Acne Birth Control And Hormone Levels
Acne is a skin condition characterized by blackheads, whiteheads, and pimples. It can either be inflammatory or non-inflammatory. One of its main causes is the increase in androgen hormone levels like testosterone, during puberty, in both women and men .
Menstrual cycles may also cause acne due to hormonal changes. During puberty, increased androgen levels enlarge the follicular glands. The androgens most linked to acne are testosterone, dihydrotestosterone, dehydroepiandrosterone, and insulin growth factor. High levels of these androgens may lead to acne breakouts. They may also occur if the estrogen and progesterone levels are lower than normal androgen levels. Prepubertal girls also may suffer from acne due to high levels of dehydroepiandrosterone sulfate .
Acne mostly occurs during adolescence. But it can also occur in older women and pregnant women. Those with Cushings syndrome, hirsutism , or polycystic ovary syndrome may also experience acne breakouts . The skin condition can also occur during menopause . It happens when testosterone levels are greater than estradiol and progesterone levels. Women also experience acne during their late reproductive years due to decreased estrogen levels and no change in androgen levels.
Hyperandrogenemia is a disorder seen in 5-10% of women during their reproductive ages . It occurs due to androgen levels or impaired inactivation of androgen. Polycystic ovary syndrome can be a cause of this disorder.
Women Hormones And Acne
Young teens going through puberty often suffer from hormone-related acne because this is a stage of life characterized by an increase in androgens. But girls and women experience hormone fluctuations every month before, during, and after their menstrual periods that can cause or exacerbate acne well into adulthood.
If youre like most women, your highest androgen level occurs about a week before your period so, if you tend to break out just before you menstruate, this may be why. Then, during your period, your estrogen level goes up and your progesterone level goes down.
But menstruation isnt the only thing that affects your hormones. Stress, medications, and pregnancy can all shake up your normal and leave you with a pimply face, chest, or back.
What You May Have Heard About How Birth Control Affects Skin And Hair
You may have heard that hormonal birth control can improve acne and make your hair fuller. You may have also heard that hormonal birth control can cause acne or make your hair fall out.
It can be confusing, especially when your personal experience is different from that of your friends and loved ones, or what youâve been told to expect.
Not all hormonal birth control is the same, so the side effects arenât all the same either. Hormonal birth control comes in many forms and contains different types and levels of hormones.
Combined hormonal contraceptives are birth control methods that contain two hormones , like the pill, patch, or ring.
Progestin-only contraceptives contain just a form of progestin hormone , like the implant, hormonal IUD, shot, or mini-pill. Different forms of birth control may affect individual people in different ways.
Hormonal fluctuations during the menstrual cycle cause changes in skin and hair. So it makes sense that the hormones found in birth control can as well. Read on to learn how different methods may improve or worsen the condition of the skin or hair.
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Does Birth Control Help Cystic Acne
Yes! Birth control is a great treatment option if you are looking to eliminate cystic acne. Cystic acne occurs when the hair follicles get clogged with sebum, dead skin cells, and bacteria, forming an acne cyst under the skin. The infected cyst can become red, swollen, and very painful. The cysts can also contain pus and should not be popped, for the risk that the pus could spread the infection. It is imperative to consult a dermatologist, such as Dr. Green, to receive treatment for cystic acne in order to prevent scarring. Combination hormonal birth control pills work to combat all kinds of acne cystic acne included.
What Is Acne Vulgaris
Acne vulgaris is the scientific name for the skin problem commonly just known as acne or colloquially called pimples, spots, or blemishes. The condition is characterized by spots on your skin that can appear on your face, upper back, chest, or arms. These blemishes arise when there is an excess of oil on your skin, which can clog the hair follicles in the oily areas of your body. When your pores are clogged only with sebum and dead skin cells, this is called noninflammatory acne, or comedones, which can manifest as whiteheads or blackheads . If bacteria gets into the clogged pores, it can cause an infection, which leads to inflammatory acne. Inflammatory acne can appear as pustules, which contain pus, or papules, which do not. Cystic acne is another kind of acne that occurs when cysts develop below the surface of the skin. When the cysts are infected with bacteria, they become swollen, red, and often painful.
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Which Birth Control Pills Are Approved To Treat Acne
The Food and Drug Administration has approved 4 birth control medications to treat acne:
Each one of these contains a combination of the hormones estrogen and progestin. Progestin-only birth control or mini-pills like Camila and Micronor do not work against acne. Besides these 4 brands, your provider may prescribe other birth control pills to improve acne, as long as they contain estrogen.
What Are The Side Effects Of The Birth Control Pill
There are some common side effects for the birth control pill including weight gain, nausea, breast tenderness, lighter periods, and spotting between periods. These side effects are common and should not be dangerous to your health. Certain symptoms could be an indication of more serious side effects such as shortness of breath and chest pain. If you are experiencing these symptoms, it could be a sign of a heart attack. Some patients may be at risk for developing gallbladder or liver disease as a result of taking birth control pills. Severe side effects can be avoided if you disclose your medical information to Dr. Green during your initial consultation.
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Five Steps If You’re Considering Taking Birth Control Pills For Treatment
Treating Mild To Severe Acne
These three oral contraceptives have been approved for treating moderate acne in women who:
- Are at least age 14 or 15
- Have already started menstruating
- Need contraception
In actual practice, doctors prescribe birth control for the full spectrum of acne, from mild to severe.
In addition, doctors may prescribe additional birth control products for acne. For example, the oral contraceptives Yasmin and Alesse have both been clinically shown to improve acne. But neither one has been approved by the FDA for this use.
If you’re already taking an oral contraceptive that’s working well in treating acne, there’s no need to switch brands. But if you are taking birth control pills for acne for the first time, it’s best to use one of the three types now approved for acne treatment.
You may need to take an oral contraceptive for a few months before your skin starts to clear. And an initial flare-up of acne is common when a woman first starts taking birth control pills.
Birth control pills work on only one acne-related factor — excess sebum. Doctors often prescribe other forms of acne treatment — topical medications or antibiotics — to be used alongside them for best results in clearing the skin.
If you have severe acne along with irregular periods, excess facial hair, or obesity, your doctor may do further testing for a medical condition called polycystic ovary syndrome or other hormonal condition.
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What Your Healthcare Provider Might Say
Birth control pills that contain both estrogen and progestin can be prescribed to treat acne and hirsutism , and sometimes hair loss.
Progestin-only methods such as the implant, hormonal IUD, or shot may worsen acne, hirsutism, or hair loss in some people.
To understand these effects requires a little anatomy and physiology lesson.
Which Birth Control Pills Are Fda Approved To Treat Hormonal Acne
There are four birth control pills that have received approval by the FDA to specifically treat acne. This means that they have been shown to be so effective at treating and preventing acne that the US Food and Drug Administration has approved the pill to be specifically prescribed to treat acne. All four use a combination of the hormone estrogen in the form of ethinyl estradiol and progesterone in the form of progestin. Those four birth control bills are as follows:
Yaz A combination birth control pill that contains estrogen in the form of ethinyl estradiol and progestin in the form of drospirenone. Drospirenone has been shown to be the most effective progestin to prevent acne.
Ortho Tri-Cyclen A combination birth control pill that contains estrogen in the form of ethinyl estradiol and progestin in the form of norgestimate. Ortho Tri-Cyclen can be available at different levels of progestin.
Beyaz A combination birth control pill that contains estrogen in the form of ethinyl estradiol and progestin in the form of drospirenone. This is the most recently FDA approved birth control pill for treating acne.
Estrostep FE A combination birth control pill that contains estrogen in the form of ethinyl estradiol and progestin in the form of norethindrone. Estrostep FE can have the level of estrogen adjusted.
There are other birth control pills that have been clinically proven to improve acne but have not yet been FDA approved including Yasmi and Alesse.
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Does Yaz Birth Control Help Acne
Yes! Yaz birth control pill is a combination pill that contains both the hormone estrogen and a manmade form of the hormone progesterone, called progestin. These hormones working in combination work to suppress the androgen hormones that cause the overproduction of sebum. Yaz is one of the four FDA approved birth control pills to treat acne. When you have your consultation with Dr. Green, Yaz is one of the birth control options that are available to you to treat acne. Yaz can also be used in combination with other acne treatments such has topical acne creams. When you are prescribed your treatment plan, be sure to take you Yaz pill at the same time each day and continue with any other prescribed acne treatments.
How Long Does Birth Control Take To Help Acne
The hormones in birth control lower the hormone levels of androgen hormones, which contribute to acne. As such, it can take your body some time to adjust to the hormonal shift so your acne will likely not clear up immediately once you begin taking birth control. Most patients see the effects of the birth control on their acne in two to three months though some patients see a reduction in acne in only a couple of weeks. Full effects of the treatment are typically seen around six months after you begin taking the birth control. When you meet with Dr. Green, she may prescribe topical acne creams in addition to the birth control for the first couple months after you start your birth control treatment.
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How Does Birth Control Help To Treat Acne
A common cause of acne, especially present among teens, is an imbalance of androgens, a type of hormone found in both men and women, but some people may produce it in higher amounts. One side effect of this overproduction is an increase in sebum, a type of oil that your skin naturally produces. Excess sebum can clog pores which leads to acne.
Birth control, however, can help to regulate hormones, reducing androgen production and thereby decreasing the amount of sebum production, and acne as a result.
Risks Of Birth Control Pills
Most birth control pills today contain lower doses of progesterone and estrogen than they had in the past. However, they are also side effects like depression, mood changes, migraine headaches, hypertension, and liver diseases.
The best approach to using anything contraception related is to seek a medical opinion. Not only will your doctor recommend the product to use, but it will also be based on your health history, acne severity, and your general need.
Each control pill contains different progestins. As a result, you can experience mild differences between different pills. It is also common for your acne to clear longer even after using the recommended products for acne.
If your acne does not respond to the treatment, your doctor can recommend using antibiotics, retinoids, and other medications that can be used together with birth control or alone.
Nonetheless, some people should avoid using birth control pills. The reason for this is that oral contraception can worsen certain medical conditions. Hence, you shouldnt use birth control pills if you:
Have a history of cancer, liver disease, diabetes, or blood clotting disorder.
Heart disease, migraine headaches, blood clots in the lungs and legs, and hypertension.
A smoker over 30 years or if you are physically immobilized.
Severe obese, breastfeeding, or pregnant.
Havent reached puberty, pregnant, or trying to get pregnant.
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Myth : Bad Hygiene Can Cause Acne
While good hygiene can help support other acne treatments, Carroll said, severe and persistent acne does not reflect poor hygiene habits. She added that blackheads are not dirt-filled pores. They are black because the oil in them is oxidized when exposed to the air.
Its important to let patients know that its not their fault and its not because theyre not doing something properly.
Carroll, who specializes in cosmetic dermatology, acne and rosacea, said that telling teenagers they need to wash their face more is not going to get to the bottom of the problem. It may just be something they are genetically prone to. Over-washing can also irritate the skin and increase inflammation, she said.
What About When I Want To Come Off The Pill
Most women wont stay on the pill forever. Some may come off the pill to have children or take a break from synthetic hormones while using other contraceptive methods in the meantime. So what happens when you stop taking the pill?
Its important to remember that birth control is not a cure for acne, but rather a temporary treatment. As long as youre taking the pill and introducing the right combination of hormones into your body, youre likely to see an improvement in your acne.
But once you stop taking the pill, the acne is likely to come back. Post-pill acne can often be worse than pre-pill acne and even harder to get rid of.
Let me repeat myself since many women are not aware of this before starting the pill. Many women find that post-pill acne is worse and much more difficult to fix than the acne they had before starting the pill.
When stopping the pill, your hormones will take some time to normalize. Your hormones could take several months before returning to their pre-pill levels, during which your skin can be prone to breakouts.
I asked some members of the Clear For Life Facebook group to share their experiences after stopping the pill. Click on the left and right arrows to browse through what they have shared.
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What Is The Birth Control Pill
Birth control pill, usually taken to prevent pregnancy. It consists of both hormones, estrogen & progesterone which helps to prevent release an egg from the ovaries. Because of birth control pills, you might see some side effects such as nausea, weight gain, swollen breast, spotting between periods & mood changes. Some serious side effects such as abdominal pain, chest pain, headache, blurred vision, swelling of the legs or thighs.
How Long Until Acne Clears After Stopping Taking Birth Control
As mentioned before, it takes several months for your hormones to normalize after coming off the pill. However, every womans body is different, so its hard to make a blanket statement to predict your acne patterns upon stopping birth control pills.
It will generally take at least 3-4 cycles for post-pill acne to resolve. Doctors also recommend using preventative measures before you come off the pill to suppress some of the effects of post-pill acne.
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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.
Certain Oral Contraceptives Are Approved For Acne Treatment
Oral contraceptives are one of the most effective methods for preventing pregnancy. Commonly called birth control pills , theyre also becoming a popular treatment for another condition that affects many women: acne. When other acne treatments have not been successful, birth control pills may be the answer.
Exactly how does birth control help with acne? Birth control affects hormones, and hormones play a major role in acne. Hormones called androgens promote the production of sebum, an oil made by your skin. Too much sebum can lead to clogged pores and bacterial growth, which create breeding grounds for acne.
Women usually produce low levels of androgens, but hormonal changes related to their menstrual cycle can raise androgen levels and, consequently, trigger acne breakouts. For some women, acne persists throughout their cycle. Even during perimenopause, when a womans body prepares for menopause, hormonal changes can continue to promote acne.
Birth control pills that contain both the hormones estrogen and progesterone reduce functional androgen levels, thereby reducing sebum production and acne. Pills that contain only progesterone can actually make acne worse.
Which types of birth control pills treat acne?
The best choice for one woman may not be right for another, says Dr. Dunn. Some women need higher levels of hormones for the most effective results with fewest side effects, while others do better with lower levels.
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