Acne relief in birth control pills

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We've long known there's a link between certain oral contraceptives and acne, right?

There's a reason that unlikely combination works: in both sexes, male hormones (including testosterone) increase during puberty, and stimulate the sebaceous (skin’s oil glands) follicles. Overstimulation results in too much sebum, which can lead to acne.

As teenagers reach adulthood, hormone levels are supposed to stabilise, and acne problems usually clear up. However, some people still experience mild to moderate acne in their 20s and 30s.

How the Pill treats acne
The Pill is usually an oestrogen-progesterone combination that alters the female hormone pattern, including reducing the amount of the testosterone in the body. With the drop in testosterone, sebum production drops.

It is widely believed that it is the progesterone and not the oestrogen in the Pill that determines whether it is effective for acne treatment.

Not all Pills work, though: some contain versions of hormones that can actually worsen acne. Oral contraceptives that contain the anti-androgen cyropterone (the name is usually listed in ingredients) work best, says dermatologist, Dr Nonhlanhla Khumalo.

Women who have polycystic ovarian syndrome (PCOS) can greatly benefit from using an oral contraceptive. It helps to clear acne brought on by the condition and can also help with other PCOS symptoms such as excessive hair growth.

How effective is the Pill in treating acne?
"Very effective," says Dr Khumalo. "Most people will get better with simple creams and antibiotics, where necessary - hormones are only used on the few patients who have not responded to these."

Oral contraceptives can be used in conjunction with acne creams, but not with other oral acne medication.

Results can be expected within three months of taking an oral contraceptive. In some women acne may initially flare up, and it is advised to continue taking the oral contraceptive as prescribed.

It is important to remember to take the pill regularly as missing doses can decrease the efficacy of the pill.

Study shows the pill is effective
A recent study done by researchers at Northwestern University Feinberg School of Medicine in Chicago researched the safety and efficacy of acne treatment using the diuretic (water pill) spironolactone and Yasmin, a combined oral contraceptive.

The study found that in the group of 27 women who had severe facial acne, 11% of the women were clear of acne lesions, 7.4% had excellent improvement and 7.4% had no change. The researchers found that the combination of spironolactone and Yasmin was effective in controlling moderate to severe hormonally-influenced acne in women.

Should you use the pill?
"It depends on the severity of the acne and the age of the patient. The doctor treating the patient will make the recommendation," says Dr Khumalo.

Like most medications there are side effects to using oral contraceptives.

"Side effects include weight gain, increase in blood pressure and an increase in the risk of developing blood clots in the leg (deep vein thrombosis). These side effects are rare and increase with age. Routine monitoring by the health care provider prescribing the treatment will pick up early (reversible) signs before they become serious," says Dr Khumalo.

(Leandra Engelbrecht, Health24, April 2009)

Sources:
-Dr Nonhlanhla Khumalo, Dermatologist
-www.skincarephyscians.com
-www.medscape.com
- San-Joyz,N. Can Birth Control Pills Still Treat Acne.American Chronicle. 25 January 2007 www.americanchronicle.com
-www.acne-resource.org
-www.acnescience.com
-http://women.emedtv.com
-www.acne.about.com
-www.health24.com

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