Does Birth Control Help or Hurt Acne? A Dermatologist Sets the Record Straight

279photo-Studio/Shutterstock, Africa-Studio/ShutterstockPersistent acne is the worst. And while there are plenty of medicines and drugstore acne products that can help battle those unsightly blemishes, there’s an option women should consider when they just can’t take it anymore: Birth control pills. Because the Pill can depress male hormones like testosterone, it can be a boon in the struggle against acne.

Doctors have been relying on birth control pills to treat a variety of issues, including menstrual cramps, PMS, heavy periods, and even difficult to manage conditions such as polycystic ovary syndrome and primary ovarian insufficiency. And while they will usually begin treating moderate to severe acne with over-the-counter and prescription medications, docs can also turn to birth control pills. The pill delivers estrogen and progesterone, female hormones that trick your body into thinking its pregnant. In the right formulation, these hormones will suppress androgens—the male hormones such as testosterone that are linked to acne. Androgens stimulate the release of a heavy oil called sebum which gets trapped in pores, allowing the bacteria that cause acne to flourish. Suppress androgens, and the oil production decreases, and acne clears up.

But not all birth control pills are equal when it comes to acne. “You need to look at the progestin component,” says New York City-based dermatologist Cybele Fishman. Progestin is a synthetic version of progesterone, and some types will actually be more likely to cause acne—they’re considered androgenic, explains Fishman. The progestin in the birth control pill Yaz is among the best for acne, she says, however this version comes with a higher risk of blood clots.

Two other FDA-approved pills to treat acne are Ortho Tri-Cyclen and Estrostep, though other pills seem to be as effective as well. Discuss your options with your doctor, and remember that results may take some time. You may not notice acne relief immediately, but be patient—switching birth controls can be hard on your health. Give your pills at least 90 days before revisiting your choice with your doctor; it’s true that women can react differently to the same pill.

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