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 The Truth About Oral Contraceptives and Acne

Yes, it’s true. An oral contraceptive, what many people call “the Pill,” can effectively clear acne in women. If you are using — or considering — an oral contraceptive to treat acne, here are a few other truths about oral contraceptives and acne that you should know:

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      Several Brands Effective
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      For Best Results: Use with Other Acne Treatment
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      Taking Other Medication? Tell Your Dermatologist
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      Not for Every Woman
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      Clearing Takes Time

Several Brands Effective
Several brands of oral contraceptives can effectively control acne. A few brands have received approval from the U.S. Food and Drug Administration (FDA) for treating acne in women.

For Best Results: Use with Other Acne Treatment
Oral contraceptives are effective because they target one of the four key causes of acne — excess sebum. Sebum, a natural oil that protects the skin against moisture loss, can clog pores when the body produces too much.

Since an oral contraceptive targets only one cause, it is generally not the only treatment used to clear acne. Here’s another key fact. Dermatologists generally do not prescribe an oral contraceptive until other acne medications have proven ineffective. Acne treatment usually begins with benzoyl peroxide and topical retinoids. Depending on the type and severity of the acne, an oral antibiotic also may be part of the treatment plan. If a woman’s acne does not respond to these treatments, an oral contraceptive may be considered.

Taking Other Medication? Tell Your Dermatologist
If an oral contraceptive is a potential treatment option, be sure to tell your dermatologist about other medication that you are taking. Medications can interact with each other — in some case producing undesirable side effects. Sometimes one medication can reduce the effectiveness of another medication. The anti-epilepsy drug, lamotrigine, can reduce the effectiveness of an oral contraceptive. A second form of birth control may be necessary to prevent pregnancy.

Not for Every Woman
While oral contraceptives can safely and effectively treat acne long term, this medication is not appropriate for every woman. Due to potential side effects, oral contraceptives are usually prescribed to women who:

• Are 35 years of age or younger
• Do not smoke
• Do not have a history of migraines
• Have normal blood pressure

Dermatologists recommend that their patients who take oral contraceptives examine their breasts regularly and see a gynecologist for regular examinations.

Clearing Takes Time
The truth is clearing takes time. Patients can expect to see results about three months after beginning to take an oral contraceptive. Before then, some women’s acne worsens. If acne flares, continue to take the oral contraceptive as prescribed. Repeatedly missing doses decreases the medication’s effectiveness.

While taking an oral contraceptive for acne treatment, it is important to follow your dermatologist’s entire acne treatment plan. An oral contraceptive targets only one cause of acne — excess sebum.

Now that you know the truth about oral contraceptives and acne, you may wonder if this treatment may be right for you. A dermatologist can help a woman decide if this is an appropriate treatment option.

References:
Harper, JC et al. “Acne.” Presented at the ACADEMY ’05 Meeting of the American Academy of Dermatology: Concurrent Session 306. July 2005: Chicago.

Wachter, K. “Resistant Acne May Respond to Hormone Therapy.” Skin & Allergy News. 2004 April;35(4):46.

Wendling, P. “OCs Are Best Used as an Adjunct Acne Therapy.” Skin & Allergy News. 2005 May;36(5):15.