Daily Health

Birth Control for Acne: Which Options are Best for You

Acne — especially when you’re still getting it as an adult — can be very frustrating. If you haven’t tried birth control as an option to treat your acne, it might be a great next step. Many people find that birth control pills actually treat their hormonal acne better than other topical medications.

It tends to work for blackheads, whiteheads, and cystic, inflammatory acne. Read on to find out how.

How does birth control treat acne?

Birth control helps treat your acne due to the way it affects your hormones, which in turn can help with acne.

This is because of the relationship between hormones called androgens and acne. Androgens are male hormones, like testosterone. All genders have circulating levels of androgens that play a role in acne.

They affect the amount of oil (called sebum) in the glands of the skin where acne forms. Increased sebum production may cause more growth of bacteria that leads to acne,

The estrogen in combined birth control pills works in several ways to lessen the effects of androgens. With less testosterone effects, your pores produce less sebum which reduces the likelihood of blocked pores and pimples. It’s also a less hospitable environment for the bacteria causing acne.

When would birth control be a good option to try?

Whether taking birth control pills for acne is the best option will depend on your personal situation.

If you are also looking to prevent pregnancy at the same time, birth control might actually be a good first option to treat your acne. Otherwise, your healthcare practitioner might recommend trying birth control as an acne treatment when topical acne creams and oral antibiotics have failed.

Keep in mind that even if you’re on birth control for acne, your practitioner will often recommend a topical agent to go along with it.

Common topical agents used alongside birth control include a retinol containing product (like tretinoin/s tieva A) or a topical antibiotic (like clindamycin solution or clindoxyl gel).

The combined effect of the pill plus a topical agent is typically best for keeping acne under control. 

Which birth control should I use for my acne?

All low dose combination pills can be used for the treatment of acne. Most often, your practitioner will recommend a standard, low dose combined birth control pill like alysena/alesse, mirvala/marvelon or Tricira Lo.

These tend to be very effective in treating acne, and using a low dose of estrogen tends to reduce other side effects like mood changes, nausea, or breast tenderness.

There are some newer formulation of combined pills with progestins that are possibly better for acne. In some studies, combined birth control pills containing drospirenone (like Yaz) performed better at reducing acne. However, this form of birth control has possibly been correlated with increased risk of blood clots.

Also Diane-35/cyestra-35 contains cyproterone as the progesterone component, which is also commonly used to treat acne. This medication also has a slightly higher amount of estrogen in it, which is why it might work more effectively for acne. 

Progestin-only birth control or “mini-pills” like Movisse/Micronor do not typically work against acne, as progesterone alone can actually cause increased androgenic activity, and increased acne.

I started birth control but my skin is no better - now what?

Whenever you start combined birth control pill, there can be some side effects that take a month or two to resolve.

One of these can actually be a flare up of your acne. This is only temporary and should improve as hormone levels become more regulated. Combined birth control does not tend to make acne worse.

As a rule, a minimum of three to six months of therapy is required in order to evaluate whether birth control is going to work for your acne or not.

Who can take birth control for acne?

There are some health conditions that would make it unsafe to take an estrogen-containing birth control. These include a history of migraine headaches with visual changes (called aura), history of blood clots or blood clotting disorder, high blood pressure, liver or breast disease or being a smoker over age 35. 

Before you decide to start taking birth control for acne treatment, be sure to talk to your healthcare practitioner about your medical history to make sure it’s a good fit for you.

What if I have acne and don’t want to take birth control?

There are many other acne treatment options, and your health care practitioner at Felix can point you in the right direction.

For mild acne, a retinol-based cream like stieva-A may be the only thing you require to treat it. We can also offer antibiotic based creams to use in conjunction with retinol cream, and even a face wash that can help. In severe cases of acne we can also offer a daily oral antibiotic to control acne, instead of birth control.

Felix Team
Updated on:
December 6, 2021
Medically reviewed by
Dr. Kelly Anderson
Family Physician, MD, CCFP(EM)

The views expressed here are those of the author and, as with the rest of the content on Active Ingredients, are not a substitute for professional medical advice, diagnosis, or treatment. If you have any medical questions or concerns, please talk to your healthcare practitioner.

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