The birth control patch is a thin, transdermal patch that adheres to the skin, delivering a combination of synthetic hormones, specifically estrogen (ethinyl estradiol) and a progestin (norelgestromin), directly into the bloodstream. This method offers a convenient, once-weekly application to prevent pregnancy. Many individuals considering this contraception are concerned about whether the steady delivery of these hormones might trigger or worsen acne. The general effect of this combination method is often an improvement in acne, but individual variability in skin response can occur.
Understanding Hormones and Skin Changes
Hormonal acne is primarily driven by androgens, which are hormones like testosterone that all women produce. Androgens stimulate the skin’s sebaceous glands, leading to an overproduction of an oily substance called sebum. Excess sebum can mix with dead skin cells, clogging pores and creating an environment for acne-causing bacteria to thrive, resulting in breakouts.
The combination of estrogen and progestin in the birth control patch works to counteract this process. Estrogen significantly reduces free-circulating androgens by increasing the production of a protein called sex hormone-binding globulin (SHBG) in the liver. SHBG binds to androgens, effectively lowering the levels of “active” testosterone that stimulate the oil glands. This reduction in androgenic activity is the main reason why combination hormonal contraceptives are often recommended for acne treatment.
The progestin used in the patch, norelgestromin, is considered a third-generation progestin. It has negligible direct androgenic activity, meaning it has a minimal tendency to stimulate the oil glands on its own. This low androgenic profile, combined with the anti-androgen effect of the estrogen, makes the patch generally beneficial for acne. However, the initial introduction of any new hormone regimen can cause a temporary skin adjustment period, and a small number of users may experience a temporary flare-up.
Contraceptive Methods and Their Impact on Acne
The birth control patch is a form of combined hormonal contraception, and its effect on acne is comparable to that of combination oral contraceptive pills (COCs). Like the patch, COCs contain both estrogen and a progestin, working by suppressing androgens to clear the skin. The patch delivers hormones transdermally, avoiding the first-pass metabolism in the liver that pills undergo, leading to a steady delivery of hormones.
Some combination pills are specifically FDA-approved for the treatment of acne, often those containing progestins known for their anti-androgenic properties, such as drospirenone or norgestimate. While the patch is not specifically FDA-approved for acne treatment, its use of the progestin norelgestromin, which is the active metabolite of norgestimate, suggests a similar systemic benefit for skin health.
In contrast, progestin-only methods, such as the hormonal implant or the mini-pill, do not contain estrogen to suppress androgen levels. These methods may be associated with a higher likelihood of acne flare-ups because the progestin alone can have a residual androgenic effect. Therefore, for individuals whose primary concern is acne, a combined method like the patch or a COC is typically a better option.
Steps to Take If Acne Develops
If you begin using the birth control patch and notice new or worsening acne, first give your body time to adjust to the new hormonal balance. Hormonal contraceptives typically require three to six months before the full effect on the skin is seen. During this initial phase, an increase in breakouts may be temporary as the body adapts.
It is also beneficial to review your current skincare routine to ensure it is non-comedogenic and not contributing to the breakouts. If acne persists beyond the initial few cycles, consulting a healthcare provider or a dermatologist is the recommended next step. They can evaluate whether the specific formulation in the patch is contributing to the problem.
If the patch is determined to be the cause, your provider may suggest switching to a different form of combined hormonal contraception. This might involve a pill containing a different progestin known to be highly anti-androgenic, such as drospirenone. Alternatively, a dermatologist can prescribe topical treatments or oral medications like spironolactone, which directly blocks androgen receptors, to manage the acne while you continue using the patch for contraception.