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What are the best and worst contraceptive pills for acne?

What are the best and worst contraceptive pills for acne?

Living with acne can be a frustrating and mentally draining experience. But there are a number of treatment options available. And for some, looking into birth control for acne can be an option. Certain contraceptive pills can help alleviate the symptoms of acne, and birth control pills for acne can also be prescribed solely for that intention.

On this page we’ll discuss which pills may be beneficial for your skin and acne symptoms, which aren’t, and what to do if you take a pill that makes your skin worse.

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical Lead
Table of contents
Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
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Can the contraceptive pill be used for acne?

There are certain birth control pills that can help with acne. These can be used to treat acne in people who struggle with it, and in turn help with feelings of insecurity, embarrassment and low self-esteem related to the problem.

Generally, birth control for acne is often prescribed to healthy women who are also looking for contraception. It’ll also usually be prescribed after you’ve tried things like antibiotics or dermatological treatments for acne without success, such as topical solutions and creams.

But do pills actually work for acne?

The evidence shows that, yes, some contraceptive pills are beneficial for acne. The benefits of taking birth control for acne include protection from pregnancy, as most pills are prescribed as contraceptives with the secondary intention of helping alleviate the symptoms of acne.

What effect does hormonal birth control have on acne?

The skin changes in response to hormonal changes. Examples of naturally occurring female hormones include oestrogen and progesterone. Lots of different things can impact your skin, including your age, environment and your menstrual cycle. 

Your skin is affected by small glands called sebaceous glands. These glands produce an oily substance known as sebum. When you experience puberty, sebaceous glands increase in size and start to secrete more sebum. 

Sebaceous glands are affected by your hormones, mostly by particular hormones known as androgens. The more androgens which bind to sebaceous glands, the more you’ll notice oily skin. The more you experience oily skin, the greater your chances of developing acne. 

It’s thought that the menstrual cycle impacts sebum secretion, particularly your levels of progesterone and oestrogen as they rise and fall throughout the month. In fact, up to 85% of women report experiencing an increase in the severity of their acne symptoms leading up to their period. Though not fully understood, it’s thought that as oestrogen and progesterone levels drop, this can trigger the sebaceous glands to produce more sebum and this can lead to more oily skin. 

There may be a number of ways to help hormonal acne, including practising good lifestyle habits like eating a balanced diet, exercising regularly and getting enough sleep. However, making sure you stay as healthy as possible won’t always clear up your skin. 

What are the best contraceptive pills for acne?

There are certain contraceptive pills that help with acne, or are at least less likely to give you skin problems. If you’re thinking about contraception and you also want to prevent hormonal acne, there’s likely a pill for you that’ll do both.

Contraceptive pills have gone through a number of incarnations over the years. The first generation of contraceptive pills were introduced to Australia in the early 1960s. However, they contained high levels of synthetic oestrogen and caused some health scares. Later formulations of the pill reduced the levels of hormones released into the body, and this reduced their side effects.  

Second generation pills followed the first generation of contraceptives, and contained lower levels of hormones. Later came third and fourth generation pills which were created to lower the risk of certain side effects associated with second generation pills.  

The best generational birth control treatments to prevent acne are most likely 4th generation pills. This includes brands such as Yasmin, Zoely and Qlaira. In fact, when Yasmin was introduced to the UK market it was reported to be one of the best contraceptive pills for acne there.  

Yasmin, Yaz and acne

Yasmin, and its lower dose sibling Yaz, both contain the same synthetic versions of oestrogen and progesterone - ethinyl estradiol and drospirenone respectively. They’re 4th generation pills, and so may be beneficial for skin problems including acne.

The Yasmin pill may help acne according to one study on the active progestogens found in combined contraceptive pills. You can talk to your doctor about Yasmin and acne if it’s a benefit you would want from a contraceptive pill.

If you’re worried about side effects, the Yaz pill contains the same active ingredients in a lower dosage. You’ll typically experience fewer side effects with lower dose pills, while still being able to benefit from them.

Qlaira and acne

Qlaira is a combined contraceptive pill that can help with heavy or painful periods. But Qlaira may help with acne too. Each Qlaira pill packet contains different types of pills – some contain estradiol valerate (oestrogen), some contain both estradiol valerate and dienogest (progesterone) and some pills contain no hormones at all. These ‘empty’ pills are taken with the intention of helping you get into the habit of taking a pill each day.

Dienogest-based pills like Qlaira may help with skin problems like acne. Certain side effects associated with other contraceptive pills are also less likely when you take Qlaira. This may include vaginal dryness, appetite increase, weight gain, cramps, mood changes and reduced libido.

However, Qlaira can cause more oestrogenic side effects including breast fullness and tenderness, headaches, fluid retention, tiredness, irritability, nausea and bloating.

Femme-Tab and acne

Another contraceptive pill used to treat Acne is Femme-tab. Femme-tab contains 100mg of a progesterone called levonorgestrel, combined with 20mg ethinylestradiol. Researchers from the Cochrane Collaboration have looked into the effectiveness of combined levonorgestrel and ethinylestradiol treatment for acne. They found that in comparison to a placebo, the treatment was found to help reduce both inflammatory and non-inflammatory acne. It’s important to remember that people respond to contraceptive pills in different ways, and what works for someone else might not work for you (or vice versa).

Marvelon and acne

Marvelon is a birth control pill that contains desogestrel, a synthetic progestogen. Desogestrel and ethinylestradiol for acne might be a good combination because they reduce the risk of acne symptoms, but also reduce the chances of developing a series of other oestrogenic side effects also.

Marvelon has been shown to help with acne, with one study finding that women who took Marvelon had significantly reduced symptoms.

NuvaRing and acne

NuvaRing is the brand of contraceptive ring used in Australia. It’s a small ring that’s placed inside the vagina which releases hormones over 21 days.

The type of progestogen found in NuvaRing, called etonogestrel, may help some women with skin problems like acne. According to Clue, an app that tracks your menstruation cycle, in ‘an analysis of three studies, people using the birth control ring for three to 13 months report less acne than people using the pill (P).’

However, in the NuvaRing customer medicine information – acne is listed as a potential side effect. Again, what works for some women might not work for others.

How long will it take for my acne to improve with birth control?

Oral contraceptive pills affect people in different ways. If you take hormonal contraceptives to help improve acne, as well as to protect you against pregnancy, it might be two to three months before you start to notice an improvement in your symptoms. Though, this might not be the case for everyone.

For acne, antibiotics are sometimes prescribed before contraception to help treat your symptoms. One study found that antibiotics helped acne at around three months, whereas hormonal contraception took up to six months to reduce acne lesions. They state that oral contraceptive pills may be a better first-line method to antibiotics because they can be used long-term to help women manage their symptoms.

Which contraceptive pills aren’t as helpful for acne?

Generally speaking, first and second generation pills will be less helpful for acne when compared with third and fourth generation pills.

Examples of 1st generation pills include:

  • Ones which contained norethynodrel, norethindrone, lynestrenol and ethynodiol diacetate.

Examples of 2nd generation pills include:

  • Ones which contain levonorgestrel and norethisterone.
  • Microgynon, Logynon and Loestrin.

However, this isn’t to say that second generation pills might not help skin problems like oily skin and acne. (First generation pills are no longer available in Australia). What works for you can depend on a number of intricate factors happening inside your body, like how your body absorbs, uses and responds to particular synthetic hormones.

Evelyn, Microgynon, Levlen and acne

Evelyn, Microgynon and Levlen are all second generation hormonal contraceptive pills. But how do they affect acne?

A dermatology solution website conducted a poll of 2,000 women who suffered from acne. In the survey, 65% of participants reported Microgynon had no impact on their acne symptoms, 19% reported it had helped a bit and 6% reported Microgynon had noticeably improved their acne.

On the flip-side, some women have also reported that Microgynon can give them acne, or that it makes their acne worse. But Microgynon acne isn’t the only side effect associated with the pill, it can cause a number of other progesterone related side effects too. Always read the patient information leaflet prior to use.

Does Evelyn help acne, or does it make acne worse? Because Evelyn is a second generation pill, it may affect women in a similar way to Microgynon. While most people will get on fine when taking Evelyn, it can cause certain progestogenic side effects. This is because it contains older versions of progesterone. These side effects can include mood swings and making your acne worse.

It’s a similar story with Levlen and acne, which is another second generation pill. The majority of women won’t be affected adversely by Levlen, but certain side effects can happen and this does include acne.

Loestrin and acne

Loestrin is a first generation pill that contains ethinylestradiol and an early version of progesterone, norethisterone.

First generation pills are no longer approved for use in Australia, because safer and better tolerated contraceptives have since been created. Loestrin has stopped being produced in the UK, and is not available in Australia.

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Are mini pills good for acne?

Pills containing only progesterone are likely not beneficial for skin problems like acne. This is because they are mini pills, or progestogen-only pills (POM), and so don’t contain any oestrogen. Though they’re just as effective contraceptives as combined pills, they’re less effective at combating acne symptoms.

If you notice acne when using a mini pill, then it’s worth speaking to your doctor or pharmacist about switching to a different method of contraception – providing there isn’t a reason that precludes you from using combined contraceptive methods.

Can cyproterone acetate be used for acne?

There are some birth control pills approved specifically for acne treatment in the UK. These include Co-Cyprindiol and Dianette. Acne is caused when certain glands produce an oily substance called sebum, which can also lead to other skin problems. Co-Cyprindiol and Dianette can impact sebum secretion and reduce it. They can also be used for excessive hair growth. Currently, Co-cyprindol and Dianette are not available in Australia.

Dianette and Co-cyprindol contain a progesterone called cyproterone acetate, combined with ethinylestradiol. While you can’t get Dianette and Co-cyprindiol in Australia, cyproterone acetate is available separately. When taking cyproterone acetate and ethinylestradiol together, your acne symptoms may improve and you’ll also be protected from pregnancy.

Can the contraceptive pill cause acne?

The hormones found in contraceptives can help to reduce acne because they reduce the circulation of androgens, which decreases sebum production. However, this will very much depend on the type of contraceptive you use, the types of hormones it contains and how much.

Can the pill cause acne? Yes, birth control acne is listed as a side effect on most contraceptive patient information leaflets. But in some cases you may see an improvement to acne.

If you want to know how to treat acne caused by birth control, talk with your doctor. Finding the right pill for you may come down to trying a few different options before you’re happy and you see an improvement in your acne symptoms.

There’s also a link between coming off the pill and something called ‘post-pill acne’. Post-pill acne typically starts in the first few weeks after you’ve stopped taking the pill.

Hormones can cause acne because the body uses and responds to them in varying ways. If you experience hormonal acne after stopping the pill, it isn’t something to immediately worry about. It may clear up after a few days or weeks. If it doesn’t, and it’s impacting your quality of life, speak with a doctor.

What should I do if I have acne and I’m using the contraceptive pill?

If you want to know how to get rid of acne caused by birth control, how to treat acne from birth control, or whether you should go on the pill for acne, you’ll need to talk with your doctor or pharmacist to see what’s best for you.

Polycystic ovary syndrome (PCOS) is a condition that affects how a woman’s ovaries work, and acne can be a side effect of it. However, you can also experience PCOS without acne. Hormonal contraception may help in managing PCOS acne, speak to your doctor for more advice about the best birth control for PCOS and acne.

If you want to know how to help hormonal acne without birth control, you can talk more with your doctor.

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