ZocdocAnswersDoes birth control help control acne?

Question

Does birth control help control acne?

Is it really true that going on the pill helps women control their acne? If so, does it work on all kinds of acne? I'm 25 and I've had bad acne (cystic) since I was 15. I am willing to do whatever I can to control it.

Answer

This is a common question that many women have. First let me say a little about what scientists believe causes acne and then I'll write about how oral contraceptives (birth control pills) are believed to help in the treatment of acne symptoms. Scientists believe that there are four major factors that lead to acne: 1) increased production of a protein on the skin which leads plugging of follicles and the creation of "blackheads;" 2) increased production of an oily substance called sebum that helps to plug the follicles; 3) breakage of the blackheads which causes inflammation of the skin; 4) and finally a bacteria called p. acnes that lives on the skin and helps to worsen the inflammation. Oral contraceptives have been used to help decrease the signs and symptoms of acne, including cystic acne for quite some time, and most family physicians have quite a bit of experience using them to help this. The pills are made of two hormones that a woman's body makes, estrogen and progestin. Almost all pills have the same form of estrogen, but there are many different types of progestin in the different brands of pills. Physicians believe that the pills help decrease acne in several ways, but the main way is by decreasing the amount of male hormones, androgens that naturally occur in a woman's body. By decreasing the level of androgens, less of that oily substance (sebum) is made and so the symptoms of acne are improved. Physicians believe that some of the newer pills which have desogestrel, norgestimate, or drosperinone as their progestin component may be better at helping to treat acne, but almost any pill can be used. You should talk with your primary care physician or a dermatologist about this and he or she can help you make the decision that's best for you.

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