Causes Of Hormonal Acne
There are two main indicators: Your breakouts happen along the lower third of your face, and they get worse before your period when there is an excess build-up of testosterone, according to Joshua Zeichner, MD, the director of cosmetic and clinical research in dermatology and assistant professor of dermatology at Mount Sinai Medical Center in New York City.
Besides Aunt Flow, there are a few other hormonal acne causes. Pregnancy and the fluctuating hormones that come along with it, for one. Also, the decline in reproductive hormones can cause hormonal acne due to your body adjusting to fluctuating levels. Polycystic ovary syndrome is another culprit. It can occur in women at a reproductive age and causes a fluctuation in hormones that can increase the length of your menstrual cycle, cause obesity, and result in breakouts.
Is Severe Acne A Sign Of Polycystic Ovary Syndrome
Polycystic ovary syndrome is a hormonal disorder that causes cysts to develop in the ovaries. Sometimes, PCOS prevents women from ovulating every month, resulting in irregular and/or painful periods. Severe hormonal acne can be a sign of PCOS, but not always. Symptoms normally show up around an individuals first menstrual cycle during puberty. Irregular periods excess facial and body hair, and trouble losing weight are some of the most common symptoms for PCOS. Going on birth control pills can help balance the hormones and, thus, decrease the severity of symptoms.
What Are Signs Of Hormonal Acne
Hormonal acne differs from other types of acne in that it is specifically related to hormones. While this is not always easy to distinguish, if you notice one or more of the following, the acne you are experiencing may be related to hormones.
- Breakouts that recur around the same time in the same areas of the skin every month.
- Painful, deep cysts
- Individual pimples around the chin, jawline, neck, or sides of the face.
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Blood Sugar Balance Is A Must
If testosterone is your issue then working to balance your blood sugar is a must. When your blood sugar is wild then your ovaries and adrenals get the signal to make androgens.
Eat regular meals and include protein and fat with each meal. This will help you optimize your blood sugar, which will balance all your hormones.
Can Birth Control Cause Acne
Only some forms of birth control can cause acne pills that only contain progestin may cause a worsening or perpetuation of acne problems. Even when taking birth control pills that have both estrogen and progestin, you might notice an initial flare up as your body gets used to the new hormones. But over time, this should go away.
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Who Shouldn’t Use Birth Control Pills For Acne
You shouldn’t use birth control pills for acne when you are pregnant, have high blood pressure, have a history of blood clots or heart disease. Birth control pills are also not prescribed for girls who haven’t reached puberty yet.
Some side effects you may experience on the pill include bloating, headaches, nausea, and a very slight risk of developing blood clots.
You can speak with your dermatologist, primary doctor, obstetrics & gynecologist doctor, or nurse practitioner about the pill and whether or not it’s right for you. They can then prescribe the right medication for you after taking your medical history.
Hormonal Birth Control And Acne
Acne is often the result of hormonal imbalance in the body your doctor might call it an androgen-mediated problem. In other words, androgens play a key role in your body regardless of your sex or gender. Androgens, such as testosterone, boost skin cell growth and stimulate the skin to produce more oil. This can then lead to blocked pores and thus acne.
Most hormones have a counterregulatory hormone a hormone that opposes its effects. The counterregulatory hormone of testosterone is estrogen, which is commonly supplied in birth control pills. This is why many doctors recommend hormonal birth control for treating acne. The estrogen supplied in the birth control can counter the effects of testosterone.
So now we know why birth control methods are often prescribed for acne, lets go back to our original question does birth control cure or cause acne? The reality is that birth control can both cure AND cause acne. Studies show that birth control pills can reduce acne by 55% on average. However, acne may come back even worse after the pill is stopped. Birth control can also make your acne worse if it lacks sufficient antiandrogenic properties.
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Does Nexplanon Help With Acne
Nexplanon is a type of hormonal birth control that looks like a small plastic rod and is inserted just below the skin. Nexplanon, in particular, is a progestin-only contraceptive. The progestin used is called etonogestrel and in some studies ~12-13% of those using Nexplanon have reported new or worsening acne.
How I Treated The Hormonal Acne I Got From Birth Control
As a teenager, I hated my skin. While I know now that my acne wasnt actually that bad, I was convinced it was blotchy, red and terrible. In my early 20s, my skin was fine not glowy or perfectly smooth, but fine. Whenever that time of the month came around, Id wake up to a few pimples here and there, particularly along my jawline and neck, but they usually went away within a week .
Last year, when I turned 26, everything changed.
I decided to get an intrauterine device, aka an IUD . Little did I know that while the small T-shaped device prevented me from getting pregnant, it would also wreak havoc on my skin.
It was January 2017. After not being on any sort of birth control for a few years, I got the hormone-based Mirena IUD. Aside from the extremely painful insertion process yes, it hurts A LOT I was happy with my decision.
A month later the breakouts started.
I began developing red, painful and downright angry cystic breakouts along my jawline and neck. After doingsome research, I realized my experience wasnt unique. I just wish Id had some sort of warning of how bad it could get before I had a foreign object placed inside my uterus.
Although Id experienced this type of acne in the past, especially around my period, there was something different this time. Before, I would get one, maybe two decent-sized pimples, but theyd typically disappear within a week or so. After the IUD, the breakouts just wouldnt go away.
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How Birth Control Pills Work
Birth control pills comprise of synthetic hormones that work to:
- Prevent the ovaries from releasing eggs
- Altering the consistency of cervical mucus to prevent sperm from even reaching the egg
- Changing the uterine lining to prevent fertilization1
Birth control pills generally come in two forms. Combination pills contain synthetic forms of estrogen and progesterone, while mini-pills contain only progestin .1
Does Birth Control Make Acne Worse Before It Gets Better
Acne is a blemish on your face and always it looks worse. At thetime of maturity, the human body takes many hormonal changes that start at theearly age at ages of 12 to adulthood and these groups are the most victim ofacne. It usually begins during the start of puberty, affecting girls earlierthan a body.
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How Does The Pill Treat Acne
Acne occurs as a result of several factors relating to a hormonal imbalance, including the overproduction of a natural oil called sebum on the skin and the accumulation of dead skin cells in the hair follicle or pores.
In addition, some females have abnormally high levels of androgens, such as testosterone. High androgen levels can stimulate the production of sebum and increase the growth of skin cells in both the skin and hair follicles.
Hormonal medication, including the birth control pill, can help regulate these hormones and minimize acne.
The birth control pill works best when a person takes it at the same time every day and as the prescription specifies. Sometimes, the birth control pill is more effective alongside other medications.
An Acne Story By Emily
I havent let someone take my picture in over 3 years, 26-year-old Emily confessed at her first visit. She came to see me with one burning question What’s the best birth control for acne, can birth control pills help acne or am I doomed to have hide from every camera I see?
Emily had tried several pills with varying degree of success. And while some had reduced the number of breakouts, none of them gave her the clear skin her doctor had promised.
Like many women, Emily was prescribed the pill to treat a symptomher acne. Her acne was a symptom of something deeper, I explained.
Her doctor had told her that the pill would help her balance the hormones he believed was causing her to break out.
But the pill doesnt balance hormonesit masks them.
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How Is Hormonal Acne Treated
If your acne is mild you might be able to treat your acne with the over-the-counter face washes, gels or creams. This will typically contain benzoyl peroxide or salicylic acid.
If your acne is moderate to severe you may, if suitable, be able to get a prescription medication to treat your acne. This may be topical gels and creams, oral antibiotics or for women, the combined contraceptive pill. You may also be prescribed a combination of these treatments.
The combined contraceptive pill is prescribed as it can help balance hormone levels, avoiding flare-ups caused by hormonal changes.
How Much Can Birth Control Pills Reduce Acne
A paper published in 2014 combines data from 32 quality studies across the globe to examine the effects of birth control pills and antibiotics for acne. The graph below is a summary of the pooled data showing the average reduction in different types of acne after three and six months of treatment with either antibiotics or birth control pills.
You can see that antibiotics produced strong results after just three months. Birth control pills took a little longer, but after the six-month mark their improvements in both inflammatory and non-inflammatory lesions were noticeable and comparable to those with antibiotics.
The total weighted reduction of lesions for the birth control group was 35% after three months and 55% after six months. The placebo group only showed a total lesion reduction of 28.6%.
While these are simply weighted average figures that combine a wide variety of results among several thousand women, it is clear that birth control pills can significantly improve acne for many women.
To further support these findings, a more recent study published in 2018 concluded that despite hormonal therapy not typically used as first-line treatment for acne, it can shorten the duration of antibiotic use or even eliminate the need for oral antibiotics.
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Birth Control For Acne: Which Options Are Best For You
Acne â especially when youâre still getting it as an adult â can be very frustrating. If you havenât 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 To Take Care Of Your Skin While On Birth Control
Whatever your reasons are for starting a new birth control method, it can be a seriously confusing time. Not only are you dealing with a completely new dose of hormones in your body, but youre also faced with a whole crop of side effects you may or may not have seen coming including changes in your skin.
There are two main types of hormonal contraceptives, and they have totally opposite effects. Combination contraceptives tend to make your face more dry, while Progesterone-Only Contraceptives make it more oily. Whatever birth control method you decide is right for you , there are certain things you can do to make sure your skin is properly taken care of. Here are some small things you can do to cater your skincare routine to your birth control, whether its making your face feel dry, greasy, or somewhere in between.
How To Treat Your Skin On Combination Contraceptives
Stick With Your Topical Treatments
While combination contraceptives can work miracles on your skin, theyre not a solo solution. Just because youre on a seemingly magical acne pill it doesnt mean you can skip out on your skincare routine. Your best bet is to stick with whatever topical solutions you may have already been using to treat your acne, like spot treatments, benzoyl peroxide, and salicylic acid.
Moisturize, Moisturize, Moisturize!
How To Treat Your Skin On Progesterone-Only Contraceptives
Use A Gentle Cleanser
Pick The Right Toner
Skip The Moisturizer
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What Type Of Birth Control Fights Acne Best
Dermatologists and healthcare professionals have been prescribing birth control pills for the treatment of acne for many decades, and there are numerous brands and types available. There is no foolproof guide to acne causes, but many health professionals tout the benefits of contraception for female acne patients.
“What’s the best birth control for acne” is a difficult question to answer, but if youre looking to use contraception to help clear your skin, there are only three specific pills that have been approved by the FDA for acne treatment: Ortho Tri-Cyclen, Estrostep, and YAZ.
All three of these pills are considered combination oral contraceptives, which means they contain both estrogen and progesterone.
How Birth Control Works
Amanda Lawrence / Stocksy
Combination hormonal birth control, or the main type of oral contraceptive prescribed for acne, contains two hormones: estrogen and progesterone. Together, these hormones suppress ovulation. A typical menstrual cycle includes menstruation , 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.
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How Birth Control Can Help Hormonal Acne
While acne is a culmination of several different factors, hormones often play an integral role in acne development. For women, the main culprit is high testosterone levels. Although testosterone and other androgens have a role in womens health, high androgen levels stimulate sebaceous oil gland activity in the skin. With increased activity, pores can clog up and become pimples.2 Puberty is time that androgen levels are higher and is often associated with acne breakouts.
However, puberty is not the only time that women get acne. Acne breakouts can coincide with menopause and menstrual periods because these are periods when estrogen levels are lower while androgen levels stay the same. This causes a state of relative hyperandrogenism which causes increased sebaceous gland activity followed by acne breakouts.3
While acne can appear anywhere, acne caused by hormonal fluctuations tends to show up in the form of pimples and cysts on the chin and along the jawline.
How oral contraceptives work for hormonal acne is by increasing levels of estrogen and/or progesterone relative to testosterone. The extra hormones in oral contraceptives increase estrogen, make testosterone less apparent to the body, and decrease hormonal acne.
Lets take a look at the clinical evidence and safety of using birth control for acne.
Why Do Some Women Say That The Pill Caused Their Acne
If youve heard that the pill can actually cause acne or make it worse, heres why. Any time a woman begins to take an oral contraceptive, it takes a while for the regulating effects to kick in. Until it does, your hormones continue to fluctuate, which means that androgens may still rise and lead to acne. Over time, your birth control pill will do its job and stabilize your hormones and your acne.
Another possible link between an oral birth control pill and an increase in acne is when the pill contains progesterone only, commonly called the mini pill. In some cases, the lack of estrogen in the pill may allow for higher levels of androgens and, therefore, the potential for hormonal acne.
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The Lowdown On Birth Control And Acne
Oral contraceptives, most commonly referred to as birth control, are medications that are first and foremost designed to prevent pregnancy. However, it has also long been tied to acne and acne treatment, leading many people to ask “does birth control cause acne or treat it?”.
To determine how birth control helps, and sometimes interferes with clear skin, its important to learn exactly how it affects the body. Lets break down the connection between birth control and acne.
Can Birth Control Pills Cause Acne
Some contraceptives are progestin-only and do not contain any estrogen. Such birth control pills are known as mini-pills. Acne sufferers should avoid these pills at all costs as they can exacerbate existing acne, rather than reducing it.
In one study, 30-40% of women using progestin-only birth control reported worse acne upon using these methods. Another study reported acne present in 34% of women on mini-pills, compared to 8% of those on combination pills and 18% of those on the copper IUD.
Copper-releasing implantable contraception is non-hormonal and thus has no impact on acne. If we use this as a baseline acne rate for the group, we can gauge that mini-pills almost doubled the rate of acne in women.
Here are some popular progestin-only methods that may worsen acne:
- Progestin-only pills Camila, Errin, Heather, Jolivette, Norethindrone, etc.
- Implant Nexplanon
- Shot Depo-Provera
- IUDs Mirena, Kyleena, Skyla, and Liletta
Remember that the ParaGard IUD is not a hormonal contraceptive. Also please note that this list is not comprehensive. Confirm to your doctor to make sure you arent using progestin-only contraception.
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