Acne problems can range from being an annoying esthetical bother to be straight up painful with chronic inflammation and scarring. Many people experience acne in their teenage years, but it can linger well into adulthood. In this case, the same measures that worked against teen pimples might not be effective any more.

Acne is largely caused by hormones, so some contraceptive methods such as combined birth control pills can make the hormonal distribution more favourable for clear skin. Since contraceptive pills can be used only by people with a uterus, it is only available to women.

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Why do I have acne as an adult?

Acne is caused by the body’s production of sebum, which is a form of fat that is utilized to waterproof and lubricate the skin. Excessive production from the sebaceous glands can clog up the sebaceous gland duct and cause an infection.

The male sex hormones androgens (testosterone) are the driving force of sebum production in the body. This is why periods of hormonal change can trigger outbreaks of infection, but the acne could also be caused by other things such as stress. 

During some periods of your life, you are more likely to experience acne. This is during times when the hormonal balance is shifted, such as during:

  • The menstrual cycle
  • Teenage years
  • Pregnancy
  • Menopause

More than 80% of cases of adult acne occur in women.

Read more about different forms of acne and how to treat them here.

How does the pill work against acne?

Acne can be mentally tough to live with, as it is often the face, chest and back that are affected. It is thus a condition that you should consider to treat, as there often are very good treatment options. Depending on the severity of your skin problems and what gender you have, there are different treatment methods on the market. For example, if you have acne during your teenage years you will often be prescribed oral antibiotics or a topic cream, but these methods fail in 70-80% of the cases of hormonal acne. If other efforts to get rid of your pimples has not given satisfactory results, you might consult your GP to have birth control prescribed for you. 

The birth control pills work since they counteract the male sex hormone, which is the cause of increased sebum production and the number of dead skin cells. Some women are more susceptible to an increase in these hormones, so if they are balanced the acne can be relieved. At the same time, the pill will protect against unwanted pregnancy, and this treatment method is therefore ideal for women who are already seeking a form of contraception.

The effect that these pills have on your acne is only active whilst using the medicines, so when you stop using it the acne might reappear. It can also take a while for the body to adapt to the new inflow of hormones, which means that it might take a while for you to see results. If several months have passed but you still see no results, you should consult your GP again.

Which contraceptive method can improve acne?

Not all hormonal contraceptives are equally efficient since some methods have been proven to worsen the state, such as IUDs, injections and implants.

The contraceptive pills that have been found to improve acne are combined pills (meaning that they consist of more than one hormone) that contain the female sex hormone oestrogen. It has been suggested that triphasic pills are the best. These have different amounts of hormones in different parts of the cycle.1

Contraceptive pills which contain oestrogen can counteract the effect of androgens and improve your skin. However, contraceptive pills which only contain progesterone can make acne worse. If you suffer from acne, you may find that a combined pill works better for you. It is well worth mentioning that individuals react differently to different forms of contraception, so it might take time to find the right one for you.2

An often used pill treatment for severe cases of acne problems is Dianette, read more about it here.

Acne caused by the pill

As mentioned above, some hormonal contraception methods can exacerbate acne problems. These are injections, implants and IUDs. During the initial months of birth control pills, one might experience reactions to the new flow of hormones, which can cause acne along with an array of other symptoms.

How to get your hands on birth control?

Most forms of contraceptive methods are not available over the counter but will require a prescription from a doctor or other relevant health care staff. Not only is this because they are not suitable for every patient, but you should also consult your GP to see if there are any other treatments that could be of better use for you. Sometimes a GP will not prescribe a birth control pill unless you actually also need contraception. 

Some side effects that can be experienced from birth control pills are:

  • Nausea, pressure in the chest, headache and mood swings, especially in the first months of the treatment
  • Pigment changes (in around 5% of women)
  • Lower blood pressure (less common)
  • Increased risk of blood clots
  • Slightly increased risk of breast cancer
  • Women over 35 and active smokers have a higher risk of haemorrhage in the brain

Birth control pills with oestrogen raise the risk of embolism, so it is likely that your doctor will recommend a different treatment if you for some reason already have a heightened risk for blood clots. This could be the case if you are over 35 years of age and have a smoking habit or if someone in your family previously has experienced embolism.

Read more about birth control here.

Other tips to deal with the outbreaks

There are some other often cited things you can do to prevent outbreaks, but it worth mentioning once again. These are:

  • Do not peel or squeeze the pigs. It will only make it worse.
  • Do not use greasy creams or make-up. This can cause the glands to tightly even more. Instead, use water-based skin care products.
  • Wash the skin with a mild soap twice a day. Avoid scrubbing or rub the skin as it only worsens the symptoms.
  • Avoid having hair hanging in your face and make sure your hair is not greasy. Avoid using a hood or other headpiece that may blemish the skin and make it greasy.
  • Make sure to consume a healthy diet, as food raising inflammation in the body might also make you more acne-prone.

References:

  1. More about the pill – Very Well Health
  2. More on treatments – NHS