Best Birth Control for Acne: Options and Effects Explained
Hormonal birth control pills are one of many options to address acne. They may effectively improve the condition.
This article discusses the best birth control pills for acne, including the benefits and characteristics of FDA-approved options. This article also explains how birth control pills for acne work, and how to use them safely.
Sex and gender exist on spectrums. This article will use the term “female” when discussing people who are assigned female at birth.
Researchers from a 2016 study suggest that acne may occur when hormones known as androgens increase sebum production in the skin. Sebum is an oil that helps protect and maintain the skin. However, excess sebum production can lead to clogged pores and inflammation, which may result in acne.
Birth control pills contain hormones including estrogen and progestin. A 2013 systematic review and meta-analysis suggests that hormones in birth control pills can lower androgen levels. This may lead to a decrease in acne-causing hormones.
However, the Food and Drug Administration (FDA) suggests that more research is needed to understand how this effect directly contributes to decreased facial acne in healthy females.
Research suggests that birth control pills can improve both noninflammatory and inflammatory acne when taken for several weeks or months.
Some research initially indicates that certain drugs may be more effective at treating acne. For example, individual studies suggest that cyproterone acetate and chloradinone acetate may be more effective than levonorgestrel.
However, other investigators have observed that many pills can have similar positive effects. As a result, researchers from the Institute for Quality and Efficiency in Health Care suggest that claims that one option is better than another may not yet be reliable.
More research is needed to understand which medication may be the most effective.
Different name brands and birth control products contain different active ingredients.
Research suggests that effective drugs in birth control pills include ethinyl estradiol, a type of estrogen, combined with different forms of the hormone progestin. Some people refer to these medications as “combined oral contraceptive pills” or “combination birth control pills.”
As of 2017, the FDA has approved only some birth control medications to treat acne. These include:
- Ortho Tri-Cyclen
Estrostep or Estrostep Fe is a combination of ethinyl estradiol and norethindrone acetate. These come in packs of 21 oral contraceptive tablets and seven ferrous fumarate iron tablets. The ferrous fumarate will not treat acne.
In research supported by the FDA, investigators observed that taking Estrostep for 6 months produced a significant improvement in reducing the number of acne lesions.
Ortho Tri-Cyclen or Ortho-Cyclen birth control pills contain ethinyl estradiol in combination with norgestimate.
Similar to Estrostep, Ortho Tri-Cyclen consists of 21 hormonal tablets and seven nonhormonal tablets.
According to the FDA, researchers have observed that Ortho Tri-Cyclen also can cause a significant reduction in the number of acne lesions after 6 months of treatment.
Yaz and Beyaz
Yaz and Beyaz are combined birth control pills containing ethinyl estradiol and drospirenone.
Both options provide 28 tablets, of which there are 24 hormonal pills and four nonhormonal pills.
The FDA recommends their use for moderate acne in females who are at least 14 years old.
Research suggests that over six 28-day cycles, Yaz and Beyaz can reduce the amount of both inflammatory and noninflammatory acne lesions. Additionally, 15–21% of participants experienced a skin rating of “clear” or “almost clear” on the Investigator’s Static Global Assessment (ISGA). The ISGA is a scale that measures the severity of skin symptoms.
Other brands of birth control pills may also alleviate symptoms of acne. These brands may contain the same ingredients and have indications that they could be beneficial for the treatment of acne. However, they may not have FDA approval for this use.
Your doctor can recommend an appropriate option for you according to your condition and health.
In order to use birth control pills, you need a prescription from a doctor. They can advise you on whether birth control pills may help, and the best one for you.
Your doctor or pharmacist can provide instructions on how to take the medication safely and effectively.
The FDA has observed benefits while using birth control pills for acne after taking them for at least 6 months. Additionally, acne improvements with Estrostep did not become significant until the sixth month of treatment. Therefore, it may be necessary to take the medications for at least that amount of time. The National Health Service (NHS) notes that it may take up to 1 year to observe the full benefits of birth control pills for acne.
The FDA typically recommends using birth control pills to treat acne when other topical treatments have not been effective. As a result, your doctor or a dermatologist may first suggest non-pharmaceutical treatment options before prescribing birth control for acne.
The FDA notes that the use of Estrostep, Ortho Tri-Cyclen, Yaz, and Beyaz for acne should only be for people assigned female at birth who:
- are 14–15 years old or older, depending on the exact pill
- have started menstruation
- also want to use the pill as a contraceptive
- plan on taking the medication for at least 6 months
- have acne that has not improved with topical acne medications
- do not have a high risk of developing complications
Hormonal therapies for acne may especially offer benefits for those who experience hormonal acne. Examples are acne around menstrual periods or with hormonal conditions such as polycystic ovary syndrome. However, birth control pills can help other cases of acne.
Risks of developing complications when taking birth control pills may increase if you:
- have high blood pressure
- have high cholesterol
- have or previously have had at least one of the following:
Like any medication, birth control pills can cause side effects. Not all of these side effects are serious, but others can threaten health.
Common side effects of birth control pills include:
- bleeding or spotting between menstrual periods
- tenderness in the breast or chest
- weight gain
- difficulty wearing contact lenses
Many of these side effects may subside within the first 3 months of using the medication.
Although less common, birth control pills can also cause acne as a side effect. Contact your doctor for advice If your symptoms of acne do not improve or if they worsen while using birth control pills.
Very rarely, oral contraceptives can cause more serious side effects or worsen underlying conditions. This may occur particularly if you have underlying conditions or experience risk factors for complications.
Severe side effects of oral contraception can include:
- blood clots, such as pulmonary embolism, a blood clot in the lung
- complications of blood clots, such as stroke or heart attack
- liver tumors
- high blood pressure
Smoking increases the risk of experiencing serious cardiovascular conditions while taking a course of oral contraceptives. This risk also increases if you are 35 years old or more, and with the number of cigarettes you smoke.
It is advisable for people who take oral contraceptives not to smoke at all.
Some clinicians may recommend other acne treatments before or in addition to using birth control pills for acne. Additionally, birth control may not be safe or effective for everyone.
These other treatments also may help alleviate symptoms of acne:
- benzoyl peroxide
- topical retinoids
- topical or oral antibiotics
- azelaic acid
- laser therapy
- corticosteroid injections
Birth control pills can be an effective way to improve symptoms of acne when other treatments are not successful. The FDA currently approves of the use of several hormonal birth control medications for treating acne. These include Estrostep, Ortho Tri-Cyclen, and Yaz.
Birth control pills may not be a safe or appropriate option for everyone who experiences acne. This treatment is recommended only for those who are more than 14–15 years old, intend to use birth control for contraceptive purposes, and do not experience risk factors for complications.
Talk with your doctor about using birth control pills for treating acne.