Whether you just get a pimple or two the day before your period or have a constant struggle, acne is a frustration that can cause embarrassment and anxiety for many women. Acne can be triggered by excess oil production, which can clog pores and promote bacteria growth. Many treatments exist, both topical and oral, that target different portions of the process leading to acne. One very effective treatment is birth control pills. Combined birth control pills (those containing both estrogen and progesterone) have been shown in many studies to cause decreased acne flare-ups, fewer pimples, less inflammation and less severe acne.

HOW IT WORKS

Birth control pills work to improve acne mainly by reducing the amount of androgens (male-type hormones, including testosterone) in your bloodstream. This occurs as a result of your liver increasing its production of a protein called sex hormone-binding globulin, which binds androgens making them inactive. This is beneficial, as oil-producing glands in the skin are stimulated by androgens. For some, the pill will also decrease the amount of androgens made by the ovary, additionally decreasing oil production in the skin. It can take a few months on the pill to maximize these effects.

WHICH PILL IS RIGHT FOR ME?

There has been an explosion in the number of new birth control pills in the past decade and few have been directly studied for their effect on acne. Currently, only 3 types have been FDA approved for treating acne: Ortho Tri-Cyclen, Estrostep and Yaz. However, all combined pills will likely have some effect. The degree of improvement can depend on the type of progesterone in the pill, since some types directly cause more androgen-like effects than others.

SIDE EFFECTS

While birth control pills are a safe and effective way to decrease acne (and prevent pregnancy) for many women, there are some side effects and risks of this hormonal treatment. Some women experience headaches, nausea, breast tenderness and mood changes, which may improve or resolve with switching to a pill with a different dose or type of progesterone. All combined birth control pills can mildly increase the risk of blood clots, such as a deep vein thrombosis or stroke. This increase is small overall, but may be of concern if you have another risk factor for clots such as smoking, obesity or a significant family history of clots. Recent studies also indicate that some types of progesterone may have a higher risk of clotting than others, although these differences are likely very small.

OTHER BENEFITS OF THE PILL

Birth control pills have other benefits, such as decreasing amount of menstrual bleeding, cramping and premenstrual symptoms, and have also been shown to cut the risk of ovarian cancer in half if taken for >5 years. If you are interested in learning more or think birth control pills might be a good option for you, come in for a discussion with your doctor or nurse practitioner.