Acne treatments: hormonal contraceptives

Hormonal contraceptives are sometimes taken by women to help with acne. The idea behind these as an acne treatment is to regulate hormonal changes which might be causing or contributing to spots. Some women we spoke to had tried oral hormonal contraceptive pills as an acne treatment. Most had taken the combined pill (known as ‘the pill’) which contains both oestrogen and progesterone. Hester had also tried the progesterone-only pill (‘the mini pill’). As well as standard combined pills, there are versions that that contain an anti-testosterone, such as Dianette which Naomi and Sarah had taken. Most people had tried a few different brands of contraceptive pill.
The timing of when women tried (or were offered) hormonal contraceptives varied. Naomi, Emma and Nina had been offered hormonal contraceptives when they were around the age of 12/13 – they all felt uncomfortable about this. Naomi remembers thinking it was “really weird” taking the pill when she was “so young”. Nina thought it “really odd at the time” when she was offered the pill and declined because she was worried about what the other girls at school would think. She was also concerned that it might affect her puberty growth, adding that she was put off it as a treatment with “an equal mixture of uncertainty or fear and like embarrassment”. Hester was 15 when her GP suggested she try oral hormonal contraceptives for acne but felt this was still too young for her. Others were fine about taking ‘the pill’ as an acne medicine and weren’t fazed about its other use as a contraceptive.
As with antibiotic tablets, taking oral contraceptives meant having a routine and getting repeat prescriptions. Marga takes her pill at the same time as her morning antibiotics. She doesn’t like taking so many tablets every day though and this is why she declined antidepressants when offered. At points, both Naomi and Hester had taken a combination of topical treatments, antibiotics tablets and the contraceptive pill for acne.

Oral hormonal contraceptives can have side effects and risks. Some people find they had mood changes whilst taking the pill. This is one reason why Nina hasn’t taken oral contraceptives for acne, or isotretinoin (e.g. Roaccutane). Sarah says oral contraceptives helped her skin but affected her mood, caused mouth ulcers and weight gain. Hester also found she gained water weight whilst on the pill. Molly gets more spots around her period and thinks that hormonal contraceptives might help her acne. She’s worried though about increased chances of blood clots/deep vein thrombosis.
There were mixed experiences with how effective oral hormonal contraceptives were for controlling acne. Marga and Deborah found taking the pill reduced their spots within a few months. Alexandra didn’t notice much change. Hester thinks one hormonal contraceptive pill gave her more frequent breakouts. The impact on acne was often weighed up against other factors, such as whether there were side effects or if oral contraceptives were wanted for sexual health reasons. Marga was “determined to stay on” the pill as she found it was helping her skin. Naomi has tried other forms of contraception but found the implant (a hormonal contraceptive strip inserted under the skin of the arm) brought back her acne and the copper coil (a non-hormonal contraceptive inserted into the cervix) was too painful. She went back to taking oral hormonal contraceptives but doesn’t want to take many tablets in the long term.
There’s more about contraception in the section on isotretinoin side effects and risks because women are often required to have a reliable form of contraceptive (such as the pill) whilst taking this. This is because of risks of abnormal development of the baby if a woman taking isotretinoin became pregnant. Some of the women we talked to didn’t have to take contraceptives whilst on isotretinoin because they were so young, but some still had to do pregnancy tests every month when getting their next prescription for isotretinoin.


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