If you’re a woman with chronic acne, you’ve likely been prescribed the birth control pill as a solution.
And the question is: Does it work? Should you use it to clear your skin from acne?
And if you are going to use it, are there certain ones that clear acne better than others?
So let’s start with the first question.
Does the Birth Control Pill Stop Acne?
In a lot of cases, yes. I will attest that when I was a teenager, I was on the slow release hormonal birth control shot (Depo Provera) for two years. And my skin was awesome.
But of course, clear skin came with an expense. Other side effects of the Depo Provera shot that I experienced included ravenous hunger and weight gain, possibly some bone loss, and a rare side effect where my vagina felt like it was being stabbed with knives if you touched it.
So that kind of turned me off a bit.
I went off it, and thats when my acne started to creep back in. On the bright side, at least my vagina didn’t feel like knives anymore.
It doesn’t mean the birth control shot had cured the acne. No, it just suppressed it while I was on it.
Hormonal birth control does this by completely over-riding your natural hormones with its synthetic versions. This forces your hormone system into a straight line, often preventing the cyclical breakouts we can experience.
Note that in the above photo, the straight lines are that of the fake estrogen and progestin from the pill. Your natural hormones will actually register as close to 0 on a test. So it’s important to note that it’s pointless to test your hormones while on the pill.
Birth Control Pills Can Clear Acne, But with Side Effects
What I’m saying is that yes, often birth control will work to clear and prevent acne and other hormonal symptoms.
But it usually comes with a whole host of other crappy side effects, a disconnect from our body’s true health, and there are risks with long term use.
And it never really cures acne, it just covers its up until you go off it, after which time you may have found it’s actually gotten worse.
That’s the other big thing to consider… women often experience worse acne for a period of time after they stop the pill, which you will likely need to do at some point in your life.
This is referred to as the dreaded “post pill breakout”.
It’s for this reason that it’s not a solution I tend to recommend solely to clear acne. There are healthier ways to get rid of acne.
However, birth control is very personal for women. Some women don’t experience the negative side effects of hormonal birth control that many do.
And for many of us, we have acne AND we need to protect ourselves from pregnancy. So in some cases it may seem to just make sense to go ahead and use it.
There are other options for contraception, of course… for example I have had a non-hormonal copper IUD for close to 10 years now and love it.
But if you’ve decided the pros outweigh the cons and hormonal birth control is for you, then you may as well choose the pill that is most likely to clear up your skin.
And the reason I say that is because not all birth control pills are created equal when it comes to acne clearing.
Some clear up acne, while others can actually cause it.
Which Birth Control Pills Clear Up Acne?
So first of all, let’s acknowledge that the pill is not the only option out there in the land of hormonal birth control.
There are many different forms of hormonal birth control, classified by their delivery method. For example, the daily pill, a three month shot, a slow release implant under the skin, a ring you place over your cervix, a patch on your arm, or an IUD in your uterus.
However, they all work in the same way: by using synthetic hormones to disrupt the signals from your pituitary gland that tell your ovaries its time to ovulate.
Which exact hormones they use has an important role in whether the birth control clears up acne or makes it worse.
Acne and Combination Pills vs Mini Pills
There’s pretty much two types.
One type contains a combination of both synthetic estrogen (“ethinyl estradiol”) and synthetic progesterone (aka progestin).
The other type of birth control pills only contain progestin (sometimes known as the “mini pill”).
Many long release methods like Depo Provera shot, the implant, and hormonal IUDs are also progestin-only.
There are also a ton of different types of progestin that could be used, which also factors into whether the particular brand of birth control pill is acnegenic or not.
Generally the options that contain both estrogen and progestin are better for acne. Progestin-only options have the potential to aggravate acne.
This also goes to show that nothing is really black and white. The Depo Provera shot that I used as a teenager is progestin-only and known to aggravate acne, and for me, it cleared me right up.
The Type of Progestin Used Matters When it Comes to Acne
Whether or not the pill has estrogen or not is not the only factor in clearing up your skin. The pill also has to have the right type of progestin.
Many types of progestins are androgenic, which means they are similar to male hormones that aggravate acne.
If you are wondering if your brand of birth control pills has an acnegenic progestin in it, please compare the type of progestin to the following lists.
Note that this list of progestins and brands isn’t exhaustive – there are other possible progestins out there and will require your own research to figure out if they are acnegenic or not.
Progestins that are known to aggravate acne, especially the top four on this list:
- Norgestrel (eg. Low/Ovral)
- Levenorgestrel (eg. Alesse)
- Desogestrel (eg. Mircette)
- Gestodene (eg. Femoden)
- Etonogestrel (eg. the NuvaRing)
- Norethindrone (eg. Aygestin)
- Norethendrone acetate (eg. Ortho Micronor)
- Ethynodiol diacetate (eg. Femulen)
- Norethynodrel (eg. Enovid)
- Norgestimate (eg. Ortho-Tri-Cyclen)
Progestins that contain anti-androgenic properties which will likely help clear up your skin are:
- Cyproterone acetate (eg. Diane-35)
- Chlormadinone acetate (eg. Belara)
- Dienogest (eg. Qlaira)
- Drospirenone (eg. Yaz)
Please note that it’s unfortunate that these particular anti-androgenic progestins also seem to come with a higher risk of deadly blood clots (although actual chances of experiencing one still remains low).
The one in particular I would very much caution staying away from is Diane-35, which is although is very powerful at clearing acne, it is very risky in terms of clots. It actually isn’t even approved as a contraceptive.
So Which Brands of Birth Control Pills are Best for Acne?
So far, we know that in order to clear acne, we need a pill or hormonal method that has both estrogen and progestin it. And that the progestin needs to be of the anti-androgenic variety.
Another consideration is finding a pill or method that has a low dose of estrogen in it (35 mcg or less). Higher estrogen levels have the potential for more unpleasant side effects, but lower doses also do not seem to diminish the acne clearing effects. So go for low dose.
Mind you, this doesn’t diminish the potential clot risks with these particular progestins.
So here’s the list of ones to consider:
Yaz, Yazmin, or Beyaz (or any of their generic names: Ocella, Syeda, Zarah, Gianvi, Loryna, Nikki, Vestura, and Rajani)
Qlaira (or it’s other names: Valette, or Climodien)
The one that sounds like it’s the safest in terms of clots, as well as with all these other benefits is one called Belara (also called Lutéran, and Prostal).
Remember, this article was mainly written if you are already on hormonal birth control, have weighed your options, and want to stay on it.
Please think long and hard about starting birth control pills just for your acne.
For one it’s risky, but two, it’s just a delaying of the problem. It’s certainly no cure. As mentioned, many women find that their skin is gets even worse after quitting.
It also can take several months, usually around six to fully clear your skin while on birth control. Some will also break out more in the first three months of use before it clears your skin.
So it’s not like a magic wand.
It still takes time, and in that time you could employ healthy lifestyle changes and supplements that will very likely work even faster and better, and keep you clear for the long run.
And What If You Want to Get Off the Pill But Fear the Acne?
Maybe you’re in that place where you’re on birth control and would way rather be off it, but fear of the post-pill-breakout has you stuck.
I totally get it!
But diet, lifestyle, and supplements can also be successfully used to prevent major breakouts whether you wean or not.
If you want my help navigating the pill and getting off it without the breakouts, connect with me in the Naturally Clear Skin Academy.
What’s your story with hormonal birth control and acne? Tell us in the comments!