Can Birth Control Pills Really Cure Acne?
Many women find that acne clears up when they go on the contraceptive Pill. For some women, however, oral contraceptives have a minimal effect on blemished skin. This article explains why most women who have acne get clearer skin but some do not.
- Many women of reproductive age break out with acne just before they get their periods.
- Increasing estrogen levels decreases the production of sebum in the skin.
- Increasing progesterone levels increases the production of sebum in the skin.
- Contraceptive pills are usually a combination of estrogen and a chemical that is similar to progesterone, and often control acne breakouts.
- Increasing the amount of estrogen in a contraceptive pill to fight acne can have other serious side effects.
- In the US, the Bayer birth control pill branded as Yaz is the most popular treatment for premenstrual acne.
- The Pill does not usually eliminate acne. It just reduces the number of blemishes by 40 to 60%.
How Hormones Interact with the Skin
Throughout a woman’s reproductive years, there is a constantly changing balance of hormones that supports the potential for conception, pregnancy, and birth. At the beginning of a woman’s menstrual cycle, the pituitary gland in the brain secretes a hormone called follicle stimulating hormone, or FSH. This hormone causes one or more follicles in the ovary to ripen so that they can release their eggs at ovulation.
The follicles secrete estrogen, which thickens the lining of the uterus. Small amounts of estrogen inhibit the pituitary gland in the brain from secreting luteinizing hormone (LH), but when estrogen levels build up high enough, the pituitary sends a pulse of LH to cause the follicle or follicles to break open, releasing the egg inside.
The egg is viable for only about 24 hours, and sperm has to be on its way to the egg before ovulation for natural conception. More often than not, the egg is not fertilized before it degenerates. Then the corpus luteum left behind in the ovary when the egg has been released begins producing another hormone called progesterone.
This hormone changes the lining of the uterus so that it could accept a fertilized egg, and also raises a woman’s core body temperature. If there is no implantation of a fertilized egg into the lining of the uterus, it sloughs off in menstruation, estrogen levels rise, and the cycle starts all over again.
When a woman’s core body temperature rises, acne tends to break out. Progesterone also increases oil production in the skin, so that most women who get this form of hormonal acne break out just before their period. Estrogen decreases the production of oil in the skin so that acne heals, at least until it builds up in the second half of the menstrual period, all over again.
How Birth Control Pills Affect Acne
Most birth control pills are a combination of estrogen and progestin, a synthetic chemical that is not progesterone but that has effects similar to progesterone. The combination of the two hormones keeps the brain from ever sending the ovaries a signal to mature an egg and ovulate. There are many different brands of birth control pills containing varying amounts of the two hormones. It’s the estrogen in the Pill that prevents acne.
The problem with estrogen is that too much estrogen increases risk of blood clots, heart disease, and cancers of the breast and uterus. High-dose estrogen can itself actually cause acne, by increasing sensitivity to testosterone. Newer forms of synthetic estrogen, however, are strong enough to prevent ovulation acne, but weak enough not to increase a woman’s sensitivity to her body’s testosterone.
How Effective Is the Pill in Treating Acne?
Most studies of oral contraceptives as treatments for mild to moderate acne in women of reproductive age have found that taking the Pill reduces the total number of whiteheads, blackheads, and pimples from 40% to 60%. Oral contraceptives are not a cure for acne, not even for premenstrual acne. They can, however, make it a lot better.
Finding the right combination of estrogen and progestin sometimes requires trial and error. Extra estrogen does more to prevent acne breakouts, but can also cause breast tenderness, bloating, weight gain, nausea, and headache. Too much progestin increases sebum production in the skin, and also causes weight gain, fatigue, and breast pain. Women who have Asian skin types may experience less acne but more brown spots when acne heals. All of these problems, of course, also have to be considered when the primary goal for using the Pill is contraception.
The Pill and Antibiotics Together to Treat Mild Acne
Many doctors try to minimize side effects from contraceptives by treating acne with a combination of the Pill and tetracycline antibiotics. This also can cause important health issues.
Tetracycline should be taken on an empty stomach, and can’t be taken with dairy products. In the United States, most doctors consider it to be safe for treating acne in anyone over the age of 8. In Canada and in Europe, most doctors won’t give it to anyone under the age of 22 out of concern for permanently staining the teeth at the gum line, creating a condition know as “blue smile.” The staining is as likely to be black as it is to be blue.
Is Yaz for You?
In the United States, when doctors don’t use a combination of other brands of contraceptives and tetracycline to treat acne in women of reproductive age, they most often write a prescription for the Bayer product Yaz. This brand of birth control is well known for its ability to clear up mild acne in women.
But because it also contains a chemical known as drosperinone, it can also cause a buildup of potassium in the bloodstream—a potentially serious side effect. This means that if you use Yaz, you should be careful not to eat too many high-potassium vegetables and fruits, such as tomatoes, bananas, and citrus fruit.
Should You Start Oral Contraceptives to Control Acne?
Doctors sometimes put girls as young as eight on the Pill to control acne, although many American parents object to introducing sexual freedom at too young an age. Women who are old enough to make their own sexual choices, however, may consider going on the Pill to help their complexions.
Generally, this is a bad idea. It is better to go on the Pill because you want to avoid pregnancy. Then after you have chosen oral contraception, see if there are brands that are better for your skin, but rely primarily on proven acne care methods to keep your skin clear. Even when the underlying cause of acne is swings in hormones, pimples and blemishes are never inevitable.
Whether you use oral contraception or not, you can control acne with comprehensive cleansing offered by a system such as Exposed Skin Care.