Expert talks

The effect of birth control on hormonal acne

Odile Bagot, gynaecologist, explains the link between contraception and hormonal acne. This article gives you answers to the most common questions on the effects of birth control pills.

Birth control pills are often accused of being the cause of hormonal acne for teenagers or young adults. There are many questions surrounding the use of this contraceptive, the effects on the skin, on infertility, …

Before reading this article, we highly advice that you take the time to read our mini-guide of hormones, to understand better the different hormones playing a role in contraception and hormonal acne.

Dr Odile Bagot, a gynaecologist based in Strasbourg (France) and author of the Mam Gyneco blog, gives us some insights into hormonal acne.

Dr Odile Bagot, Gynaecologist.

The pill is a method of contraception, but also has secondary benefits including regulating the menstrual cycle, reducing period pain and improving the skin’s appearance.

Dr Odile Bagot, Gynaecologist.

The birth control pill is associated with 2 hormones: progesterone and oestrogen. There are also some versions that only use progesterone, but most are not recommended for hormonal acne.

The pill has a multiple effect on androgens if it contains enough oestrogen and anti-androgenic progesterone.

Blocks the production of androgens in the ovaries, leaving only adrenal production
Reduces the number of active androgens via protein carriers
Modulates the action of androgens on skin receptors

Some birth control pills are recommended for treating acne, in addition to their contraceptive function, such as Oedien, Diane 35 and Triafemi. Others have a proven positive effect on the skin including Jasmine, Belara and Varnoline.

Dr Odile Bagot, Gynaecologist

The biggest risk is forgetting to take to it, but that’s another story!

The main proven risk of taking an oestroprogestative pill is cardiovascular (heart attack, thrombosis and AVC). The pill doubles or triples cardiovascular risk for women, depending on the type of pill. We can evaluate this risk on an individual basis. But for a young, non-smoking woman, with a healthy weight and who exercises, the base risk is 0. If you multiply 0 by 2 or 3, you still get 0. Cardiovascular risk largely depends on lifestyle and genetics. What’s more, this increased risk only lasts for the first 6 months of taking the pill, before going back to normal.

Can stopping the pill trigger acne?

No, you just go back to the way things were before !

When you stop taking the pill, there is no rebound effect. The skin simply goes back to the way it was before you started taking a birth control pill. If you hadn’t suffered from acne for several years, this was probably thanks to the pill. It is, however, possible that the pill masked late-occurring acne that appears after the age of 25.

The problem of lower fertility for women isn’t related to the pill, but rather age.

The pill doesn’t increase the risk of sterility; on the contrary. In theory, it helps conserve your ova. The current generation is having babies between 30 and 35 years on average, versus 20-25 years for previous generations. Fertility reduces with age. Added to that, among men living in the west, there is the catastrophic alteration of sperm due to environmental reasons. They have half as many sperm as their counterparts in the 1930s, and this makes them less fertile.

The pill is the contraceptive method that is most beneficial for acne. The contraceptive patch or ring with the same hormones, although administered differently, may also have a positive effect.

Progesterone-based IUD
Avoid these devices as they don’t block ovulation, and increase androgen secretion, particularly in the case of polycystic ovary syndrome.

Progesterone-only pills and contractive implants
Apart from Slinda that has just arrived on the market, all progesterone contraceptives (desogestrel pill, implant or progesterone IUD) should be avoided if you suffer from acne, as progesterone is slightly androgenic.