The contraceptive pill and acne

Acne is commonly associated with teenagers and tends to be common with adolescents, but these spots and pimples can persist right into adulthood. While it can be frustrating to deal with, adult acne is common, and many different treatments are available for it.

What causes adult acne?

Hormonal fluctuations are the culprit behind acne. Spots breakout due to a buildup of sebum oil, blocking the hair follicles. Excess production of sebum oil is caused by a higher level of a group of hormones called androgens. These levels can fluctuate during hormonal changes in the body, such as puberty, menstruation and pregnancy.

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How does the pill help acne?

The combined pill releases estrogen and progesterone hormones into the body, regulating the menstrual system and reducing the number of androgens produced in the body. In turn, this lowers the amount of sebum and helps to reduce existing acne. The pill will help prevent further acne breakouts, reduce the inflammation and number of spots you already have.

Which types of the pill are used for acne?

Various types of combined pill have been prescribed to treat acne as an off-label use for many years. This tends to work well for women of menstruating age who also need a reliable contraceptive and don't have any underlying health issues. The mini-pill, or progesterone-only pill, cannot be used to treat acne. In some cases, it can make acne worse. Tell your GP if you wish to try using the combined pill for this purpose to ensure they prescribe you with the correct type of pill.

Can I use the pill alongside other acne treatments?

The benefit of the combined pill is that you can use it simultaneously with any other acne treatment. Two types of antibiotics affect the way the pill: Rifampicin and Rifabutin, but these are not used to treat acne. Examples of acne treatments include:

Retinoid creams such as Differin
Antibiotic creams
Antibiotic tablets such as Oxytetracycline
Azelaic acid gels
Isotretinoin

Over-the-counter creams, gels or cleansers containing benzoyl peroxide are usually the first lines of treatment for mild acne. If your symptoms persist then a GP can prescribe you with a stronger treatment. We have several varieties of acne treatments available and advice on how to deal with acne.

What are the risks of taking the pill?

There are certain risks involved in taking the combined pill. If you consider it a treatment, you must be fully aware of the potential side effects and risks before taking it.

As a serious side effect, the pill increases the risk of blood clots which can lead to a heart attack or stroke. This is rare, but your GP will assess your medical history before prescribing you with the pill. If you have heart problems or high blood pressure, your risk is higher, so the pill may not be suitable.

There are other common side effects associated with the pill that usually ease off after the first couple of months which include:

Nausea
Breakthrough bleeding or spotting
Bloating
Abdominal pain
Mood changes
Breast tenderness
Headaches
Weight gain

What else can I do to deal with acne?

Whether you are using the combined pill, antibiotics or a cream for your acne, it won't disappear overnight. The treatments need time to work, so it's important to persist and be patient. However, this might be easier said than done as acne can have a negative impact on your confidence and self-esteem. The best thing you can do is take care of your skin, use a mild cleanser and moisturiser twice a day and drink plenty of water. Over-washing tends to make your skin worse while nourishment from a healthy diet can help. Makeup can help you to cover up acne to boost your confidence. Make sure you look for non-comedogenic products (that won't block up your pores) so that you don't welcome an additional buildup of sebum and bacteria.

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