Choose The Right Birth Control to Treat Acne

Not all birth control can be used to treat acne. There  are 3 things to take into consider on taking the birth control pill for treating acne.

1. Type of Progestin

Every birth control uses progestin (a synthetic form of the progesterone hormone). There are many different types of progestin. It is very important that the type of progestin is LOW in androgenic activity, meaning it doesn't send your testosterone into overdrive and create acne.

Here is a list to help choose a birth control.

Neutral (won't affect acne either way)
No hormones. Copper Paraguard IUD

Good (can reduce acne)
Drospirenone. Anti-androgenic. Used in Yaz, Yasmin, BeYa, Gianvi, Loryna, Ocella, Zarah
Norgestimate. Low androgenic. Ortho Tri Cyclen, Tri Sprintec, TriNessa, Ortho Cyclen, MonoNessa, Sprintec.
Cyproterone acetate. Low androgenic. Diane-35, Dianette.

Chlormadinone. Low-medium androgenic. Belara.

Not-so-good (may not make it worse, but probably won't make it better)
Ethynodial diacetate. Medium androgenic. Zovia, Demulen.
Desogestrel. Medium androgenic. Mircette, Apri, Reclipsen, Desogen, Kariva.
Gestodene. Medium androgenic, Femodene, Femodette, Millinette.
Norethindrone. Medium androgenic. Estrostep, Ortho Novum, Loestrin, Minestrin, Brevicon, Synphasic, Ovcon, Cyclafem.

Bad (pizza face alert!)
Levonorgestrel. High androgenic. Enpress, Plan B, Mirena IUD, Seasonique, Lutera, Portia, Amethyst, Alesse, Seasonale, Triquilar, Triphasil, Aviane.
Nogestrel. High androgenic. Cryselle, Ovral, Ogestrel, Ovrette.
Etonogestrel. Medium-high androgenic. NuvaRing, Implanon, Nexplanon.
DMPA. Medium-high androgenic. DepoProvera.

2. Level of Estrogen

Most birth control pills add in estradiol, which is a synthetic form of the hormone estrogen. Generally, skin is clearer when a pill has a moderate to a high level of estrogen.

The new "low-dose" pills basically take an existing pill, and cut down the estrogen, so you have way more progestin circulating in proportion to estradiol. It still works for birth control, since you can prevent pregnancy with progestin alone. But cutting the estrogen is bad news for acne most of the time.

This isn't a comprehensive list, but some common low-dose BC you should avoid:

No Estradiol, all Progestin

Depo Provera

Implanon

NuvaRing

Mini-pill

Mirena IUD

Nexplanon

Ultra Low-Dose

Alesse (Aviane, Lessina, Lutera, Sronyx)

Levlite

Loestrin Fe

Mircette

Ortho Tri Cyclen Lo

Low Dose

Cyclessa

Desogen

Levlen21

LoOvral

Microgestin Fe

Nordette

Orthocept

Seasonale (Seasonique)

3. Hormone Stability

For many, the right progestin type and the right estradiol level will clear them up just fine. For others, however, an extra step is needed. Some acne sufferers have breakouts every time their hormones fluctuate, such as at ovulation (when testosterone rises), or leading up to menstruation (when progesterone rises). Many pills, since their primary purpose is to prevent pregnancy as invisibly as possible, try to replicate normal hormone fluctuations. So each pill has a slightly different set of hormones, to put your body in a cycle. Some people just cannot get clear with their hormones changing all the time. If this sounds like you, please consider trying a "monophasic" pill, which keeps your hormone levels at an even keel throughout the month.

Example: Ortho Tri Cyclen is a "triphasic" pill which varies your hormones. A better option would be "Ortho Cyclen", a "monophasic" pill that keeps them stable.

Monophasic Pills (NOT a comprehensive list, same colors from Progestin Type List)

Alesse

Brevicon

Diane-35 (Dianette)

Kariva

Ortho Cyclen (MonoNessa, Sprintec)

Yasmin

Yaz

Demulen (Zovia)

Make it easy for me, what do you recommend?

For some of you, this is just way too much information. However, don't just go to your dermatologist and tell him/her you want birth control. Many dermatologists, however educated they are, don't make very informed choices about hormonal acne. They'll just give you whatever brand is giving them free samples that month, or else their knowledge of hormonal acne is 10+ years old (concurrent with when they graduated medical school).

So, if you just want an easy answer, this my Top 6 list.

1. Yasmin (or Ocella or Zarah)

     • best type of progestin, monophasic, 30ug of estradiol

2. Yaz (or BeYaz)

     • best type of progestin, monophasic, but only 20ug of estradiol

3. Ortho Cyclen (or MonoNessa or Sprintec)

     • good progestin, monophasic, 35ug of estradiol

4. Diane-35 (or Dianette)

     • good progestin, monophasic, 35ug of estradiol

5. Demulen 1/35E or Demulen 1/50E (or Zovia 1/35E or Zovia 1/50E)

    • okay progestin, monophasic, 35ug or 50ug of estradiol

6. Ortho Novum 1/35 or Ortho Novum 1/50

    • okay progestin, monophasic, 35ug or 50ug of estradiol

Frequently Asked Questions

What about the mini-pill?

There are several different brand names for the mini-pill. A mini-pill uses only progestin and has no estrogen at all. Mini-pills are a terrible choice if you have acne, as they frequently cause acne in people who never had it in the first place. Some of the implant types of birth control, such as the Mirena IUD, also only use progestin, and can increase acne.

But my friend is on ______ and her skin is great! Even though it's on your bad list!

Look, I am just here to provide information and some general principles. There are always exceptions, and new information is coming out all the time. Feel free to ask questions, but in the end, you're gonna do what you want...if it doesn't work out in the end, well I won't say I told you so.

That is all. and Ihope this information will be helpfull for you. Have a nice day