While birth control offers many advantages, it can sometimes contribute to or worsen acne. This article explores practical approaches for treating acne that may arise while using birth control.
The Hormonal Connection
Acne frequently stems from hormonal fluctuations, particularly involving androgens. These hormones stimulate the skin’s sebaceous glands to produce more sebum, an oily substance. Excess sebum, combined with dead skin cells, can clog pores, creating an environment conducive to bacterial growth and leading to breakouts.
Different types of birth control can influence these hormone levels. Progestin-only birth control methods, such as the mini-pill, hormonal IUDs, or implants, can sometimes increase androgen levels or produce progestins that have androgenic effects, potentially exacerbating acne. Conversely, combined oral contraceptives (COCs), which contain both estrogen and progestin, typically work to reduce androgen levels. Estrogen in COCs can increase sex hormone-binding globulin (SHBG), a protein that binds to and reduces the amount of free androgens circulating in the body, thereby decreasing sebum production and improving acne.
At-Home and Over-the-Counter Care
Managing acne often begins with consistent at-home skincare practices and over-the-counter (OTC) treatments. A gentle skincare routine involves regular cleansing with a mild cleanser and moisturizing to maintain skin barrier health. It is beneficial to choose products labeled as “non-comedogenic,” meaning they are formulated not to clog pores.
Common OTC ingredients can target different aspects of acne. Salicylic acid, a beta-hydroxy acid, works by helping skin cells shed more readily, which prevents pores from clogging and can also reduce oil. Benzoyl peroxide helps by killing acne-causing bacteria and reducing excess oil on the skin. Topical retinoids, available in some OTC strengths like adapalene, normalize skin cell turnover and help prevent clogged follicles.
Beyond topical treatments, certain lifestyle adjustments can support skin health. Avoiding frequently touching the face can prevent transferring oils and bacteria, while regularly changing pillowcases helps reduce exposure to accumulated oils and debris. Managing stress through relaxation techniques or exercise can influence hormone levels and sebum production. Staying hydrated supports overall skin function.
Medical Treatments and Birth Control Adjustments
When at-home and OTC options are insufficient, medical treatments and adjustments to birth control can provide more targeted solutions for acne. Dermatologists may prescribe stronger topical medications, such as higher-strength retinoids (e.g., tretinoin, tazarotene), which are effective in normalizing cell growth and reducing inflammation. Topical antibiotics like clindamycin or erythromycin can reduce acne-causing bacteria and inflammation.
Oral medications are an option for more widespread or severe acne. Oral antibiotics, typically tetracyclines, are prescribed for their anti-inflammatory properties and ability to reduce bacteria. Spironolactone, an oral medication, can be effective for hormonal acne by blocking androgen receptors.
Changing birth control methods is another strategy for managing acne. Combined oral contraceptives (COCs) are often prescribed for acne because they regulate hormones and reduce androgen levels. The U.S. FDA has approved specific COCs for acne treatment, including Yaz, Estrostep Fe, and Ortho Tri-Cyclen, all of which contain both estrogen and a progestin. These pills work by decreasing ovarian androgen production and increasing sex hormone-binding globulin, which collectively lowers circulating androgen levels and reduces oil gland activity.
Consulting a Healthcare Professional
Deciding when to seek professional medical advice for acne, particularly when linked to birth control, is an important step. If at-home treatments have not yielded improvements after several weeks, or if acne is severe, persistent, or causing distress, consult a doctor or dermatologist. Signs such as deep, painful cysts or nodules, or the presence of scarring or dark marks, indicate a need for professional intervention.
A healthcare professional can accurately diagnose the type and severity of acne, considering potential hormonal influences related to birth control use. They can offer personalized treatment plans, which may include prescription medications or a change in birth control methods. It is important to avoid discontinuing birth control without medical guidance, as this could disrupt hormonal balance further or lead to unintended pregnancies. Professional guidance ensures a safe and effective approach to managing acne while maintaining contraceptive needs.