradiol	drospirenone and ethinyl estradiol	drospirenone and ethinyl estradiol	levonorgestrel and ethinyl estradiol
FDA-approved for acne	yes	yes	yes	no	no
Contraindi-cations	having cardiovascular problems or smoking	having cardiovascular problems, diabetes, or other chronic conditions	having blood clots	having blood clots	having cardiovascular problems or smoking

Although a prescription is necessary to purchase the best birth control for acne, it is possible to buy it through some online retailers. In addition to convenience and privacy, purchasing birth control online can sometimes be much cheaper.

These e-commerce sites typically require a person to share their health history and may include a telehealth session with a licensed medical professional. A professional will write a prescription if appropriate. The following are some of the leading websites for birth control pills:

Even the best birth control for acne has the potential to cause side effects , such as:

weight gain
tender breasts
nausea
irregular bleeding

If a person does not want to use birth control to treat their acne, they have other options. Depending on the type of acne a person has and the other treatments they have tried, a dermatologist could recommend:

retinoids
benzoyl peroxide
azelaic acid
salicylic acid
topical antibiotics
laser therapy
corticosteroid injections

Lifestyle management techniques can also help people manage acne. They include:

regularly using gentle, noncomedogenic skin care products
lowering stress
following a healthy diet and minimizing intake of refined carbohydrates and sugars
getting enough sleep

Below are some of the most common questions and answers about acne and birth control.

Does birth control help acne?

Research has found that birth control pills containing estrogen and progestin can reduce inflammatory and noninflammatory acne.

How long does it take for birth control to work?

A person may need to take birth control pills for several weeks or months before their skin improves.

When should someone speak with a doctor?

It is best to treat acne breakouts as soon as they appear. If recurring acne breakouts cause social, emotional, or psychological discomfort, speak with a doctor for evaluation and treatment options.

Acne is a common problem that can cause significant distress. Combination birth control pills are effective for preventing pregnancy and can also help reduce acne. Three CHCs currently have FDA approval for use as an acne treatment.

Although CHCs are prescription drugs, many are available online through telemedicine.

Last medically reviewed on March 23, 2022

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Acne: Diagnosis and treatment. (n.d.).
https://www.aad.org/public/diseases/acne/derm-treat/treat
Britton, L., et al. (2020). An evidence-based update on contraception.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533104/
Contraception. (2022).
https://www.cdc.gov/reproductivehealth/contraception/index.htm
Lorrtscher, D., et al. (2016). Hormonal contraceptives and acne: A retrospective analysis of 2147 patients.
https://jddonline.com/articles/hormonal-contraceptives-and-acne-a-retrospective-analysis-of-2147-patients-S1545961616P0670X/
Noncontraceptive benefits of birth control pills. (2011).
https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/noncontraceptive-benefits-of-birth-control-pills/
Oral contraceptives and the skin. (2016).
https://dermnetnz.org/topics/oral-contraceptive
Trivedi, M. K., et al. (2017). A review of hormone-based therapies to treat acne vulgaris in women.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419026/
Which birth control pills can help reduce acne? (2019).
https://www.ncbi.nlm.nih.gov/books/NBK279209/

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