Why going on the pill might not clear your acne or breakouts


A young woman recently told me that she switched her oral contraceptive pill, and subsequently suffered bad breakouts. 

Young women are forever going on the Pill to save their skin. Be it from teen or adult acne and breakouts, it has always been 'general knowledge' among women in particular that the Pill works for skin issues. 

Image: Giphy

READ MORE: Will this “magical” pill cure your adult acne for good? 

But is this a myth? 

Many still believe that going on an oral contraceptive like the Pill will result in weight gain, for example. Stylecaster.com notes that this is a myth - "Generally, this perceived 'weight gain' is due to water retention, similar to the bloat you feel before and during your period. Furthermore, modern birth control pills contain much lower amounts of hormones than those that were available in the ’60s, which is probably when this rumour started."

READ MORE: It’s time to stop shaming people with acne 

Dermatologists have been using birth control pills to treat acne in women for decades. However, "...most oral contraceptives (OCs) have not been specifically approved for the treatment of acne and only few OCs have actually been approved for treating acne," says dermatologist, Dr. Nomphelo Gantsho.  

But there is compelling evidence that OCs are effective in the management of mild to moderate acne as the Pill decreases circulating androgens, which decreases the production of sebum and can decrease acne lesions.

"Acne is triggered by the excess production of sebum. Along with skin cells, sebum can clog pores and promote the growth of bacteria that contribute to acne," says Gantsho. 

For OCs to be effective in treating mild acne, they must contain oestrogen and low levels of progestin such as Diane, Yasmin, Yaz, Ginette, Marvelon (the common ones in South Africa). The minipill only contains progestin, so it doesn't improve acne. In fact, OCs that contain only progesterone can cause stronger androgenic effects and have the potential to exacerbate acne.

Benefits of OCs for mild acne: 

Several clinical trials have shown that taking combination birth control pills can result in:

• Decreased acne flare-ups
• Fewer pimples
• Less inflammation
• Less severe acne

"If you're already taking an oral contraceptive that's working well in treating acne, there's no need to switch brands. But if you are taking an OCs for acne for the first time, it's best to use one of the types approved for acne treatment," urges Gantsho.

And there is no quick fix when it comes to skin. OCs can take about three cycles to start kicking in, so be patient. They also are considered long-term treatment, as acne may recur when they are stopped. You may need to take a OCs for a few months before your skin starts to clear. And an initial flare-up of acne is common when a woman first starts taking OCs.

OCs work on only one acne-related factor that is excess sebum. Doctors often prescribe other forms of acne treatment with topical medications or antibiotics, to be used alongside them for best results in clearing the skin.

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