Will A Birth Control Pill Control Your Acne?
Millions of women take oral contraceptives so they can plan pregnancies. Most women discover that when they go on the Pill their skin changes, and the right formulation of the Pill can sometimes cure premenstrual acne. Your doctor has to prescribe the best brand of the Pill for your health and your personal choices, but here is the information you need to know before you ask for a different brand of oral contraceptive for acne.
- Testosterone causes increased skin oil production in both sexes, but women’s skin also responds to progesterone.
- Among women in their reproductive years, progesterone production is greatest after ovulation, during the second half of the menstrual period.
- Increasing estrogen production at the beginning of the period normalizes production of oil and tightness of the skin, relieving acne until progesterone levels once again go up around the time the woman ovulates.
- The contraceptive Pill can help relieve acne by supplying estrogen.
- A contraceptive Patch, however, delivers estrogen more reliably allowing the use of a smaller dose. This reduces side effects.
- Acne usually does not begin to clear up until a woman has been on the Pill or the Patch for three months.
- Even when women used hormone-based contraception, they still need regular skin care to prevent acne. An acne treatment system like Exposed Skin Care combined with appropriately prescribed contraception may greatly accelerate healing of acne-prone skin.
What Is the Relationship Between Hormones and Acne?
Many women of reproductive age notice that they break out with pimples just before they have their periods. The reason acne is in sync with the menstrual cycle is that estrogen and progesterone change the flexibility of the skin.
During the first half of a woman’s period, her ovaries release more estrogen in usual so that the lining of the uterus can thicken to receive a fertilized egg. Estrogen levels continue to increase during the first 10 or 11 days of a 28-day period, until the woman ovulates. Then, the corpus luteum begins releasing progesterone either to prepare the womb for the implantation of the embryo or to remove the lining of the uterus so the cycle can start all over again.
Estrogen opens the skin. Progesterone thickens the skin. Estrogen cools a woman’s core body temperature. Progesterone increases a woman’s core body temperature.
As a woman’s estrogen levels increase, her pores open and acne heals. As a woman’s progesterone levels increase, her pores tighten and pimples can pop out. The cycle continues month after month until menopause.
How the Pill Affects Acne
The contraceptive Pill stops ovulation but, in typical doses, does not stop menstruation. A woman who does not ovulate cannot get pregnant. The Pill stops ovulation with a combination of synthetic estrogen and progestin, a chemical similar to progesterone. Different brands of the Pill contain different amounts of estrogen and progestin.
When women receive added estrogen during the third week of their periods, their core body temperature does not increase as much and their skin produces less oil. These changes do not guarantee that pimples won’t break out, but usually the right brand of the Pill can reduce the total number of blemishes by 45% to 65%. The Pill is not a cure for acne, but it usually helps.
So Why Not Take a High-Estrogen Oral Contraceptive for Acne?
Larger amounts of estrogen have greater effects on the skin. The problem with supplemental estrogen is that it can have far-reaching effects on women’s health. Estrogen can increase risk of breast cancer and cancers of the ovaries and uterus. It can increase risk of blood clots, heart attacks, and stroke. It also cause fluid retention and weight gain.
Most doctors try to minimize the side effects of estrogen by giving women some brand of the Pill plus antibiotics. Antibiotics, however, also have side effects. The most commonly prescribed acne antibiotic in the US, minocycline, can cause staining of the teeth in women under the age of 22. The most commonly prescribed acne antibiotic in Canada, clindamycin, often causes abdominal pain and diarrhea. Other antibiotics have side effects ranging from flatulence to kidney failure, and no antibiotics gets rid of every pimple. Usually about 20% of pimples remain after a month or more of antibiotic therapy, and acne can come back with a vengeance when the antibiotic is discontinued.
Another Approach to Hormonal Management of Acne
The Pill, however, is not the only way to control fertility and manage skin health at the same time. Many women report that a contraceptive Patch gets better results for a variety of reasons.
- Teenaged girls who are on the Pill often forget to take it. In any given month, one survey found, about 1/3 of teens (and a little over 10% of women over the age of 30) forget to take a Pill. The Patch only has to be changed once a month, if it does not fall off the skin. About 1% of contraceptive Patches have to be replaced because the adhesive fails.
- Because the hormones in the Patch do not have be processed through the digestive tract, dosing is more predictable and reliable.
- Younger women, in particular, experience less dysmenorrhea and fewer heavy periods when they use the patch.
- The kind of estrogen used in the Patch, norgestimate, slows down the conversion of testosterone into 5-alpha-testosterone, the form of the hormone that stimulates skin oil production and unwanted hair growth.
- This kind of estrogen reduces the response of the skin (and uterus) to progesterone during the second half of the user’s menstrual period. This keeps the skin from producing excessive oil and also reduces the likelihood of heavy periods.
The effects of the Patch on acne are not immediate. They are usually not seen until the fourth month. The Patch also can cause some undesirable side effects. Like Pill users, Patch users may experience irregular vaginal bleeding when they first start the drug. Some women are concerned about the appearance of the patch when they are nude. (The Patch is usually applied to the lower abdomen or the buttocks.) There can be a dark circle on the skin around the patch, although this is usually caused by the adhesive and can be resolved by carefully washing the skin. For ease of use, however, most women prefer the Patch over the Pill.
Should You Get the Patch for Acne?
No matter whether you take the Patch or the Pill, chances are that you will continue to have some acne blemishes. The younger you are, the more blemishes you will have.
Even if you are on hormonally based contraception, you still need to cleanse and exfoliate your skin to keep acne to a minimum. Combining the Patch or the Pill with a complete acne treatment system like Exposed Skin Care, however, may completely resolve your acne. Or if it doesn’t, Exposed Skin Care will give you your money back.