What’s the lowdown?
It’s a cruel fact of life that some people don’t leave acne behind in their teenage years. Some adults continue to get zits well into their 20s, 30s and even 40s. Acne may be a cosmetic issue but it is certainly not a trivial problem. It can even lead to feelings of depression and low self-esteem.
Annoyingly, women are more likely than men to be affected by acne in adulthood, suggesting hormones may play a key role. It’s perhaps not surprising then that many women find that changing their birth control affects their skin. In this article, we look at the contraceptive methods – such as the pill, patch or copper coil – that can help or hinder your efforts to bust blemishes.
What is acne?
Acne is a really common skin condition – but that doesn’t mean it’s not distressing. It causes black, white or red spots to appear on the face. Some people get acne on their back or their chest too.
While it’s true that acne is most common in young people (around 8 in 10 teenagers develop it at some point), it can affect older people too.
There are loads of myths about what causes spots. Some people think it’s to do with eating certain foods (such as chocolate or fizzy drinks) or poor hygiene, but this is complete rubbish. The best explanation for acne is hormonal changes and that’s why it tends to flare up during and after the already rocky ride that is puberty.
Certain hormones cause glands in your skin to produce larger amounts of oil (called sebum) than normal. The sebum can interact with usually harmless bacteria on the skin, causing inflammation and pus. Some hormones also thicken hair follicles, causing pores to block.
Noticed you’re more prone to spots at certain times of the month? You’re not alone. Your menstrual cycle can have a profound effect on your skin. Acne is also a common symptom of Polycystic Ovary Syndrome (PCOS) – a condition that can also cause irregular periods and excessive unwanted hair. See our guide to PCOS and see your GP if the symptoms sound familiar.
How do hormones affect our skin?
Our skin glands are really sensitive to hormones called androgens. Androgens are sometimes called male hormones, but both men and women produce them. Learn more in our androgens blog. Androgens cause our skin to make more sebum, which often leads to spots.
Oestrogen – one of the main hormones involved in the menstrual cycle – has the opposite effect on sebum production. Experts think high levels of oestrogen reduce sebum by preventing the ovaries from making androgens. This might explain why some women experience acne just before their period when oestrogen levels plummet.
Progesterone is the other main hormone involved in the menstrual cycle. It is not yet clear how progesterone affects acne. But some studies suggest it can make skin problems worse.
Hormonal birth control therefore might affect your skin. The general rule is that ‘combined’ methods containing both oestrogen and progestogen (a synthetic form of progesterone) can improve acne, while progestogen-only birth control might lead to spots or worsen acne in some people.
But remember, it’s not a one-size-fits-all thing. As you’ll see from our user-generated reviews, some people find their birth control gives them a clearer complexion, while others find the same method makes things worse!
What’s the best combined pill for acne?
The good news is that people who take the combined pill often see an improvement when it comes to acne. Some people are actually prescribed the combined pill to clear up their skin even if they don’t need contraception.
Studies show that women with acne who take the combined pill tend to see an improvement in their skin compared to individuals who aren’t on birth control. But different pills can have very different results.
And it can take a few months of use to see a noticeable improvement in your skin after you start taking the pill. Some people even find their skin gets worse after they start taking a new pill, but it often settles down after a few months.
Anti-androgen pills such as Yasmin for acne
There’s not a tonne of research on which brands of the combined pill are most likely to improve acne, but scientists think the type of progestogen it contains might make a difference. One study found pills that contain a progestogen called drospirenone are the most helpful for preventing acne. It also concluded that pills containing levonorgestrel and norethindrone were the least helpful.
Should I take Dianette for acne?
You might have heard that the contraceptive pill Dianette can help treat acne. This pill contains a progestogen called cyproterone acetate, which like drospirenone, blocks androgens. Dianette used to be licensed as birth control in the UK, but the (small) risk of developing dangerous blood clots with Dianette is higher than other contraceptive pills. For this reason, Dianette is no longer prescribed purely for contraceptive reasons.
Doctors will sometimes prescribe Dianette for treating moderate to severe acne and excess facial or body hair in young women when other treatment options have failed. Dianette provides birth control in women who require it to treat these conditions, but it will not be prescribed purely as a contraceptive.
Will the patch or ring affect my skin?
The skin patch (such as Evra) and the vaginal ring (NuvaRing) prevent pregnancy by releasing small amounts of both progesterone and oestrogen into the body. Like the combined pill, these contraceptive methods may improve acne for some women.
One study found women who used the ring even experienced less acne than women taking a combined birth control pill. But more research is needed on the impact of these forms of contraception on the skin.
Does the progesterone-only pill cause acne?
Popular brands of progesterone-only pills (also called the mini-pill) include Cerazette and Cerelle. This type of birth control doesn’t contain any oestrogen.
Some women find the mini-pill has lots of advantages – particularly if they experienced side effects when taking the combined pill. But unfortunately, progestogen-only pills haven’t been found to improve acne. Some women find taking the mini-pill actually makes their skin worse. This could be because the mini pill only contains progestogen, which may cause your skin to produce more pore-clogging sebum
Women who take the contraceptive injection or depot in the arm tend to also report worsening acne as these methods are also progestogen-only.
What about the hormonal coil?
The hormonal coil (or IUS), such as the Mirena coil, slowly releases progestogen (usually levonorgestrel) into your womb to prevent pregnancy. This method of birth control does not contain any oestrogen. It’s great if you don’t want to have to think about contraception for several years. Some women find they experience more acne after having a hormonal coil inserted, but the amount of progestogen in the coil is much lower than that found in contraceptive pills, so there may be less of a noticeable impact on the skin.
Non-hormonal contraceptives and acne
If you’ve sworn off hormonal contraceptives because you hate the side effects, rest assured that hormone-free methods such as the copper coil, condoms, or using an app like Natural Cycles, should not worsen acne in theory.
But if you’ve switched from a combined hormonal contraceptive (like the pill, the patch or vaginal ring) to a hormone-free option, you may notice some changes to your skin. That’s because the birth control you were previously taking may have been helping to keep breakouts at bay.
Other treatments for acne besides birth control
If you’ve tried contraception containing both oestrogen and progestogen and found it doesn’t help your acne – or you can’t take the combined pill, patch or ring -, speak to your GP to find out about other acne treatments that might help. Possible options include creams containing ingredients like benzoyl peroxide or retinoids. They might even recommend an antibacterial cream – or antibiotic tablets.
Don’t suffer in silence. Acne sucks, but there are plenty of effective treatment options. Your GP should be able to help find the best one for you.
Natalie is a freelance science journalist, copywriter and content strategist from London who has been writing about science and health for several years for a range of print magazines and online publications. Former Head of Editorial at Patient, she has also written for publications such as WIRED UK, Which?, Nature, the Times and Harper’s Bazaar. Natalie loves interviewing interesting people and her superpower is conveying complex information in a clear and engaging way.