The Best Birth Control for Acne, According to Dermatologists

Fact checked by Anna HarrisReviewed by Blair Murphy-Rose, MD, FAADFact checked by Anna HarrisReviewed by Blair Murphy-Rose, MD, FAAD

In skincare, health, and life in general, solutions rarely come in the form of a magic pill. Acne is a skin condition that many of us deal with on a recurring basis and its list of potential causes is nearly as long as that of all the treatments we've tried in an effort to cure it. But for those navigating hormonal acne, there may just be an encapsulated prevention method that's surprisingly effective. When prescribed by a licensed doctor and taken responsibly, studies show that taking birth control can provide some serious skin-clearing results.

Of course, birth control isn't a one-size-fits-all solution, and picking the best one for your health condition and lifestyle is incredibly important, so make sure you go to a doctor you trust for your prescription. In the meantime, we spoke to three dermatologists and an OB/GYN to get the basics. Below, they outline how birth control works, why some help treat certain types of acne, which brands are FDA-approved for the treatment of acne, how long it takes to work, and so much more.

Meet the Experts

• Melissa Kanchanapoomi Levin, MD, is a board-certified dermatologist and the founder of Entière Dermatology in NYC.

• Sara Twogood, MD, is an OB/GYN in Los Angeles.

• Julie C. Harper, MD, is a Birmingham-based dermatologist.

• Adam Friedman, MD, FAAD, is a board-certified dermatologist

How Birth Control Works

Combination hormonal birth control is the main type of oral contraceptive prescribed for acne and it contains two hormones: estrogen and progesterone. Together, these hormones suppress ovulation. A typical menstrual cycle includes menstruation (a period), a follicular phase, ovulation, and a luteal phase, which are all driven by fluctuations in hormones from the brain and ovaries. The pill stops these fluctuations and in turn, stops ovulation.

How Birth Control Can Improve Acne

Birth control works by affecting your body's hormone levels, which is how–along with preventing unwanted pregnancy–can impact hormonal-related issues like acne.

"When women's hormone levels shift from a more female profile (for example with estrogen and progesterone) to a more male profile, (for example, testosterone) during our cycles, this has an effect on oil production and acne," says Melissa Kanchanapoomi Levin, MD, a board-certified dermatologist and the founder of Entière Dermatology in NYC.

"When the hormone profile is more male dominant, a couple of skin changes occur: The sebaceous glands (the glands that make oil) become more active, there is an increase in dead skin cells, and the skin cells become stickier. This environment is perfect for acne flares. Some women are more sensitive to circulating testosterone and develop hormonal acne," says Dr. Levin. Taking birth control pills can stabilize these hormones and decrease the amount of testosterone in your body.

Birth Control vs. Skincare for Acne

While being on birth control can help manage hormonal acne, you still need a solid skincare routine. In fact, most dermatologists will consider topical solutions for acne before releasing a prescription. "Topically, my feeling is everyone and their mother should be on a retinoid," says board-certified dermatologist Adam Friedman, MD, FAAD. "This first-line medication can be difficult to get covered in our current healthcare climate, so fortunately, there is an over-the-counter form available called Differin Gel."

Dr. Levin agrees: "In addition to clearing existing acne, Differin will also help to prevent future breakouts from forming by increasing skin cell turnover to minimize clogging of pores." As for your skincare routine, Dr. Friedman says it should take on a "less-is-more approach" as opposed to loading up on anti-acne products. "Many believe over-washing, exfoliating, [and] scrubbing will improve acne, but it will only make it worse. The inflammation that causes the visible pimple disrupts the skin barrier, impacting its ability to keep water in and harmful things out. Overwashing or using harsh cleansers can further disrupt the skin barrier, which can, in turn, create more inflammation and even more acne." Dr. Friedman recommends a gentle wash, like Cerave's Foaming Facial Cleanser.

Birth Control vs. Oral Antibiotics for Acne

When it comes to acne solutions, it can be difficult to navigate the differences between birth control and antibiotics like tetracyclines. Both are taken orally to prevent acne flare-ups, but their similarities end there. Oral antibiotics inhibit acne-causing bacteria and mitigate active breakouts with anti-inflammatory properties. The devil, as they say, is in the details because these antibiotics really shine with particularly inflammatory types of acne that appear red, swollen, and spread across large surface areas. Birth control, on the other hand, treats acne that originates from hormonal fluctuations (more on that below). According to Dr. Levin, teenage or inflammatory acne can be treated with oral antibiotics, but hormonal acne is not usually successfully treated by antibiotics. So while each solution is proven to be effective, their efficacy is restrained to a single type of acne.

Types of Acne That Birth Control Can Treat

Acne can take the form of a blackhead, whitehead, a small mark, or even a cyst, but it's the underlying cause of your acne that determines whether birth control might be an effective treatment. That's where hormonal medication, such as birth control, can come into play. If home treatment doesn't help your breakouts, or if you're finding yourself with large, hard, or pus-filled bumps, you may want to consult your doctor to learn if you're experiencing hormonal or cystic acne—both of which may be treated with birth control. Other signs that you're dealing with hormonal acne rather than good old-fashioned inflammatory acne include breakouts that follow a cyclical pattern with your menstrual cycle and acne that pops up mainly along your jawline or chin.

The Best Types of Birth Control for Acne

Dr. Levin says that Ortho Tri-Cyclen, a popular brand of birth control, has been cleared by the Food and Drug Administration (FDA) for the treatment of acneic skin. Along with Ortho Tri-Cyclen, Estrostep, and Yaz are two other brands of birth control cleared by the FDA for acne treatment. Yaz contains the hormone progestin drospirenone which is known to be especially effective in the reduction of hormonal acne.

While certain brands of birth control carry the FDA's approval as an acne treatment, others are still prescribed off-label with some success. Other times, people who are prescribed oral contraceptives for other indications may find that a bonus "side effect" is an overall reduction in their acne symptoms. OB/GYN Sara Twogood, MD, notes that all oral contraceptive pills can have the effect of being anti-androgenic, meaning that they can lower the level of androgens like testosterone in the body. Androgens are one factor that leads to the development of hormonal acne, so blocking them can help to improve acne over time.

However, different people will have varied responses to oral contraception. "There are no set requirements or parameters for starting birth control pills for acne. The decision about when or if starting the pill to help control acne should be individualized," says Dr. Twogood.

How Long It Takes to See Results

While it can take as little as a month to notice an improvement, says Dr. Twogood, "in most studies, it took three to six months to show a reduction of acne due to birth control use." Of course, oral contraceptives are considered long-term treatment, and acne may flare back up with discontinued use of the medication.

Potential Side Effects of Taking Birth Control for Acne

Side effects of taking birth control pills for acne are the same as those of someone who takes the pill for contraception or any other indication. The most common short-term side effects of birth control are nausea, breast tenderness, and bloating. You may also experience longer-term mood changes and changes in libido. You should speak with your doctor about whether you're a good candidate for this medication given your medical history and to get more information about other possible side effects.

"If a person has a history of a blood clotting disorder, is a smoker, or suffers from migraine headaches, they are not good candidates for a birth control pill," warns Birmingham-based dermatologist Julie C. Harper, MD.

Who Can Prescribe Birth Control for Acne?

While any physician can write the script, "dermatologists, OB/GYNs, and primary care doctors are the usual prescribers," Dr. Twogood says. Whatever you do, make sure you see a licensed professional so they can do a full assessment and recommend the best birth control for you.

When to Talk to Your Doctor About Birth Control for Acne

If your acne is getting especially bad and isn't responding to other treatments, consider speaking with a specialist or your primary care physician. Your doctor can help identify the underlying cause of your breakouts and suggest a treatment plan.

While there is no harm in asking your doctor about taking birth control for your acne– particularly if you believe your breakouts are hormone-related– be prepared to follow a suggested treatment plan, even if it doesn't include the pill. While birth control may be incredibly effective against certain types of acne, it's important to note that it's not usually intended to be the first line of defense. Usually, dermatologists will first recommend a topical retinoid in addition to skincare and dietary changes. Foods that are high in sugar or contain dairy are known to cause acne. To establish a diet conducive to fighting acne, look for foods with anti-inflammatory properties, such as those packed with essential fatty acids and antioxidants, to try to help get acne under control.

The Final Takeaway

While birth control can be an effective treatment for certain types of acne, it's not appropriate for all acneic skin types nor is it typically the first recommendation for treating acne. If you're struggling with acne, talk to your doctor about various treatment options, and ask if birth control could be your route to clear skin.

Read the original article on Byrdie.