What Kind of Birth Control Helps Treat Acne?
The American Academy of Dermatology (AAD) indicates that 50 percent of adult women between the ages of 20 and 29 continue to suffer from acne. Women may also notice that their acne gets worse after age 20, says dermatologist Bethanee J. Schlosser of Chicago's Women's Skin Health Program at Northwestern University Feinberg School of Medicine. Many women experience an increased number of pimples on the lower half of their face, breakouts prior to menstruation and resistance to oral antibiotics, Schlosser says. A treatment option for some women who suffer from hormonally influenced acne is also a type of birth control: oral contraceptives, or birth control pills.
More about Hormonal Acne
Adult acne in women is caused by a several factors, including excess sebum (oil) production, inflammation in the skin, abnormal shedding of skin cells within the hair follicle and a bacteria called Propionibacterium acnes (P. acnes) which normally resides on the skin. Male sex hormones called androgens are present in both men and women and can trigger the sebaceous glands to over-produce, as well as affect how skin cells mature, explains the AAD. Excess oil production, a primary cause of hormonal acne in women, can be curbed by birth control pills.
How Birth Control Pills Work
Oral contraceptives are considered a long-term acne treatment that serve the dual purpose of preventing pregnancy and reducing both inflammatory acne lesions (papules, pustules and nodules) and non-inflammatory lesions (whiteheads and blackheads). The estrogen contained in birth control pills reduces the amount of testosterone and other androgens produced in the ovaries, decreasing the amount of testosterone in the body. The sebaceous glands produce less oil, which in turn results in fewer plugged hair follicles--and decreased acne.
Oral Contraceptives That Work
Not all types of birth control pills treat acne, cautions the AAD. Schlosser points out that the progestins in some pills can mirror the effect of testosterone and make acne even worse. Schlosser advises birth control pills that have little or no risk of affecting the testosterone receptors that contain norgestimate, desogestrel or drospirenone. The U.S. Food and Drug Administration has approved three oral contraceptives for the treatment of acne, says the Mayo Clinic. These include combinations of ethinyl estradiol and norgestimate; ethinyl estradiol and norethindrone; and ethinyl estradiol and drospirenone. You may know these by their respective trade names: Ortho Tri-Cyclen, Estrostep and Yaz.
Birth control pills, although an effective treatment for acne, aren't without side effects and possible complications, says Mayo Clinic dermatologist Lawrence E. Gibson. These may include sore breasts, nausea and vomiting, depression, decreased libido, changes in menstruation, headaches and an increased risk for hypertension, heart disease, blood clots and hyperkalemia. Schlosser states that patients are screened very carefully before they are given oral contraceptives to treat acne, as this is not an appropriate therapy for every woman. Unless a patient's gynecologist recommends oral contraceptives, the AAD indicates they are not prescribed for women over the age of 35, those who smoke or those who have migraine headaches or a blood-clotting disorder.
Birth control pills for acne are generally used as a last resort when all other treatment methods have failed, says Gibson. Before a dermatologist prescribes oral contraceptives, prescription medications, such as topical retinoids and oral antibiotics, will likely be employed as a first-line treatment for acne, says the AAD. Women who are good candidates for hormonal therapy who've exhausted all other options should talk with their dermatologist to discuss a customized plan of care that includes ongoing monitoring.
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