According to the American Academy of Dermatology, acne now affects approximately 15% of women. Outbreaks of acne can be embarrassing and uncomfortable and can even cause facial scarring. A well-known effect of using many combination birth control pills is that they can often help clear breakouts of acne. In fact, after significant research, the FDA has approved several combination birth control pills for the treatment of acne. Knowing which birth control pills can potentially clear your acne may help you make an informed decision about what birth control medicine might be best to treat your acne. Before we discuss your options, let’s talk about what acne is.
What is Acne?
Acne is an inflammatory skin condition that occurs as a result of an interaction between hormones in the body called androgens, sebum (an oily substance that lubricates the skin that is secreted by pilosebaceous glands), keratin (a fibrous protein that overlies, protects and waterproofs the skin) and pathologic bacteria (such as P. acnes which is an anaerobic bacteria that causes acne).
Typically, acne begins in puberty when the levels of androgens are increasing. This higher level of circulating androgens causes the size and activity of the pilosebaceous gland to increase.
As the pilosebaceous glands produce more and more sebum, the pores in the skin eventually become clogged with sebum and keratin and dead skin cells. This clogging of the skin pores then creates an environment that allows bacteria such the P. acnes bacteria to reproduce out of control, causing inflammation, infection, and ultimately an acne outbreak.
Can Birth Control Pills Cure Acne?
Natural estrogen is synthesized in the body mainly from the androgens testosterone and androstenedione.
When a woman takes her combination pill, it decreases the production of testosterone in the body through a “negative feedback mechanism” and reduces the activity of the pilosebaceous glands leading to a clearing of the acne breakout. This can lead to clearer skin.
The Cochrane Library conducted an exhaustive study in 2012 that concluded all combined oral contraceptive pills containing estrogen and progestin were effective in treating acne. A 2014 Journal of the American Academy of Dermatology study also concluded that combination birth control pills were found to be just as effective as an antibiotic treatment in the reduction of acne after six months. The study even hypothesized that combination pills might be a superior form of treatment.
FDA Approved Combination Birth Control Pills for Acne Treatment
The FDA has now approved the following combination oral contraceptive pills to be used in the treatment of acne:
Ortho-Tri-Cyclen
Ortho-Tri -Cyclen is a combination birth control pill approved by the FDA for the treatment of acne in patients who are at least 15 years old and who wish to use a birth control pill as their preferred form of birth control. It contains the female hormones ethinyl estradiol and the progestin norgestimate and has no known contraindications for its use.
Yaz
Yaz is a combination birth control pill approved by the FDA for the treatment of moderate acne in patients who are at least 14 years old. It contains the progestin drospirenone and the estrogen Ethinyl estradiol and has no known contraindications to its use.
Beyaz
Beyaz is a combination birth control pill approved by the FDA for the treatment of moderate acne in patients who are at least 14 years old, have no contraindications to the use of birth control pills and who wish to use birth control pills for contraception. It contains drospirenone, Ethinyl estradiol, and levomefolate calcium.
Diane 35
Diane 35 is a combination birth control pill approved by the FDA for the treatment of acne. It contains the synthetic estrogen Ethinyl estradiol and the synthetic progestin cyproterone acetate which has anti-androgenic properties and which over a 3 to 4 months period decreases oily discharge from pilosebaceous glands and thus decreases acne due to the blockage and inflammation of facial skin glands.
Estrostep Fe
Estrostep Fe is a combination birth control pill used for the treatment of acne in patients who are at least 15 years old, desire oral contraception, have failed trials of topical medications and have no contraindications to the use of oral contraceptives. It contains norethindrone acetate and Ethinyl estradiol and should only be used if the patient stays on it for at least six months.
Conclusion
Having acne breakouts is unpleasant and emotionally stressful and can even lead to scarring on the face. The FDA has now approved certain types of combination birth control pills, which lead to a suppression of the body’s androgen production, which in turn decreases pilosebaceous gland stimulation and thus decreases breakouts of acne. Women who are interested in using birth control pills for contraception now have the additional option to treat their acne using combination pill therapy effectively. This type of treatment is as good as an antibiotic treatment in the treatment of facial hormonal acne.