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The Efficiency Of Contraceptives In Treating Acne

By on October 22, 2012

Contraceptive medication is rarely the first choice when treating skin problems like acne. However, there are some particular situations when this form or treatment can reduce or eliminate acne by itself or along with topical forms of medication.

When is this form of treatment recommended?

Contraceptive therapy is only available by prescription, so you should discuss this aspect with your doctor before deciding to try it, because it’s not suitable for everyone.

If you’ve tried to treat your skin problems with other types of medication but without any success, your problem might be related to a hormonal imbalance, and will not go away with local treatment alone.

Contraceptive therapy will have amazing results if you acne due to excess testosterone, polycystic ovary syndrome or other hormonal related disorders.

There are a few situations when contraceptives are preferred over other types of acne treatment:

  • when birth control is desired along with acne treatment
  • women (especially teenage girls) with an irregular menstrual cycle
  • Women that have been prescribed Accutane.

Women who are taking contraceptive therapy, as a birth control method, might notice that their skin condition will improve, and acne will remain under control.

Impressive results are obtained with this form of treatment, especially among teenage girls or women in their early 20’s, because hormone levels can be stabilized this way.

How does contraceptive medication work in reducing acne?

Oral contraceptives were initially used for preventing pregnancy, but the hormone leveling they produce has many other beneficial effects on a women’s metabolism. The basic mechanism this type of medication has includes stopping ovulation, thus causing the fertilized egg to not be able to implant in the uterus.

Contraceptive acne treatment aims to block the effect of androgen hormones (like testosterone) on the sebaceous glands. The estrogen contained in these formulas regulates the menstrual cycle and suppresses ovulation, but also causes an improvement in skin conditions like acne.

This is accomplished by either reducing the ovarian secretion of androgenic hormones or by blocking the androgens that have already been produced from stimulating the sebaceous glands. Any stimulation of sebaceous glands causes them to produce a higher quantity of oil and leads to acne, so stopping or reducing this mechanism leads to a lower amount of oil and helps reduce acne.

This makes estrogen become what is scientifically called an “androgen receptor blocker”.

The testosterone blocking process is accomplished by increasing the amount of a protein called “sex hormone binding globulin” or SHBG – a protein that binds to the testosterone molecules, not allowing them to stimulate the oil glands and produce acne.

How efficient is this scheme?

Contraceptive therapy, if used in the correct situations, can have a very high efficiency in reducing acne, especially if the cause of acne is a hormonal imbalance, or a high level of androgens. Women with unbalanced hormone levels that manifest as polycystic ovary syndrome will never be able to completely cure acne if they only treat superficial symptoms by using topical treatments.

The efficiency of birth control pills is related to the fact that they address the cause of acne, not the symptoms.  Having normal levels of hormones and a regular menstrual cycle positively impacts a women’s life and can produce an improvement in some other hormonal caused conditions, like acne.

Contraceptives that have been proven to be the most helpful with this condition are those that contain both estrogen and progesterone, or their synthetic equivalents. Usually pills contain estrogen and progestin, which is synthetic progesterone.

The pill containing only progestin (also known as the minipill), is a very effective birth control option, but its effects on acne are controversial. While it can also help regulate the progesterone level, the minipill might have some androgenic effects that are not desired during an acne treatment. These types of androgenic effects may even cause or worsen acne.

The more modern pills have different types of progestin with a much lower androgenic activity, thus being less likely to worsen acne, but the ability of treating it has not been proven yet.

Taking oral contraceptive pills can help in treating your acne even if there is no evidence of an increased production of testosterone or other androgenic hormones. In most women, blood tests will not show any increase in the level of androgenic hormone, even though they suffer from acne. Even in these cases, it is possible for acne to respond positively to hormonal treatment. The best oral contraceptives that have proven to have very good results in treating acne are Ortho Tri-Cyclen, Yasmin and sometimes Estrostep. Yasmin contains along with estrogen, a progestin called drospirenome – a substance closely related to spironolactone, a very efficient anti-androgenic hormone. Many dermatologists recommend Yasmin, as it is a very effective type of birth control and a helpful treatment for acne.

Ortho tri- cyclen contains a combination of norgestimate and ethinyl estradiol, and is recommended to women with androgen sensitivity and hormonally based blemishes. Ortho Tri-Cyclen is the first contraceptive that has been approved by the Food and Drug Administration (FDA) for treating acne, because it contains a progestin that, unlike others, doesn’t cause the release of androgens.

When are contraceptives not recommended for acne?

You should know that not any type of acne can be successfully treated using contraceptive therapy. This is due to the fact that, either the type of acne you have is not hormonal-related, or you might have some other conditions that prevent you from being able to take such medication.

Acne that is caused by bacteria, skin irritation, diet or stress might not respond so well to contraceptives. In these cases, topical or antibacterial treatment might be the better option for you.

Also, women who suffer from some conditions should not take contraceptives as an acne treatment. It is absolutely contraindicated in:

history of embolisms(thromboembolism or embolism of pulmonary arteries)

cerebro-vascular disorders like coronary artery disease, ischemic accidents or  cerebrovascular accidents

hepatic conditions like abnormal liver function, hypercholesterolemia, hypertriglyceridemia, or chronic conditions like hepatitis

women over 35, especially those who smoke

Breast cancer, or other type of cancer located in the reproductive system area.

known or suspected pregnancy