The Contraceptive Pill and Acne

Acne is a condition that causes spots on the skin. This happens when the hair follicles in your skin get blocked. Many cases of acne are caused by changing levels of hormones, which causes the amount of sebum (an oil) we produce to increase. This extra sebum can mean follicles get blocked more often.

Taking the pill changes your hormone levels. Some pills can lower the amount of oil the body is making but others may increase it.

The hormones that can cause acne are known as androgens. Androgens make the body produce more sebum, an oil made in the glands in your skin. When too much sebum is made, it can combine with dead skin cells and create a plug in your hair follicles. This can lead to spots.

The effect that taking the pill has on acne depends on the type of pill you take and the way your body responds to the hormones.

The combined pill contains oestrogen and progesterone. Studies have shown that taking these hormones together can make the androgen levels in your body more regular, so that the production of sebum does not increase too much. This helps keep the pores in your skin clearer and reduces spots.

Many people find that their acne gets better when they start taking the combined pill but others do not. Taking the pill is also unlikely to clear your acne completely.

Other forms of contraception containing oestrogen and progesterone, like the patch and the vaginal ring, can have the same effect on acne as the combined pill.

The mini pill contains progesterone only. Some studies have found that progesterone-only contraceptives may increase the levels of androgens and make acne worse. But other studies have suggested that there’s not enough evidence to prove this.

It normally takes a few months for the combined pill to have an effect on acne. You may even have a flare-up when you start taking the pill, but your hormone levels should become more regular over time. If your acne does not improve in that time or it seems to be getting worse, you should talk to a doctor. They’ll be able to help you work out why, or prescribe a different pill.

There are many reasons why a doctor might prescribe a contraceptive pill. It’s most often prescribed as contraception for sexually active women, but it’s also one way that doctors treat acne.

A common and effective pill that is used to treat acne is co-cyprindiol. But because co-cyprindiol can cause more side effects than other pills, it is often prescribed only when other treatments have not worked.

The combined pill can be used in combination with most acne treatments. But if your acne medication, for example antibiotics, makes you throw up or have diarrhoea, this can make the pill you’re taking less effective. This also means you’ll need to use extra contraception to avoid pregnancy, while you’re unwell.

You should talk to a doctor about any acne treatments you plan to use alongside the combined pill.

Studies into the effect of progesterone-only contraceptives on acne have not proved a direct link between the two. If you find that the mini pill (progesterone-only pill) makes your acne worse, you may also find contraceptives that contain the same hormones have a similar effect. These include the implant, injection, and the IUS (intrauterine system, or hormonal coil).

If you think a form of hormonal contraception you’re using is causing acne, your doctor may be able to offer you an alternative type of contraception or an acne treatment.

There are a number of other ways that you can treat acne. These include:

• gels or creams that you rub onto the skin
• a combination of antibiotic pills and gels