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Oral contraceptives and acne

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Cause of acne

Androgens or hormones stimulate the sebaceous glands that secret oil. As a result, the glands start producing excess sebum, which is an oily substance found naturally in the skin. This sebum mixes with bacteria as well as dead skin cells and gets trapped inside the pores and develops acne. The emergence of acne usually occurs when hormone level increase and coincides with the onset of puberty and menstruation.

Birth control pills

Oral contraceptives reduce acne in the following way:

  • Oral contraceptives that contain estrogen (combination pills) reduce both inflammatory and non-inflammatory lesions.
  • Oral contraceptives decrease the levels of ovarian androgens and free testosterone in the blood by increasing sex hormone-blinding globulin.
  • Combination oral contraceptives contain both estrogen like ethinyl estradiol and a progestin. Older progestins had stronger androgenic effects which exacerbated acne. However, newer combinations contain drospirenone, desogestrel, or norgestimate which are less androgenic and are more beneficial for the treatment of acne.


Brands Used

Several brands of oral contraceptives are effective in controlling acne. Moreover, a few brands like Ortho Tri-Cyclen® and Estrostep® have received approval from the U.S. Food and Drug Administration (FDA) for treating acne in women.

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Need for other Acne Treatment

Though oral contraceptives reduce acne, it target only one of the four key causes of acne, which is excess sebum. However, since oral contraceptive targets only one cause, it is generally not used by the dermatologists for the treatment of acne. Dermatologists prescribe an oral contraceptive for the treatment of acne only when other medications are ineffective. The usual treatment of acne involves medications like benzoyl peroxide and topical retinoids. At times an oral antibiotic may also be used. In case if the acne does not respond to these treatments, an oral contraceptive may be considered. 


Other Medications

If an oral contraceptive is used for treatment, the dermatologist should be informed about the other medications that are consumed. Medications interact with each other and in some case produce undesirable side effects. Moreover, at times one medication can reduce the effectiveness of another medication. For example, anti-epilepsy drug, lamotrigine, reduces the effectiveness of an oral contraceptive. 


Types of Woman

Oral contraceptives can safely and effectively used for treating acne on a long time basis. However, this medication is not prescribed for every woman. It is prescribed for the following classes of women:

  • Women of 35 years of age or younger
  • Women who do not smoke
  • Women who do not have a history of migraines
  • Women with normal blood pressure

However, women who take oral contraceptives should get their breasts examined regularly. 


Clearing Time

Clearing of acne takes time. It takes about three months for the oral contraceptives to take effect. However, repeatedly missing doses decrease the effectiveness of medicines.

Next page: Oral contraceptives and monthly period

Written by: Healthplus24 team
Date last Updated: April 22, 2012