Acne is a potential side effect of all hormonal birth control methods including birth control pills, the patch, the depo-shot, and the NuvaRing can all cause acne or make it worse. However, many people who take birth control report that hormonal birth control methods improve their skin. In fact, some combination birth control pills are so effective that they are prescribed to resolve problem skin.
How Can Birth Control Cause Acne?
The ovaries and adrenal glands produce androgens, a group of hormones that produce sebum. This oily substance is secreted by the pores to lubricate and protect the skin and remove dead skin cells. When skin is clear, the ovaries and adrenal glands produce the perfect amount of androgens. If they produce too much, the body makes too much sebum. Too much sebum clogs pores, causing bacterial growth which triggers acne. There are two main types of this skin condition:
- Non-inflammatory acne: Acne which isn’t inflamed or swollen. Blackheads and whiteheads are common types of non-inflammatory acne.
- Inflammatory acne: Acne which is sore, red, and swollen. Papules, pustules, nodules, and cysts are the key types of inflammatory acne.
Hormonal birth control impacts hormone levels. Whenever you change hormone levels, there’s a chance it could interfere with the way your body should work. While many people report clearer skin after starting birth control, taking birth control can also have the opposite effect and cause non-inflammatory and inflammatory acne. Birth control pills containing the androgen progestin (the manmade version of progesterone) are more likely to cause acne than other forms of birth control. Some of the most common are Norgestrel, Norethindrone acetate, and Levonorgestrel.
It’s also common for women who start taking birth control to have an initial acne flare as their bodies adjust to the hormones. After two to three months, most women find their bodies adjust to the hormones and their skin settles down.
What Else Causes Acne?
Birth control certainly isn’t the only factor that can trigger acne. The following things can also make non-inflammatory and inflammatory acne flare:
- Natural hormonal changes during puberty and adulthood.
- A history of acne in your family.
- Use of steroid medications, including prednisone.
- Cosmetics that clog the pores.
- Rubbing or placing pressure on skin.
- A yeast infection of the hair follicles.
- Irregular hygiene habits.
- Ingrown hairs.
What Birth Control Can Improve Acne?
Combination birth control pills and other birth control methods containing both progestin and estrogen have proven very effective in controlling both non-inflammatory and inflammatory acne. The mix of hormones help reduce androgens in the body. This, in turn, reduces sebum production, so pores are less likely to get clogged and acne is less severe, or eliminated entirely.
While anecdotal evidence suggests a variety of birth control methods may improve acne, the U.S. Food and Drug Administration has approved only the following four birth control pills for treating moderate acne in menstruating females at least 14 or 15 years of age (depending on the brand) who require contraception. If you are concerned about your skin, these pills are good options:
- Ortho Tri-Cyclen (also known as Tri-Sprintec): contains norgestimate and ethinyl estradiol.
- Estrostep Fe: contains norethindrone acetate, ethinyl estradiol, and ferrous fumarate.
- Beyaz (also known as Drospirenone-Ethinyl estradiol levomefolate): contains drospirenone, ethinyl estradiol, and levomefolate calcium.
- Yaz (also known as Drospirenone-Ethinyl estradiol): contains drospirenone and ethinyl estradiol.
The authors of a 2012 review by Cochrane Reviews suggest combination pills containing cyproterone acetate were the most effective at treating acne. Combination pills containing drospirenone were second-best, followed by pills containing norgestimate or nomegestrol acetate plus 17 beta-estradiol. The differences in performances were only marginal though, with the study’s authors suggesting they shouldn’t even be considered when determining which combination pill to use.
While they do not yet have FDA approval, studies show Yasmin and Alesse (also known as Lutera) can also reduce acne. Other reports state all combination pills can effectively clear up problem skin. Evidence also suggests the depo-shot, the patch, and the NuvaRing can also improve skin.
These birth control options can only reduce the level of sebum secreted through the skin, which is usually just part of the problem. You should get the best results if you use them in conjunction with other acne treatments, which can help neutralize the impact of diet, cosmetics, dirt, and other environmental factors which can also cause acne.
What Can I Do If My Birth Control Caused Acne?
If you think birth control has caused your acne, you may want to discuss your options with a Nurx™ medical expert. The Nurx medical team may suggest some of the following options:
- Switching to one of the birth control pills likely to improve acne.
- Switching to a non-hormonal form of birth control.
- Using over-the-counter skincare treatments, such as cleansers and face lotions containing salicylic acid and topical retinoids.
- Avoiding picking or squeezing the pimples, which could leave scarring.
- Eating a low glycemic index diet with fewer carbohydrates, gluten, and dairy.
- Change to water-based or oil-free cosmetics.
- Always shower after exercise to remove bacteria from the skin.
You shouldn’t expect to see immediate results, even if you change your birth control. It takes around three months for your hormones to regulate themselves and get used to any changes you’ve made. Resist the urge to try too many over-the-counter products at once. This can dry out the skin, which makes the pores produce more sebum which can actually make your acne worse.
If these methods don’t work, medical experts may recommend you try a prescribed topical cream or oral medication. Stronger topical retinoids, products containing benzoyl-peroxide, and isotretinoin (Sotret) can all help clear up skin impacted by severe acne.
You may also like to confirm that your skin is really impacted by acne. There are several other skin conditions that can cause bumps similar to acne. If the treatments above don’t work, talk to your medical care provider to determine whether you have another condition, such as:
- Keratosis pilaris.
- Sebaceous filaments.
- Sebaceous hyperplasia.