Acne is often associated with hygiene, but in reality it is tied more to hormonal imbalances. In women, oral contraceptives are often recommended as a means of controlling acne, but is it safe to take birth control pills for acne? Read on to learn more.
How Birth Control Pills Work
Birth control pills comprise of synthetic hormones that work to:
- Prevent the ovaries from releasing eggs
- Altering the consistency of cervical mucus to prevent sperm from even reaching the egg
- Changing the uterine lining to prevent fertilization1
Birth control pills generally come in two forms. Combination pills contain synthetic forms of estrogen and progesterone, while mini-pills contain only progestin (a synthetic form of progesterone).1
How Birth Control Can Help Hormonal Acne
While acne is a culmination of several different factors, hormones often play an integral role in acne development. For women, the main culprit is high testosterone levels. Although testosterone and other androgens (male hormones) have a role in women’s health, high androgen levels stimulate sebaceous oil gland activity in the skin. With increased activity, pores can clog up and become pimples.2 Puberty is time that androgen levels are higher and is often associated with acne breakouts.
However, puberty is not the only time that women get acne. Acne breakouts can coincide with menopause and menstrual periods because these are periods when estrogen levels are lower while androgen levels stay the same. This causes a state of relative hyperandrogenism (higher androgens relative to other sex hormones) which causes increased sebaceous gland activity followed by acne breakouts.3
While acne can appear anywhere, acne caused by hormonal fluctuations tends to show up in the form of pimples and cysts on the chin and along the jawline.
How oral contraceptives work for hormonal acne is by increasing levels of estrogen and/or progesterone relative to testosterone. The extra hormones in oral contraceptives increase estrogen, make testosterone less apparent to the body, and decrease hormonal acne.
Birth control pills can also stimulate the production of sex-hormone binding globulin which are the sponges that soak up sex hormones and render them inactive. They also reduce the body’s production of steroid precursors like dehydroepiandrosterone (DHEA) which get converted into androgens by the body. 6
Let’s take a look at the clinical evidence and safety of using birth control for acne.
Research Says Combined Birth Control Pills are Effective in Reducing Acne Lesions
In a meta-review, researchers looked at 31 clinical trials evaluating the use of combination oral contraceptives containing both estrogen and progesterone and their effect on acne. The results of the meta-review found that combination birth control pills were significantly effective in reducing both inflammatory and non-inflammatory acne lesions.5
These results support the use of combined (estrogen and progesterone) oral contraceptives for acne. However, it’s important to understand that not all birth control products are necessarily the same.
Intrauterine Devices Worsen Acne Compared to Combined Oral Contraceptives and Vaginal Rings
1% of patients using intrauterine devices (IUDs) have reported acne as the reason for premature removal. Furthermore, in a large study of 2147, a statistically significant (P<0.001) worsening of acne was reported by patients utilizing hormonal intrauterine devices when compared to patients using vaginal rings and combined oral contraceptives6.
Birth Control Risks and Side Effects
While birth control pills are generally considered safe, the direct effect on your hormones naturally means that it may come with come side effects. Contraceptive pills make it easier for your blood to clot8 which can have some serious implications. Birth control pills are not recommended for women who smoke because smoking while on birth control pills increases clotting risk greatly.
You should avoid oral contraceptives if you have ever had:
- Blood clots in the arms, legs, or lungs (also called deep vein thromboses or pulmonary embolisms)
- Serious heart or liver disease
- Cancer of the breast or uterus
- Uncontrolled high blood pressure
- Migraines with aura
Some minor side effects that you may experience include:
- Weight gain or loss
- Sore or swollen breasts
- Mood changes
These side effects should subside as you use your birth control, but you should consult your doctor if they persist. Some less common but more serious side effects you should tell your doctor about include:
- Chest and abdominal pain
- Severe headaches
- Blurry vision and other eye problems
- Swelling or aching in the thighs and legs
If you are suffering from acne, birth control may be an effective way to reduce your acne and keep breakouts under control. However, oral contraceptives are not right for everyone. Talk to your healthcare provider to determine your options and identify the best form of birth control for your personal needs.
There are natural alternatives to using birth control for acne. DrFormulas® Dermatrope™, utilizes diindolylmethane (DIM), a natural ingredient derived from broccoli and cauliflower, to help balance androgens. It also contains turmeric, fish oil, and probiotics to reduce inflammation and support clear skin. Click here to see our article on natural remedies for hormonal acne.
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