For years, you’ve tried all the OTC cleansers and creams to clear up acne, but so far nothing’s been able to really zap the zits. Could birth control be the clear skin solution you’ve been looking for?
It’s a definite possibility. Birth control pills are considered a first-line alternative to antibiotics for treating acne in women, concluded a review of 32 trials. So they’re certainly worth bringing up with your doc.
How exactly does BC help though — and are some pill types more effective than others? Here’s a look at the benefits of birth control for acne, the side effects you should consider before going on it, plus other treatment options that may be worth considering.
Birth control pills use combinations of the hormones estrogen and progestin to prevent your ovaries from releasing an egg during your monthly cycle.
Without an egg hanging around, there’s nothing for sperm to fertilize, so you can’t get pregnant. (Most of the time anyway. No contraception method is foolproof, including the pill.)
It’s that same combo of hormones that can help keep breakouts at bay. Before getting into why, it helps to understand a little about how acne works.
Acne is a skin condition where hair follicles on the skin get clogged with oil and dead skin cells, leading to the formation of blackheads, whiteheads, and pimples.
The clogs tend to form when the skin produces too much oil, a problem that’s usually rooted in high levels of hormones called androgens.
That’s where oral contraceptives come in. The estrogen and progestin in birth control pills can lower androgen levels and tamp down excess oil production. With less oil around, follicles are less likely to get clogged — which results in fewer breakouts.
Not every birth control pill will work for acne. In order for it to be effective, the pill needs to contain both estrogen and progestin. These are called combination pills. Low-dose pills that only have progestin — like the minipill — won’t get the job done.
Four combination birth control pills are FDA-approved to treat acne:
- Ortho Tri-Cyclen
- Estrostep Fe
All of these pills contain estrogen and progestin, but each one has other active ingredients as well. In terms of their ability to fight acne, research shows that they all seem to work about the same. Your doctor can help you figure out which option is worth trying first.
Your doctor might also recommend using another combination birth control pill off-label to treat your acne. The different hormones in combination pills can play a helpful role in fighting acne and related skin inflammation, a 2018 review concluded.
An older review found that pills containing drospirenone are more effective than ones with norgestimate or nomegestrol acetate plus 17 beta-estradiol.
What about other hormonal birth control options — can they treat acne too? Sorry, the answer seems to be no.
Birth control shots, like Depo-Provera, are one of the most effective options out there for preventing pregnancy. As far as acne goes, it hasn’t been shown to do a thing. And hormonal IUDs like Mirena can actually increase the chances of acne, findings show.
Birth control won’t get rid of your acne overnight. (Wouldn’t that be nice?) It generally takes between 2 and 3 months to see results. That can feel like a long time, sure. Once the effects kick in, they should keep your skin clear for as long as you keep taking the meds.
Combination birth control pills can be a great option for getting your acne under control. But the pill, just like other meds, comes with side effects. It’s important for you and your doctor to weigh your personal pros and cons before you start on a prescription.
Taking birth control pills could increase the risk of:
- weight gain
- breast tenderness
- spotting in between periods
- melasma, or dark patches on the face
- high blood pressure
- blood clots
- heart attack
While some of those sound scary, the risk of serious side effects, like blood clots, is small if you’re young and healthy.
Some people may need to use caution when using birth control pills. You shouldn’t take them for acne if you:
- are over 35 and smoke
- have high blood pressure
- have a history of migraine, blood clots, or abnormal uterine bleeding
- have a history of breast cancer, heart disease, or liver disease
Also: Not every pill causes exactly the same side effects, and some women respond differently to certain pills. If you have a specific side effect concern, your doctor might opt to recommend a certain type of pill over another. If the side effects from one pill become an issue, you can talk to your doctor about trying a different one.
Combination birth control pills aren’t the only way to treat acne. If they don’t help your skin or you’d rather try something else first, there are other options worth discussing with your doctor. Some of these can be used in tandem with birth control for a one-two punch approach, too.
Non-BC acne treatments include:
- Antibiotics. Oral ones like minocycline, doxycycline, or macrolide can fight bacteria and inflammation on your skin. They work best in combo with topical treatments.
- Spironolactone. This drug is made to treat high blood pressure, but it’s often used off-label to treat acne in women, sometimes in combo with birth control pills. (Men can’t take spironolactone for acne due to side effects.) It works by blocking the effects of androgen hormones, thwarting oil production.
- Isotretinoin. This oral med can be a powerful tool for fighting acne. But it comes with serious side effects like ulcerative colitis, depression, and even suicidal thoughts. So it’s only recommended if you’ve exhausted all your other options.
- Skin treatments. Laser therapy, chemical peels, extractions, and steroid injections can all be performed while you’re taking other treatments. The effects tend to be temporary, though.
Combination birth control pills containing estrogen and progestin can balance out wonky hormone levels and decrease excess oil production. That, in turn, can help clear up acne and keep blemishes at bay.
If you think the pill might be a good option for your skin issues, talk with your doctor. They can help you weigh the pros and cons in terms of side effects and help you figure out which type of pill the best for you.