Christopher Jacoby When other measures can’t control your acne outbreak, you should consider using birth control pills. They can help to even out the fluctuating levels of progesterones and estrogens. Oral contraceptives can be a good choice if:
- You are sexually active and want birth control pills
- You need oral hormonal therapy to work on your menstrual cycle
- You are prescribed with Accutane
Many women with moderate cases of acne often discover that these pills may bring their acne symptoms under control. More severe acne cases may also be treated with contraceptive pills if combined with medical and topical therapies.
If you’re disinclined in using birth control pills or other contraceptive methods for religious or moral reasons, anti-androgens or other alternative treatments, such as lights or laser can be considered. Some hormonal birth control using ring or patch can have unpredictable effects on acne and may actually provoke it. Depo-Provera, an injection that contains synthetic progesterone, may worsen or trigger acne outbreak at times. Birth control pills may bring both positive and negative side effects to acne. Talk to your skin specialist to decide whether this step is good for you.
Birth control pills can prevent pregnancy in women who are given Accutane (isotretinoin), unless they underwent hysterectomy or can’t get pregnant due to some physical reasons. Accutane is a potent drug for treating serious acne, however it is associated with birth defects. Other than abstinence, birth control pills can be considered as the favored method of contraception for those who are taking Accutane.
Suppressing the Acne Cycle With Oral Contraceptives
Oral contraceptives are available since 1960s. They stop ovulation and prevent a fertilized egg from attaching on the uterus wall.
Oral contraceptives can block the androgens effects on your sebaceous follicles. Oral contraceptives introduce additional estrogen, which manages menstruation. Besides preventing ovulation, the extra estrogens may help cure your acne by:
- Reducing the production of ovarian androgen
- Blocking the androgen production due to the stimulation of sebaceous follicles
Estrogen can decrease the androgen levels by boosting the production of SHBG (sex hormone binding globulin), a protein that “clears up” your free testosterone and prevent the stimulation of acne-producing oil glands. Oral contraceptives that can be helpful in managing acne should contain a combination of synthetic progesterone (progestin) and estrogen.
Progestin-only pills show less side effects compared to combination pills. However, it may have unpredictable effects on acne. Progestins can also display androgenic effects (acting like male hormones). Latest generations of progestins often have less androgenic activities and have better chance in improving your acne. For women over 35 years, have bad migraine, or heavy smokers, birth control pills with estrogen aren’t appropriate.
Using the Best Contraceptive Pills for Acne
Contraceptives pills may improve your acne problem even if there is no evidence of abundant androgen production. As a matter of fact, the testosterone level in women with acne problem is usually within the normal range, however the level can be further lowered and even be blocked if you are taking the correct pill.
Most dermatologists advise the use of contraceptives pills with minimal effective androgenicity. These drugs improve the production of SHBG and thus lower androgen level in healthy females.
The oral contraceptives Yasmin, Ortho Tri-Cyclen, and Estrostep are excellent if you have acne. In the case of, Yasmin, other than the presence of estrogen, it contains drospirenone, (a progestin) which is nearly similar to spironolactone, a very effective anti-androgenic hormone. Most dermatologists feel that it is the most potent oral contraceptive available when it comes to treating acne.
Several of these pills have convenient dosing schedules and each package holds 28 tablets. 21 of them are active pills; which contain hormones or other active ingredients. The last 7 tablets have inactive ingredients and use different color.
Read the labels and follow the indicated directions. Other contraceptives pills that have low androgenicity including Levlen, Levlite, Triphasil, Seasonale, Tri-Alesse and Desogen.
Diane-35 is available Canada and Europe, it is also very effective in treating acne, but it is currently unavailable United States. It has cyproterone, a potent progestin and androgen receptor blocker. Be patient when using them, you may need to wait for three months before seeing positive results.
Watching for Side Effects
Although early generation of contraceptive pills had a few side effects, they have been modified to limit their risks. Often, the worst side effect of contraceptive pills was blood clots (thromboembolism) that appear in leg veins. However, minimal dosages of estrogens in pills can eliminate any potential complication, like:
- Nausea, bloating, abdominal cramping, or vomiting: These are the most likely minor side effects, it happens when your body is adjusting itself to the drug.
- Headaches: They tend to be tolerable, but if they become serious, discuss it with your doctor.
- Breakthrough bleeding and spotting: Spotting or irregular vaginal bleeding may happen if you take the pills.
- Slight weight gain: It may happen due to higher appetite.
- Mood swings (anxiety, depression): Hormonal disruption after taking these pills may result in lower libido and mood swings.
- Breast tenderness: Tender, swollen breasts and/or non-cancerous breast lumps may occur.
Notify the doctor if you have early problems with your breasts such as fibrocystic breast disease or lumps. But most studies indicate that these pills neither increase nor reduce the risks of breast cancer. Early detection is important in treating breast cancer. Doing breast self-examination is easy, and you can get better after a few tries. Better yet, mammography with the latest MRI machine can find smaller tumors that may not be easily detected by touches.
If you are taking contraceptive pills, you should understand about possible risks while performing regular breast exams and Pap smears. A Pap smear session examines cervix cells for abnormal changes, which might lead to cancer. Birth control pills that contain a combination of progestin and estrogen seem to lower the risk of ovarian and uterine cancer. The effect of contraceptive pills is unpredictable and you may need to try several different products before choosing the one that is good for you.