The balance between the female hormones progesterone and oestrogen is delicate, not to mention disruptions related to androgens such as testosterone. Put briefly, there is often acne when progesterone is the dominant hormone. With oestrogen dominance, the skin is fairly healthy, but premenstrual syndrome is more pronounced. Only a gynaecologist can assess the benefits for acne and the risks associated with the use of a given type of contraception.
All birth control pills stop ovulation and supply both progesterone and oestrogen, but at different levels. 1st, 2nd, 3rd and 4th generation contraceptive pills are each characterised by the type of progestin they contain. Some progestins in birth control have androgenic effects and can thus potentially aggravate acne, while for others, this is not the case or only minimally so. However, they pose a higher risk of thrombosis, which affects the veins and is extremely serious.
Hormonal IUDs (intrauterine devices) and contraceptive implants also contain a progestin. They can therefore increase seborrhoea and blemishes in predisposed women.
It is therefore down to doctors to assess the risks posed by each method of contraception and consider all of the possible consequences to choose the option best suited to each patient.