Taking the contraceptive pill for acne

The combined contraceptive pill works best for acne. The combination of progesterone and oestrogen together counteracts the male sex hormones (androgens) that can trigger the condition.

One effective combined pill for acne is co-cyprindiol (brand name Dianette). However, it’s only usually prescribed when conventional acne treatments have not worked, as it has more side effects than other contraceptive pills. This is not an option we provide at the moment.

Doctors can also prescribe Yasmin or its generic version Lucette.

How well your acne responds to the pill depends on the type of pill you take and how your body reacts to the hormones. Not everyone who takes a contraceptive pill for acne will get the same effects, and you may find conventional acne treatments far more suitable.

Hormonal acne is caused by hormones called androgens, which are found in both men and women. They perform various tasks in the body, including activating the sebaceous glands. If you have too many androgens, the sebaceous glands produce excess sebum. This clogs up the follicles on the skin and causes spots.

Puberty can also affect our hormone levels, making hormonal acne even more common during this period.

The contraceptive pill helps with acne by reducing the production of sebum. Less sebum can lead to clear skin and fewer spots.

It can take 6 to 12 weeks to see improvements. However, for some people taking the pill does not improve their acne. It varies from person to person and depends on how your body responds to the hormones. It is also possible to experience a worsening in your acne when you start taking the pill.

ZAVA's doctors will help you find the right contraceptive pill for you. They can also discuss alternative treatments for acne and ensure you are aware of the potential side effects of taking the pill.

Studies have shown that the combination of hormones in the combined contraceptive pill can regulate your androgen levels and reduce sebum production. Likewise, other contraceptives containing combined hormones (like the patch and the vaginal ring) can also help with acne.

On the other hand, some studies suggest that the progesterone-only pill (also known as the mini pill) can increase your androgen levels and make acne worse. Although other studies have contradicted this, doctors do not usually prescribe the mini pill to treat hormonal acne.

It can take between 6 and 12 weeks before you see any improvement in your skin. This is because your body can take some time to respond to the new hormone levels. If there are no improvements after a few months, your doctor may try a different pill or an alternative treatment for your acne.

You can usually use your existing treatments for acne alongside taking the pill, but you should check this with your doctor first. In some cases, your current treatment may impact how effective the pill is at preventing pregnancy. If you are using the pill for contraception as well as an acne treatment, you may need to use additional contraception such as a condom.

As with all hormonal contraceptives, you can get side effects when taking the pill for acne. While many people get no side effects, for some people, they can be severe or more frequent than other acne treatments.

The most common side effects of the pill are:

• nausea and being sick
• stomach problems
• headache
• mood swings
• painful breasts
• spotting

Occasionally, depression, hair loss, and exhaustion may occur.

Rarer but severe side effects of taking the pill include liver tumours, breast cancer and blood clots (thrombosis). Due to these possible side effects, smokers, older women, some migraine sufferers and women who are very overweight may not be able to take the pill to treat acne.

You can find a complete list of the side effects for each pill in the patient information leaflet that comes in the box.

You should not take the pill for acne if you:

• are allergic to any of the ingredients
• are pregnant
• have a BMI over 35
• smoke (in some cases)
• regularly get certain types of migraines
• have existing or previous thrombosis
• have high blood pressure
• have had a pulmonary embolism
• have liver disease
• have breast cancer

Popular acne medications include:

• acne creams
• acne gels
• tablets or capsules
• tinctures

If you have mild acne, over the counter treatments available from the pharmacy might be all you need. But if you have moderate to severe acne, you may need to take prescription medications. These can be either oral or topical and may contain an antibiotic, antibacterial or retinoid.