What's the Best Form of Birth Control for Treating Acne?

    What's the Best Form of Birth Control for Treating Acne?

    Dealing with acne can be a frustrating, stressful experience. While the occasional whitehead or blackhead isn’t likely to affect you too much, recurring or severe acne can take a significant toll on your social confidence and self-esteem. 

    If you have acne, you might have experimented with over-the-counter treatment such as facial washes and creams, including those containing ingredients like benzoyl peroxide and salicylic acne.

    You may have even tried products containing retinol, or medications like tretinoin or isotretinoin that contain retinoids.

    All of these products and medications can be effective for treating acne. However, there’s also another acne-preventing medication that you may not be aware of -- the birth control pill.

    While not all birth control pills can treat acne, certain birth control pills have been approved by the FDA as treatments for hormonal acne.

    Below, we’ve listed the best birth control pills for treating acne that are currently available in the United States. We’ve also explained how they work as acne treatments, as well as how you can use them to deal with whiteheads, blackheads and other forms of acne. 

    Which Birth Control Pills Treat Acne?

    First introduced in the 1960s, the birth control pill is used by tens of millions of women  in the United States alone. 

    As a result of this, there are countless different birth control pill brands and formulas currently on the market. Our range of birth control pills alone includes 10 different pills that cover upwards of 30 different brand names.

    Currently, the FDA has only approved three birth control pills as treatments for acne. They are:

    • Estrostep, a combination birth control pill that contains ethinyl estradiol (an estrogen) and norethindrone (a progestin).
    • YAZ, a combination birth control pill that contains estrogen and drospirenone.
    • Ortho Tri-Cyclen, a combination birth control pill that contains estrogen and norgestimate.

    You may already know that birth control pills are available in two main types -- combination pills, which contain an estrogen hormone and a progestin hormone, and mini-pills, which only contain a progestin hormone.

    Combination and progestin-only pills work slightly differently. We’ve compared the key strengths and weaknesses of each pill type in more detail here.

    All of the birth control pills currently approved for treating acne are combination pills, or pills that contain both an estrogen and a progestin hormone. Currently, there are no FDA-approved birth control pills for treating acne that use a progestin-only formula. 

    How Do These Birth Control Pill Treat Acne?

    Before we can get into how these birth control pills prevent acne, we’ll need to cover the basics of how acne develops in the first place, as well as how it’s related to your hormones. 

    Acne develops when your pores -- the openings in your skin that lead to the sebaceous glands and hair follicles -- become blocked. Several different substances can cause blockages in your pores, but the most common are sebum and dead skin cells.

    Sebum is an oil-like substance that’s produced by your sebaceous glands. If your skin feels wet and oily at the end of a busy day, it’s almost always the result of sebum building up on the skin’s surface. 

    Your skin naturally produces sebum to keep your skin soft and moist, as well as to protect your skin from wind, dust, dirt and other irritants. While it can be annoying when it builds up in large amounts, sebum is an essential component of healthy skin. 

    When too much sebum builds up on your skin, it can become clogged inside the pore, resulting in a pimple.

    Depending on the amount of sebum that blocks the pore, you’ll develop either a whitehead or a blackhead. A whitehead forms when the sebum completely blocks the pore. The white color is a result of the sebum forming a complete seal in the pore, blocking air from entering.

    A blackhead forms when the sebum only partially blocks the pore. Blackheads aren’t black as a result of dirt or poor hygiene -- instead, the black color forms when air comes into direct contact with the sebum. 

    When bacteria is trapped inside the pore, it can lead to inflamed or cystic acne -- a painful type of acne that can result in severe discomfort and scarring. 

    Most over-the-counter acne treatments work by targeting sebum on the surface of your skin. If you use an acne prevention face wash, for example, you’re washing away excess sebum every time you take a shower. 

    The three birth control pills listed above work a little differently. Instead of targeting sebum after it builds up on your skin, they work by lowering the production of hormones that are responsible for your body’s sebum protection.

    Sebum, Acne and Hormones Explained

    A variety of factors control your body’s production of sebum. One of the most important is your level of certain androgen hormones such as testosterone.

    Yes, you read that right -- testosterone. Although it’s primarily viewed as a male hormone, the female body also produces testosterone. In fact, adequate levels of testosterone are essential for you to maintain optimal physical health and cognitive function as a woman. 

    By the way, the same is true for men, only in reverse. Men produce testosterone and estrogen (with significantly more testosterone than estrogen), but both are essential for optimal physical and mental wellbeing. 

    Your body’s testosterone levels are closely linked to the total amount of sebum your sebaceous glands produce. When your testosterone levels are elevated, your body ramps up its production of sebum, resulting in oilier, more acne-prone skin. 

    It’s common for your production of testosterone and other hormones to fluctuate over time. For example, most women get an increase in the production of androgens like testosterone before and during their period. 

    This is one reason why it’s common to develop breakouts of hormonal acne in the days leading up to your period. 

    These breakouts are often worsened by the fact that your body generally produces lower levels of progesterone -- the hormone responsible for keeping your skin soft and elastic -- during your period. 

    Testosterone can also convert to more potent androgens like dihydrotestosterone (DHT), which may also be responsible for acne breakouts

    The exact relationship between androgens and acne is complicated and something that we’ve explained in more detail in this guide. In general, just remember that more androgens can lead to more sebum, which in turn leads to a higher chance of developing blocked pores and acne. 

    So, how do the three birth control pills listed above fit into this? All three of the birth control pills listed above have anti-androgen effects, meaning that they can reduce the effects of androgens such as testosterone or dihydrotestosterone (DHT). 

    For example, Estrostep contains the hormone norethindrone (or norethisterone). This hormone is associated with a fall in free testosterone, one of the androgens most closely linked to sebum production and acne. 

    Likewise, YAZ contains the progestin drospirenone, an anti-androgen that can reduce levels of testosterone in the body.

    Ortho Tri-Cyclen contains the progestin norgestimate, which can lower testosterone levels when used with ethinyl estradiol

    These anti-androgen effects can significantly reduce the severity of hormonal acne. In a review article from 2017, researchers identified more than 10 studies indicating that combination birth control pills can treat and prevent acne breakouts. 

    In one of the studies featured in the review, women were treated using a medication containing drospirenone and ethinyl estradiol (the same hormones contained in YAZ). After 24 weeks, the women experienced a reduction in acne lesions of more than 50 percent.

    In another study, women who used a medication containing norethindrone acetate and ethinyl estradiol (the same hormones contained in Estrostep) had a significant decrease in acne over the course of six 28-day cycles. 

    In short, the scientific evidence shows that these birth controls work very effectively not just as contraceptives, but also as acne treatments. 

    Which Birth Control Pill is Best For Acne?

    Like we mentioned above, Estrostep (norethindrone and ethinyl estradiol), YAZ (drospirenone and ethinyl estradiol) and Ortho Tri-Cyclen (norgestimate and ethinyl estradiol) are all approved by the FDA for treating acne. 

    If you have hormonal acne, you’ll likely experience significant improvements using any of these birth control pills or their generic equivalents. 

    Several studies have been conducted to determine which of these birth control pills is the most effective at treating hormonal acne. For the most part, these studies have only found very small differences between each medication, with no pill standing out as superior to any other for acne

    In short, there’s no clear “best” birth control pill when it comes to treating or preventing acne. All three of the pills approved by the FDA work well and produce similar improvements. 

    Does The Progestin-Only Mini-Pill Work For Acne? 

    Unfortunately, the progestin-only mini-pill doesn’t appear to have the same benefits for acne as combination pills such as Estrostep, YAZ and Ortho Tri-Cyclen. 

    In fact, although it’s not common, certain progestin-only pills may actually increase your risk of experiencing acne breakouts. For example, the FDA label for Ortho Micronor, a fairly common progestin-only birth control pill, lists acne as a potential side effect.

    In general, acne from the progestin-only pill is rare. However, birth control pills of this type are not designed as acne treatments and are not shown to lower the frequency or severity of acne breakouts. 

    What About the Patch, Ring and Hormonal IUD?

    Although the pill is the most common form of hormonal contraception, it’s certainly not the only option that’s available. 

    If you’re prone to acne and don’t like using the birth control pill, you may have considered using the patch, ring or hormonal IUD as your form of contraception. Unfortunately, research into the effects of these medications on acne isn’t as thorough as it is for the birth control pill. 

    Currently, the FDA has not approved any birth control patch as a treatment for acne. Study data on the patch’s effects on skin are limited, making it tough to know whether it helps or hurts when it comes to skin. 

    According to the FDA label for Xulane®, a common birth control patch, 2.9% of women who use the patch experience acne as a side effect. On the other hand, Planned Parenthood states that the ingredients in the patch may help to lessen or prevent acne. 

    Likewise, there are no studies indicating that NuvaRing®, the vaginal ring, has a positive effect on acne breakouts. The FDA label for NuvaRing® lists acne as a potential side effect and notes that approximately 2.4 percent of women experienced acne in clinical trials. 

    As for the hormonal IUD, data appears to show that the progestin hormone used in the IUD can often make acne worse. 

    The FDA label for Mirena®, a common hormonal IUD, notes that acne occurred as a side effect in 6.8 percent of women in clinical trials. For Kyleena®, another hormonal IUD, 14.1% of women that took part in clinical trials reported acne as a side effect. 

    For Liletta®, another hormonal IUD, the rate is even higher, with 14.9% of women experiencing acne in clinical trials. 

    In short, any type of hormonal IUD is best avoided if you’re concerned about acne. Not only will the hormonal IUD not get rid of acne, but the study data appears to show that it has a relatively high risk of worsening acne breakouts. 

    How to Use the Birth Control Pill to Treat Acne

    If you have acne and want to use the birth control pill to treat it, the best approach is to talk to your healthcare provider . Depending on the severity of your acne, they may recommend a specific pill as a treatment. 

    If you’re uncomfortable talking to your healthcare provider about birth control, we offer an online consultation with a healthcare provider  and a choice of 10 different birth control pills, including generic forms of Yaz or Ortho Tri-Cyclen, both of which are approved by the FDA as acne treatments. 

    It can take several months for the birth control pill to help bring your acne under control. For the best results, it’s important to be patient and give your medication at least three to six months to work before assessing your skin. 

    Although some birth control pills can help to treat acne, they may not be enough to ensure you no longer experience acne breakouts. If you have severe or difficult-to-treat acne, your healthcare provider may prescribe a medication like tretinoin, clindamycin or isotretinoin in addition to the pill.

    Finally, it’s important to be aware that the birth control pill can potentially lead to a range of side effects. While most of these side effects are mild and temporary, they could affect your health if you’re a smoker or have a history of cardiovascular health issues

    In Conclusion

    Currently, the FDA has approved three birth control pills for treating acne: Estrostep, YAZ and Ortho Tri-Cyclen. Studies show that all three pills are similarly effective for acne treatment and prevention, meaning there’s no “best” pill out of the three for most people.

    We offer generic versions of YAZ and Ortho Tri-Cyclen with discreet, convenient home delivery following an online consultation with a healthcare provider.

    As for other forms of hormonal birth control, none are currently approved by the FDA for acne treatment or prevention. Some, such as the hormonal IUD, may worsen acne. 

    Learn More About Birth Control

    Can’t decide which form of birth control is right for you? From the pill to the patch, ring, shot and IUD, there are a huge variety of safe, effective contraceptive options available for reducing your risk of becoming pregnant. 

    Our guide to choosing the right form of contraception looks at 10 of the most common forms of birth control available and shares tips that you can apply to choose the most suitable option for your needs, preferences and lifestyle.  

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.