Regular day-to-day breakouts can easily be tamed with the help of an over-the-counter topical treatment such as a Mighty Patch. But, when you're dealing with hormonal acne caused by the fluctuating hormone changes throughout your cycle, that's an entirely different ball game that may require a different course of action.
Birth control is one popular and effective hormonal acne treatment that's available. Starting a contraceptive is not a decision to take lightly. It's important to educate yourself on the topic, and of course, consult with your doctor to see if it's a good fit for you.
To help you with the education portion, we chatted with a couple of dermatologists to get the scoop on how birth control for acne works, what options are available, and potential side effects to know.
So really, how does birth control clear up acne?
Androgens, like testosterone, increase oil production. Female sex hormones estrogen and progesterone help slow down the production of oil. So, when your hormone levels are not regular and balanced, this can result in an overproduction of oil that clogs pores and leads to acne.
Therefore, Tanya Kormeili, MD, FAAD, a board-certified dermatologist in Santa Monica, California, says anything that helps regulate your hormones, such as birth control, will, in turn, improve acne as well.
Birth control regulates your hormones by taking over your body's hormone production and replacing it with the hormones it provides, says Susan Bard, MD, a board-certified dermatologist based in New York.
However, not all forms of birth control will help clear up acne. Dr. Bard says only those birth control options with both estrogen and low levels of androgenic progestins are effective.
Birth control methods such as the mini-pill or IUDs contain only progestin, so they won't work to control acne. And methods with high androgenic progestins, such as the birth control ring or the birth control patch, may worsen acne.
Types of birth control for acne
From birth control pills and IUDs to the birth control patch, there are many different forms of contraceptives. Ones that the FDA has approved as a treatment for acne include Ortho Tri-Cyclen, Yaz, and Estrostep.
However, both Dr. Kormeili and Dr. Bard prefer to prescribe their female acne patients with an oral hormone blocker medication called spironolactone instead of birth control. The medication's primary use is treating high blood pressure and heart failure, but it's shown to be effective at controlling acne.
"Spironolactone works to block the effect of androgens (male hormones, like testosterone) in the body, which are responsible for hormonal acne," Dr. Bard says. Dr. Kormeili adds that most people will see a huge improvement in hormonal acne by just blocking these extra male hormones without the need to put synthetic hormones in the body.
The results from taking spironolactone won't show up overnight. Everyone's skin and hormones are different, but most users will see an improvement after a few weeks of taking it and its full effect after three months.
RELATED READ: What Causes Hormonal Acne?
Side effects of birth control
As with any medication, there are side effects to note. Each type of birth control will have its own set of possible side effects. Be sure to go over them with your doctor before starting on them.
For spironolactone, in particular, Dr. Kormeili says some possible side effects include breast tenderness, dizziness, spotting, and increased potassium levels. And because it is a diuretic, meaning it flushes fluid from the body, you're probably going to need to pee a lot.
But, the acne may come back
So, let's say you get on birth control, your acne clears up, and then you get off of it for whatever reason. What happens then? Well, it depends. "If your hormones stay regular, then there's a chance that your acne will not come back," Dr. Kormeili says. "But, if your hormones are abnormal, it can then trigger the skin to break out again."
Dr. Bard adds that in order for the acne to go away for good, your endogenous hormonal makeup would need to change. "This can occur spontaneously throughout one's lifetime, especially after events that can lead to hormonal changes such as post-pregnancy," she says.
Next steps to take
All that said, birth control isn’t the only solution for hormonal acne. There are other options you can explore, such as Retinoids and natural supplements.
There are also diet changes you can try to help keep the breakouts at bay. For one, Dr. Bard suggests avoiding dairy. “Milk products contain a lot of hormones and can exacerbate hormonal acne,” she says. “Some patients report improvement in acne when going dairy-free.” Dr. Kormeili also advises ditching processed food and sugar to maintain your skin and body healthy.
If you do decide to start birth control, talk to your doctor or gynecologist about it. They’ll go over which form of birth control will be a good fit for you. Or, ask your dermatologist about spironolactone as an alternative.