Pimples. Blemishes. Spots. Whatever term you use to describe those painful, persistent bumps on your face or body, one fact remains: Acne is a common problem for many people—up to 50 million Americans—way beyond their teenage years. According to a study published in the Journal of the American Academy of Dermatology, adult acne affects a wide range of age groups: 50.9% of women in their 20s, 35.2% of women in their 30s, 26.3% of women in their 40s, and 15.3% of women 50 years of age and older.
Acne is a skin condition that occurs when a hair follicle becomes clogged with dead skin cells or sebum (oil), leading to whiteheads, blackheads, and pimples. For adult women, fluctuating hormone levels (specifically increased levels of androgens, such as testosterone) are often to blame for these breakouts, which are also known as hormonal acne. Women typically experience acne-causing hormonal shifts during puberty, menstruation, menopause, and due to conditions like polycystic ovarian syndrome (PCOS).
To treat your hormonal acne, a dermatologist may prescribe birth control pills.
Which birth control is best for hormonal acne?
There are several hormonal birth control methods on the market. Oral contraceptive pills remain one of the most popular forms. There are two types of birth control pills: combination pills (which contain both hormones estrogen and progestin) and minipills (which contain only progestin). Different forms of hormonal birth control include:
- implants (aka Nexplanon),
- IUDs (including Mirena, Kyleena, Liletta, and Skyla; plus copper versions that don’t contain hormones),
- the ring (aka NuvaRing),
- the Depo-Provera shot
To treat acne, a dermatologist will prescribe a combined oral contraceptive pill, which contains both estrogen and progestin. (Pills with just progestin can actually make acne worse.) The Food and Drug Administration (FDA) has approved four birth control pills for acne treatment: Ortho Tri-Cyclen, Estrostep, Beyaz, and Yaz.
How does birth control help with acne?
Combination birth control pills help with acne by preventing androgen levels from spiking, which, in turn, keep sebaceous glands from producing too much oil and clogging pores. The estrogen component here is key—progestin on its own won’t work, which is why minipills aren’t approved for the treatment of acne.
What is the best birth control pill for acne?
The best birth control pill for acne is a combination pill—one that contains both estrogen and progestin. The FDA has approved four such birth control pills for the treatment of acne: Ortho Tri-Cyclen, Estrostep Fe, Beyaz, and Yaz.
The type of progestin the pill contains can also affect a birth control pill’s efficacy, per a study in the Journal of Drugs in Dermatology. According to their findings, drospirenone (the progestin found in Yaz) was the most helpful in preventing acne, while levonorgestrel and norethindrone (the progestins found in Levora and Lo Minastrin Fe, respectively) were the least helpful.
In fact, one combination birth control pill that contains norethindrone acetate, Lo Loestrin (Lo Loestrin coupons | What is Lo Loestrin?), can actually cause breakouts (acne is listed as one of its side effects), so it should probably not be taken if you are looking to clear up skin problems. Bottom line: Not all birth control pills treat acne or treat it with the same level of effectiveness.
How long does it take the pill to clear acne?
Once you begin taking birth control pills, it could take several weeks to months to see a difference in your skin. Many studies show some improvement at three months with the greatest improvement evident at six months. This is because the pill needs some time to recalibrate the hormone levels in the body that cause acne.
There are a handful of side effects associated with birth control pills. Headaches, nausea, menstrual irregularities (such as spotting in between periods), weight gain, and breast tenderness are the most common. Although rare, a more serious side effect is the risk of deep vein thrombosis—in which a blood clot forms in your vein, often in the thigh or lower leg.
If birth control pills do not clear up your acne, your doctor may prescribe another kind of medicine to clear up your skin. Topical treatments such as benzoyl peroxide and retinoids, particularly used in conjunction, have been shown to be effective in fighting pimples. Meanwhile, the high blood pressure medicine spironolactone, though not FDA-approved to treat acne, has been shown to be effective, especially among women. Spironolactone should generally not be used in conjunction with oral birth control products containing the progestin, drospirenone, due to increased risk of adverse effects. In some severe cases, your dermatologist may consider isotretinoin (Isotrentinoin coupons | What is Isotrentinoin?), a vitamin A derivative most commonly known under its former brand name of Accutane. Of course, these medicines all come with their own side effects, so you’ll want to speak to your docto r to find out if they’re right for you.