When approaching acne that typically worsens around menstrual period it is important to consider modifying your birth control method— finding a treatment that has benefits of contraception and will help prevent and treat cosmetically displeasing acne.
What is hormonal acne? If you experience painful pimples and cystic acne along the lower cheeks, jawline, temples and neck it is likely you have a variant of acne called ‘hormonal acne’. This type of acne is triggered by fluctuations in our male and female hormone levels and typically worsens at the onset of the menstrual period.
Treatment: Modifying Birth Control
Oral contraception may be helpful in controlling this type of acne by regulating hormone levels, specifically increased androgen levels, such as testosterone, which is often the root of ‘hormonal acne’. When searching for an oral birth control to treat acne it is important to consider a combined oral contraceptive pill meaning it contains both estrogen and progestin vs progestin only as the latter may, in fact, worsen acne breakouts.
The Food and Drug Administration (FDA) has approved four prescription birth control medications for the treatment of acne:
(1) Ortho Tri-Cyclen (Generic: ethinyl estradiol/norgestimate)
(2) Beyaz (Generic: drospirenone /ethinyl estradiol /levomefolate calcium)
(3) Yaz (Generic: drospirenone/ethinyl estradiol)
(4)Estrostep (Generic: Ethinylestradiol/norethisterone acetate)
In general, oral birth control may help with mild-to-moderate acne breakouts; however, those with deeper cystic acne, severe acne and acne resulting in scarring may require additional oral and/or topical prescription treatment. Modifying or adding oral birth control may be an initial way to target and treat hormonal acne. For all women considering oral birth control for treatment of acne, patience is key! It can take up to 3 months on oral birth control before noticing improvement in one’s acne with the most significant improvement at 6 months.
More often than not, oral birth control is used in combination with a topical retinoid and either an oral antibiotic or spironolactone (i.e. a diuretic used in hormonal acne, blocks activity of testosterone at the level of the receptor).
Discuss with your OBGYN and/or dermatologist some birth control options and what works best for you. Unfortunately, not everyone is an ideal candidate for oral birth control. Individuals with a history of coronary artery disease or heart failure, stroke, history of blood clots, untreated high blood pressure, ovarian and/or uterine cancer, breast cancer and smokers above the age of 35 are recommended to discuss alternative contraceptive options with gynecologist.
Oral birth control pills may cause mild and often temporary side effects including mood swings, breast tenderness, headaches, weight gain, menstrual irregularities and nausea. Less frequently, oral birth control medications may increase one’s risk for blood clots involving the legs, lungs and heart. Some oral birth control medications may increase one’s blood pressure.
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