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Top 4 Birth Control Options for Managing Acne

Written by Andrew Le, MD

UpdatedMarch 9, 2024

Acne is usually thought of as a teen problem, but it can affect people at any age. Hormonal shifts or imbalances, like those during menstruation, can make acne an ongoing struggle for adults. Fortunately, hormonal birth control—which prevents pregnancy by regulating hormone levels—can be effective as an acne treatment as well.

This article will share the most effective methods of hormonal birth control for fighting acne, along with their potential side effects and risks, from birth control pills to hormonal IUDs, implants, and injections.

What Is Acne and What Causes It?

Acne occurs when your skin's sebaceous glands produce too much sebum (oil), and it mixes with dead skin cells to clog your pores, causing pimples. Hormonal changes or imbalances, such as during puberty or menstruation, can cause acne flare-ups by increasing sebum production.

How Does Birth Control Help with Acne?

Birth control can be an effective approach for managing acne because it regulates the hormones that trigger it.

Birth control pills can help control hormonal fluctuations that trigger acne flare-ups, promoting clearer and healthier skin. The combination of estrogen and progestin in birth control pills can create a more stable hormonal environment, potentially leading to improved skin conditions and reduced acne severity over time. It also reduces testosterone, which can contribute to clogged pores and inflammation,

What Are the Hormonal Changes in Birth Control that Help with Acne?

Birth control can help stabilize hormone levels, particularly estrogen and progestin.

Many birth control pills contain estrogen, which lowers testosterone levels. That in turn reduces sebum, so your pores are less likely to become clogged. Progestin, on the other hand, works by lowering hormonal fluctuations and maintaining a stable hormonal environment. Maintaining consistent hormone levels is what prevents flare-ups. Hormonal birth control that maintains a balance between estrogen and progestin levels tends to be the most effective at managing acne.

What Are the Top 4 Birth Control Options for Managing Acne?

There are several birth control options that not only provide effective contraception but also help regulate hormone levels to prevent acne. Whether you prefer birth control pills, the patch, IUDs, or implants, these are the most effective options available.

Yaz (Drospirenone and Ethinyl Estradiol)

Yaz is a combination oral contraceptive pill that contains drospirenone, a progestin, and ethinyl estradiol, a form of estrogen. It helps manage acne because it contains drospirenone, a form of progestin that blocks androgen—the hormone responsible for increasing oil production and causing acne. Yaz is a good choice if you’re looking for a birth control pill that is also effective at managing acne over time.

Ortho Tri-Cyclen (Norgestimate and Ethinyl Estradiol)

Ortho Tri-Cyclen is also another combination birth control pill (containing estrogen and progestin) that’s FDA-approved for acne treatment. Instead of keeping hormone levels consistent, like other pills, the amount of progestin gradually increases throughout the menstrual cycle, mimicking the natural menstrual cycle more closely. Consider this pill if you’re sensitive to the side effects of hormonal therapy.

Xulane (Hormonal Patch)

Xulane is a hormonal contraceptive patch that delivers norelgestromin (a progestin) and ethinyl estradiol (an estrogen) through the skin into the bloodstream. The constant delivery helps to reduce hormonal fluctuations as well as testosterone levels, both of which can lead to acne. With a once-weekly application, the patch may be a good option if you have trouble remembering to take a daily pill. The patch also gives you the option of going period-free, which can be a convenient bonus, particularly if you’re traveling.

Nexplanon (Contraceptive Implant)

Nexplanon, about the size of a matchstick, is implanted under your skin in your upper arm. It works for up to three years. It delivers a consistent level of etonogestrel, a progestin, into the bloodstream. Nexplanon not only regulates the hormonal imbalances that can lead to acne but also improves even smaller daily fluctuations that can accompany pills or patches. Consider this implant if you’re looking for long-term, low-maintenance birth control that also has the potential to improve your skin.

What are the different classes of birth control?

There are other forms of contraception, including IUDs, injections, and barrier methods like condoms and diaphragms. But the following hormonal forms of birth control are the ones that can also effectively treat acne.

Combination Birth Control Pills

Combination birth control pills contain both estrogen and progestin, which work together to regulate hormone levels and reduce sebum production. The progestin keeps fluctuations down while the estrogen decreases the amount of sebum your skin produces and helps reduce inflammation, which calms existing blemishes and helps prevent new ones.

Contraceptive Patches

The birth control patch delivers both progestin and estrogen into your bloodstream through your skin. The hormones work together to reduce hormonal fluctuations and testosterone levels, delivering powerful acne control. The patch is a convenient option that only needs to be changed once a week, and also provides the option of going period-free.

Contraceptive Implants

The size of a matchstick, a hormonal implant is placed under the skin on your upper arm, where it releases progestin into the bloodstream and can work for up to five years. Because there is no room for error, implants are an extremely reliable form of birth control. And because they work by maintaining steady hormone levels, they also reduce the hormonal imbalances and fluctuations that are often responsible for acne.

What Are the Side Effects and Risks of Using Birth Control for Acne?

While some forms of birth control can help treat acne, they may also carry certain side effects and risks, including hormonal fluctuations that could cause mood swings or disrupt your body's natural balance. Be sure to consult with your healthcare provider to weigh the benefits and any potential side effects before selecting a birth control to manage your acne. They’ll need to review your medical history to help you determine the safest and most effective option.

Increased Risk of Blood Clots

One potential risk of some forms of birth control is an increased likelihood of blood clots. Blood clots can have serious implications, as they can lead to complications such as deep vein thrombosis or even pulmonary embolism. A history of having blood clots, being a smoker over 35, obesity, and certain genetic predispositions all heighten your risk. Your healthcare provider will carefully review these factors before prescribing any birth control that heightens your risk.

Mood Changes

Another side effect of using hormonal birth control can be changes in your mood. Mood changes are often a result of the alteration in hormone levels that certain types of birth control can bring about. In some people, the fluctuations in estrogen, progesterone, and other hormonal levels can have a significant impact on their emotional well-being. For example, they could exacerbate existing mood disorders. It’s important to be aware of these potential effects and to consult your healthcare provider to monitor any mood changes you may experience.

Acne

Not all birth control helps manage acne. In fact some birth control can lead to acne because of your body’s reaction to the change of hormone levels in your body.

Nausea and Vomiting

Nausea and vomiting are common side effects of some forms of hormonal birth control. In some cases, your healthcare provider may recommend taking birth control pills with food or at bedtime to reduce gastrointestinal upset.

Lifestyle modifications, such as staying hydrated and eating smaller, more frequent meals, can help these symptoms, however, if symptoms persist, you’ll need to work with your healthcare provider to consider a different method. Or you may want to avoid hormonal birth control altogether. Non-hormonal contraceptive options like copper IUDs or barrier methods, don’t have these side effects—however, they aren’t effective for acne treatment.

How to Choose the Right Birth Control for Acne Treatment

In truth, there is no one best birth control for treating acne. The most effective option for you depends on your hormones, the condition of your skin, your medical history, and whether you experience any side effects. Work with a healthcare provider who can thoroughly review your medical history, assess your skin, and what triggers your acne. That way, they can narrow down the safest and most effective birth control options for you. It will be equally important to have them monitor your progress to ensure you don’t experience any side effects and that the treatment continues to be safe and effective over time.

Frequently Asked Questions

What are the top 4 birth control options for managing acne?

1. Yaz (Drospirenone and Ethinyl Estradiol). This combination oral contraceptive contains both estrogen and progestin, which work together to help regulate hormones and decrease acne breakouts.

2. Ortho Tri-Cyclen (Norgestimate and Ethinyl Estradiol). This combination pill also contains estrogen and progestin to help regulate hormones and decrease acne breakouts. Unlike other pills, the hormone dosage more closely mimics your body’s hormone levels, making this a good option if you are sensitive to hormone therapy.

3. Xulane (Contraceptive Patch). The birth control patch delivers both progestin and estrogen, which work together to reduce hormonal fluctuations and testosterone levels, making this patch an excellent choice for effective acne control in a convenient weekly patch.

4. Nexplanon (Contraceptive Implant) This matchstick-sized implant is placed under the skin and releases progestin to regulate your hormone

Are there any risks or side effects associated with using birth control for acne management?

As with any medication, there are potential risks and side effects to the different kinds of birth control. They may include nausea, breast tenderness, mood changes, changes in menstrual bleeding, and blood clots. Discuss your medical history and any potential risks with your healthcare provider before starting a new birth control method.

How long does it typically take for birth control to start improving acne?

It usually takes between two and six months to see improvement. However, some people have reported results within a few weeks. Taking your birth control as directed will improve results.

Can birth control be used as the sole treatment for acne?

Using birth control alone to treat your acne isn’t recommended. Discuss a comprehensive treatment plan with your healthcare provider and maintain a consistent skincare routine. Address any underlying factors that may contribute to your acne, such as diet and stress levels.

Is there a specific type of birth control that is more effective for managing acne?

Research suggests that combination oral contraceptives (“the pill”) containing estrogen and one of these progestins—norgestimate, norethindrone, or drospirenone—may be more effective than other forms of birth control at managing acne. However, results will vary from person to person, so discuss your needs with your healthcare provider.

Can birth control be used for managing acne in men?

No, birth control is not indicated for managing acne in men. These methods contain hormones that could have feminizing effects on men. Men who are experiencing acne should consult with their healthcare provider for other treatment options.