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Acne is a source of skin irritation that can range from mild to severe. It’s often caused by an increase in androgens, which are male sex hormones.

Androgens are also present in people assigned female at birth (AFAB). They become active in the teenage years for everyone and cause sebaceous glands to produce more sebum, or oil.

If you’re AFAB and you have acne, birth control may help treat it. The synthetic hormones found in some birth control pills can help decrease the secretion of oil from your glands. This can actually lessen breakouts.

The ingredients in birth control pills can vary, so you should make sure your medication contains the right mix of hormones.

The birth control pill contains synthetic (human-made) hormones that prevent the sperm from fertilizing an egg. It does this by:

  • stopping the ovaries from releasing an egg
  • changing the consistency of cervical mucus to make it harder for sperm to reach the egg
  • altering the lining of the uterus to prevent implantation

Several birth control pills contain synthetic forms of the hormones estrogen and progesterone. These types of pills are known as combination pills. The ratio of the hormones differs in each form of the combination pill.

Other birth control pills only contain progestin, the synthetic form of progesterone. They’re sometimes referred to as minipills.

The birth control pill can offer a variety of benefits. Those on birth control may experience:

  • lighter, more regular periods
  • fewer menstrual cramps
  • reduced risk of certain cancers, including ovarian, uterine, and colon cancers
  • improved acne

Birth control pills don’t protect you from sexually transmitted infections (STIs), however. You should consider using a barrier method, such as a condom, to protect against STIs.

The hormones in combination birth control pills can help reduce acne. The pills decrease the circulation of androgens, which decreases the production of sebum.

The pills must contain both estrogen and progestin to be effective against acne. The minipill only contains progestin, so it doesn’t help improve acne.

Many combination birth control pill brands are available. Each contains its own variation of hormones. Pills prescribed for acne should contain progestin with low androgenic possibility. This means the progestin has less androgenic side effects, such as oily skin and acne.

The Food and Drug Administration (FDA) has approved the following pills for the treatment of acne:

Beyaz

Beyaz combines drospirenone, ethinyl estradiol, and levomefolate calcium.

Each package contains 28 pills:

  • 24 pink tablets containing:
    • 3 mg drospirenone
    • 0.02 mg ethinyl estradiol
    • 0.451 mg levomefolate calcium
  • 4 light orange tablets containing 0.451 mg levomefolate calcium

Potential side effects include:

  • headaches or migraine episodes
  • irregular menstrual cycles
  • nausea and vomiting
  • tender breasts
  • fatigue
  • irritability
  • low libido
  • weight gain

Estrostep Fe

Estrostep Fe combines norethindrone acetate, ethinyl estradiol, and ferrous fumarate.

Each package contains 28 pills with 21 hormonal contraceptive tablets and 7 nonhormonal tablets.

Potential side effects include:

  • nausea and vomiting
  • cramps and bloating
  • changes in the menstrual cycle
  • spotting or breakthrough bleeding
  • migraine episodes or headaches
  • weight changes
  • breast tenderness
  • rash
  • yeast infection
  • increased risk of blood clots

Ortho Tri-cyclen

Ortho Tri-Cyclen combines norgestimate and ethinyl estradiol. Each package contains 28 pills.

There are 21 hormonal tablets with:

  • 0.250 mg of norgestimate
  • 0.035 mg of estrogenic compound
  • ethynyl estradiol

The 7 light green tablets are nonhormonal.

Potential side effects include:

  • nausea and vomiting
  • cramps and bloating
  • rash
  • breast tenderness or enlargement
  • swelling
  • changes in the menstrual cycle
  • spotting or breakthrough bleeding
  • yeast infections
  • migraine episodes and headaches
  • depression
  • increased risk of blood clots

Yaz

Yaz combines drospirenone and ethinyl estradiol. Each package contains 28 pills. Of these, 24 tablets have 3 mg drospirenone and 0.02 mg of ethinyl estradiol, and 4 tablets are nonhormonal.

Potential side effects include:

  • nausea and vomiting
  • headaches and migraine episodes
  • spotting and breakthrough bleeding
  • cramps and bloating
  • period changes
  • changes in weight and appetite
  • mood changes, like irritability or depression
  • vaginal infections
  • increased risk of blood clots

Other

Other combination pills that aren’t on this list may still help improve acne. Talk with your healthcare professional to fully explore which option is best for you.

Most combination birth control pills are equally effective in helping improve acne.

A 2012 review looked at 31 trials involving the use of birth control as an acne treatment. After looking at six new trials, the authors concluded that all combination birth control pills treated noninflammatory and inflammatory acne.

The study also suggested that combination birth control pills containing drospirenone were more effective than those that contained norgestimate or nomegestrol acetate plus 17 beta-estradiol.

Combination pills containing drospirenone were then found to be less effective than those containing cyproterone acetate. This distinction isn’t significant enough to favor one type of combined birth control over another, though.

In a summary of this study, the Institute for Quality and Efficiency in Health Care concluded that any claims of one pill leading to better skin should be taken with caution.

A 2018 review confirmed that all the different hormones in combination birth control pills are effective at reducing inflammation of acne.

A 2021 review also reports that oral antibiotics are the first choice to treat acne that’s resistant to topical treatments, and that adding on oral contraceptives that contain both estrogen and progesterone (combination pills) works even more efficiently.

Acne can manifest in a variety of forms, including:

Acne can develop from:

Having a family history of acne can also make you more prone to getting acne.

Sometimes, acne can be stubborn and will resist basic treatment options.

Research from 2017 showed about 80% of women with adult acne failed multiple courses of antibiotic medications. In addition, about 30% of these participants had acne that returned after multiple treatments with isotretinoin.

According to a 2018 research review, studies show hormonal birth control pills may help these cases of acne and provide relief from symptoms.

Here are the potential benefits of birth control for acne:

  • less frequent acne flare-ups
  • fewer pimples
  • less severe acne
  • reduced inflammation and redness

Taking birth control for acne isn’t the right option for everyone. Before starting treatment, discuss the potential benefits and risks of birth control for acne.

Birth control may be a good option for controlling your acne if you:

  • are over age 14 (recommended age may vary depending on the brand of birth control)
  • reached puberty and started menstruating
  • have frequent or severe acne flare-ups

Your dermatologist or healthcare professional will look for any risk factors that may rule you out as a candidate. It’s usually not recommended to take birth control for acne if you:

  • have a history of:
    • heart disease
    • stroke
    • blood clots
    • deep vein thrombosis
    • high blood pressure
    • liver disease
    • breast cancer
  • smoke and are over age 30
  • are pregnant or nursing

Birth control isn’t right for everyone. Your doctor will take into account your medical history when considering this option.

Birth control for acne isn’t recommended for people who:

  • smoke cigarettes and are over age 30
  • have a history of blood clots, especially in the legs or lungs
  • have a history of breast, uterine, or liver cancer
  • have a history of liver disease, migraine headaches, or diabetes
  • are pregnant or nursing
  • have limited or no physical mobility

It’s best to see a dermatologist if you have persistent acne. This means it doesn’t go away after 4 to 6 weeks of drugstore acne treatments. It’s also a good idea to see a dermatologist for any moderate to severe acne.

A dermatologist can help determine the cause of your acne and recommend the best treatments to try for your skin. Their recommendations could include prescription-strength creams, gels, cleansers, or oral medications like hormonal birth control.

Birth control for acne needs to be prescribed by a medical professional, like a dermatologist, doctor, physician assistant, or nurse practitioner. It can be prescribed following an in-person doctor visit or through an online healthcare service.

There are several companies available that offer online birth control services, like Pill Club or Nurx. With these services, you’ll review options virtually with a medical professional, and the birth control pills are sent to your home.

If you’re prescribed a birth control pill to treat acne, you should be aware of the pill’s side effects.

Side effects of birth control pills include:

Rare but serious side effects of birth control include deep vein thrombosis (DVT), heart attack, and stroke.

People who smoke, are older than age 35, and have risk factors for cardiovascular disease are at a higher risk of these severe side effects.

Treatment for acne depends on its severity and your reaction to different methods. The first line of treatment includes over-the-counter options, such as cleansers, lotions, and other topical treatments.

Prescription-based options include both topical and pill-based medications in the form of antibiotics, retinoids, and others.

Which birth control pills work best for acne?

The FDA has approved the following birth control pills for treating acne:

  • Beyaz
  • Estrosteps
  • Ortho Tri-Cyclen
  • Yaz

Can birth control pills get rid of acne for good?

Birth control can help stop some types of acne by decreasing sebum production. This may get rid of acne while taking the pill. However, acne could return for some people after stopping the pill.

How long does it take for birth control to clear acne?

Most people start to see improvements in their acne about 2-3 months after starting oral birth control pills. Birth control doesn’t immediately change acne because it takes time for the hormones to balance and stop causing acne.

If your acne doesn’t clear up with basic methods, you should talk with your doctor about what acne treatment might be best for you. A combination birth control pill may be a good option.

According to a 2014 study, birth control can be a first-line alternative to antibiotics in the long-term treatment of acne in women.

If you take combination birth control pills to improve acne, it may take anywhere from a few weeks to 3 months before you notice a visible improvement. This is because the hormones need time to get into your system and recalibrate your levels.

If you’re unable to find a suitable birth control pill that meets your needs, your doctor can help you find another treatment option.