How Does Birth Control Treat and Prevent Acne Breakouts?

Using Birth Control for Acne Treatment

Millions of people suffer from painful and embarrassing acne breakouts. Unfortunately, acne breakouts can happen at any time during a person’s life, not just during their teenage years. Unfortunately for some people, they will never grow out of acne, and acne can even get worse as a person ages. For women especially, acne breakouts can be incredibly hard to treat, as they are often related to hormonal fluctuations associated with the menstrual cycle and perimenopause.

Unlike teenage acne, hormonal adult acne is stubborn and if left untreated, can lead to scarring and emotional distress. The good news is, the birth control pill can safely and effectively treat and prevent stubborn breakouts. For teenagers and adult women alike, taking the pill can lead to clearer skin, less stress, and higher levels of self-esteem.

What causes acne?

There are several different types of acne, and in many cases, bacteria, excess sebum, and inflammation are to blame for flare-ups. However, hormones are a huge culprit in adult acne. Women who have sensitive androgen receptors are at risk of experiencing acne breakouts well into adulthood. Up to 26% of women in their 30s deal with hormonal acne breakouts and even women who go through perimenopause will deal with acne thanks to hormonal fluctuations.

Certain risk factors can also contribute to adult acne flare-ups:

  • Hormone fluctuations
  • Diet
  • Some medications
  • Makeup that clogs pores
  • Frequently touching or rubbing the skin
  • Having a family history of adult acne

Dairy and also high-glycemic index foods can worsen acne. It’s crucial that women who are prone to acne know their food triggers.

Acne is triggered by excess sebum, or oil, on the skin. A group of hormones called androgens is what stimulate the glands in the skin to produce sebum. Excess sebum traps skin cells and bacteria in the pores, and sebum itself clogs pores. The ovaries and the adrenal glands produce androgens, and higher levels of androgens, and also having a sensitivity to androgens can cause breakouts. Stress can also trigger the adrenal glands to produce more hormones, which in turn can cause acne flare-ups.

Signs of hormonal acne include the following:

  • A woman is in her 20s, 30s, or 40s and experiencing breakouts.
  • Acne recurs around the same time every month.
  • Acne is painful, deep cysts and not whiteheads or blackheads.
  • Pimples tend to recur in the same spot each time.
  • Pimples are around the chin, jawline, neck, or sides of the face.

Because hormonal acne manifests as deep, painful cysts, it’s not always possible for someone to manually extract the bacteria and oil from the skin. Cystic, hormonal acne is inflammatory and often requires a clinical approach to treatment. Topical ointments or other treatment methods usually will not work when it comes to hormonal acne. Attempting to manually extract deep hormonal acne can cause severe pain and also permanent scarring.

Non-inflammatory acne, or acne not related to hormonal breakouts, are whiteheads, blackheads, and open or closed comedones.

How can birth control treat acne?

Taking birth control pills, or other forms of hormonal birth control decrease hormonal fluctuations, delivering a steady dose of hormones throughout the month. Also, birth control pills contain both estrogen and progesterone, which lower the number of androgens in a woman’s body, resulting in less sebum, and less acne.

Many different studies have found that some birth control pills are effective at treating both inflammatory, hormonal acne, and noninflammatory acne.

What types of birth control are used to treat mild to severe acne?

Currently, the FDA has approved only 3 birth control pills to treat acne: Ortho Tri Cyclen (discontinued), Estrostep, and Yaz. However, research has shown that ANY birth control pill can improve acne. So you do NOT have to use the 3 that spent the money to get tested and approved for acne. Each one is a combination pill, in that they use both estrogen and progesterone hormones.

Beyaz and Yaz contain drospirenone, a progesterone with a theoretical diuretic effect. Women with a history of blood clots or who have risk factors for blood clots should not take any birth control with estrogen.

It may take a few months after starting birth control pills to see any noticeable decrease in acne. Also, it is common for many women to experience an initial flare-up of acne after starting birth control, but it should eventually go away. The reason it takes a while for acne to go away after starting birth control pills is that it can take the body a few months to get used to the new hormones.

It’s important to note that birth control pills for acne work by decreasing the extra male hormone circulating in the blood. Women who have more severe acne will need to use topical medications like treinoin cream or other acne treatment products (like topical or oral antibiotics) to get the best results.

Is severe acne always a sign of polycystic ovary syndrome (PCOS)?

Severe hormonal acne can be a sign of PCOS, but not always. PCOS affects one in ten women but is usually accompanied by other symptoms, not just acne. Irregular periods, excess facial and body hair, and trouble losing weight are some of the most common symptoms for PCOS. Going on birth control pills can help balance the hormones that cause PCOS symptoms.

What birth control makes acne worse?

Birth control pills that only contain progesterone hormones, otherwise known as the mini pill, will make acne worse. Women who suffer from acne breakouts should steer clear of these contraceptives.

Fortunately, women can find relief from painful, annoying breakouts with birth control pills. With four different types of birth control pills to choose from, it’s possible for any woman to find a pill that will work for her lifestyle and treat acne effectively. If you’re concerned about acne flare-ups, talk to your doctor about getting started with safe, effective birth control for hormonal skin problems.

Disclaimer: The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.

updated 1.22.2020