How do birth control pills help with acne?

(This article is part of our new series – “A closer look at medical treatments for acne.”)

For women under the age of 35 who have moderate acne that is partly caused by a hormonal imbalance – signs include pre-menstrual acne flare upsirregularities in periods and acne on the jawline or neck – certain birth control pills can help and offer a long term solution.

These pills can do double duty – help to control acne and provide birth control. Today’s birth control pills contain lower doses of hormones. Some ‘low dose’ estrogen pills and combination pills with estrogen and progestin can help. The ‘mini pill’ containing only progestin is likely to make acne worse. Discuss the choice of pill with your physician.

There are 2 main drawbacks. Firstly, it takes up to 6 months to see significant results. However, there should be visible improvement at 3 months. Secondly, there are well-known, potentially serious side effects associated with the use of birth control pills.

*The birth control pill is generally prescribed in combination with other acne treatments such as topical (applied to the skin) treatments.

How these work: Birth control pills alter the hormonal balance in the body and reduce the level of male hormones, in particular testosterone. Testosterone, present in males and females, is a major culprit in acne because it stimulates the oil glands to enlarge and produce excess oil that combines with dead skin cells to clog the pores.

Side Effects: There are many well-known side effects associated with birth control pills such as weight gain (by causing increased appetite), nausea and mood swings. Less common but serious side effects include blood clots, stroke, headaches, high blood pressure and depression. Read all drug safety information provided.

Dos and Don’ts – Not for smokers, those who get migraine headaches (especially with aura) or are obese, diabetic, epileptic, have a history of blood clots or strokes, have high blood pressure or are at risk for breast cancer.

Expect results: from 3 – 6 months.

See a complete list of the many treatments available for moderate acne at How do I treat moderate acne?

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