Contraceptive pill treatment for acne
The Pill and acne
Acne can have a profound effect on a woman's life, it can be distressing and can affect confidence and self-esteem.
If creams in ever increasing strengths or antibiotics aren't helping clear your acne you may be prescribed the combined oral contraceptive, known as the Pill.
The combined pill gets its name because it combines two types of hormones - progestogen and oestrogen.
How does the Pill help clear up acne?
It's all about hormones and their effect on our sebaceous glands.
In teenagers, it's thought too much of the hormone testosterone causes the glands to produce more sebum than the skin needs which blocks pores.
In adults, women are more likely to have acne than men and fluctuating hormones. Periods, pregnancy or polycystic ovary syndrome are often to blame.
By taking the combined pill you are manipulating your hormones so that their levels are more stable, and the production of sebum is reduced.
Young women may be prescribed the Pill even if they aren't sexually active but it may be less suitable for girls whose periods are not yet well established.
The Pill isn't prescribed for men with acne.
How effective is The Pill in controlling acne in women?
A highly respected international research network looked at 31 studies into the effectiveness of contraceptive pills in the treatment of acne. It found all of the contraceptive pills used in the studies reduced both inflammatory and non-inflammatory acne. They all contained ethinylestradiol, a type of oestrogen, combined with other drugs.
However, not all hormone treatments will produce good results - the progestogen-only pill (mini- pill) and contraceptive implant can make acne worse.
Which pill is best for acne control?
Co-cyprindiol ( cyproterone acetate with ethinylestradiol) is licensed in the UK for use in women with moderate to severe acne. Brands include Acnocin, Cicafem, Clairette and Dianette.
There are three different types of combined pills and a number of different brands. Some are taken for 21 days in each cycle, others for 28. With some, each pill has the same amount of hormone in it, with others the amount varies. So, you may find one type of pill works better for you than another.
Does it work immediately?
Unfortunately not. The combined pill can improve acne in women but it usually takes at least 3 to 4 months for the benefits to show. It may take up to a year for the full benefits to be felt.
If you are taking co-cyprindiol and your acne clears up but you still need contraception, your health care provider will probably change your prescription as co-cyprindiol isn't usually prescribed solely as a contraceptive.
Are there any risks with this acne treatment?
There is a small risk with the combined pill of blood clots (around 1 in 2,500 women a year on co-cyprindiol). This risk is greater if you smoke, are overweight or there is a family history of blood clots.
There's also a small increased risk of developing breast cancer in later life, although the likelihood of some other cancers (of the ovaries, womb and colon) may be reduced by taking the combined pill.
Co-cyprindiol can also cause headaches, reduce your interest in sex, lead to mood changes and weight gain or loss.