Acne can lead to anxiety and loss of self confidence in a person along with risks of permanent scarring. It is the most common skin disease affecting people across the globe irrespective of race, gender or age.
The major cause of acne breakout is hormonal changes inducing increasing in the level of androgens. This is the reason why acne is most persistent during or after puberty. The breakout is also very like in women during pregnancy.
Acne is majorly caused due to excess production of sebum (an oily substance) which is secreted by the sebaceous glands. Excessive sebum can lead to the clogging of pores and promote the growth of acne causing bacteria under the skin. Androgens stimulate the skin to produce sebum thereby resulting in an acne breakout.
What are Oral contraceptives?
Oral contraceptives are one the most popular form of birth control and its use was first approved for in the United States in 1960. They contain estrogen and progestin which prevents ovulation thereby preventing pregnancy.
In 1996, The Rocky Mountain Medical Journal published an article illustrating the effectiveness of estrogen-progestin combination towards the treatment of acne vulgaris.
However, it was only in 1997 that the United States Food and Drug Administration approved for the marketing of an oral contraceptive (Ortho-Tri-cyvlen) as a treatment option for acne.
How oral contraceptives help in acne?
Oral contraceptives function through anti-androgen therapy in the treatment of acne. High level of androgen leads to excess of sebum. A woman’s ovary and adrenal glands normally produce less sebum.
However the birth control pills contain estrogen and progestin that lowers the amount of androgen in the body and thereby leads to less sebum secretion and reduction in acne.
They are used to treat mild to severe acne in women. There are two kinds of contraceptives available, first containing progestin only and the second, combined contraceptive pill containing estrogen and progestin.
Acne usually improves by 45% to 50% by the third cycle and 80% to 90% by the ninth cycle. These treatments, however, are not available for men and their effectiveness in men is still under the experimental stage.
While it can be very effective for treating acne, it is not suitable for all kind of women. It has been approved for acne treatment in women who:
- Are 35 years of age or younger
- Have already started Menstruating
- Do not smoke
- Do not have a history of migraine
- Have normal blood pressure
Other advantages of using combined oral contraceptive with anti-androgenic component:
- They regulate the menstrual cycle in majority of women
- Periods becomes lighter and less painful
- Increased HDL cholesterol (high density lipoprotein also known as the “good” cholesterol) protects against altherosclerosis (hardened arteries pre-disposing to heart disease)
- Sebum production is reduced by 30% leading to improvement in 80% of those with seborrhea
- Many women with facial hair found out that it improves within 9 months
- A decrease in number of ovarian cysts occur in polycystic ovarian syndrome
These must be kept at room temperature and away from excess heat or moisture. Its disposal must be discussed by the pharmacist.
Possible Side effects
Here are some possible side effects:
Heart attack/stroke: Oral contraceptive induced changes in both carbohydrate and lipoprotein metabolism leads to increased risk of heart attacks. Women who are aged 35 or above and are smokers have a high risk of a cardiac arrest. In cases of high blood pressure, high cholesterol or family history of cardiovascular diseases, the risk may be higher.
However it has been suggested that by the Virginia Commonwealth University that after discontinuing the pills, the risk may disappear . As such the risk of a stroke is higher or rather double in women who are on oral contraceptives.
Blood clots: The use of oral contraceptives might cause blood clots in the veins of the legs. This might become dangerous and life threatening if the blood clot reaches the lungs.
This again is more probable in women above 5 years of age and those who are regular smokers. It is caused by the presence of estrogen and progestin, both of which affect blood clotting by causing an increase in the plasma fibrinogen.
Hypertension/High Blood Pressure: Contraceptive pills tend to increase the risk of high blood pressure. This risk may be higher if other factors like being overweight, smoking, family history of Blood Pressure problem contribute to it.
It occurs as a result of the hormones narrowing the blood vessels.
Spotting: This refers to the irregular mild bleeding between periods and according to a survey, 10% women experience this in the first month of their taking the contraceptives.
However, this figure is reduced to 3% by the end of the sixth month. In some cases, though rare, periods may stop completely (amenorrhoea)
Breast tenderness: It is usually advised for patients on oral contraceptives to get their breast examined regularly by the gynecologist. These contraceptives might lead to up to 20% of tenderness of the breasts.
Others: Other side effects include nausea, weight increase (in rare cases), loss of appetite, mood swings resulting in depression and headaches.
Precaution
Oral contraceptives can lead to the worsening of certain medical conditions and therefore before taking them, the doctor must be informed about your medical history. It is usually not prescribed by the doctor in case of the following medical conditions:
- History of heart disease and hypertension
- History of blood clotting disorder such as Leiden V deficiency
- History of blood, uterine or liver cancer
- Liver disease
- Diabetes
- Migraine headaches
- If you are a smoker over 35 years of age
- If you are pregnant or breast feeding
- If you are obese
Drug interaction
Some medications can interfere with the efficacy of an oral contraceptive and lead to unwanted pregnancy. Its effectiveness can also be reduced by the anti-epilepsy drug, Limotrigine. These conditions may make it necessary for a second form of contraception to prevent pregnancy.
Some popular brand names
United States Food and Drug Administration have approved three types of oral contraceptives for the treatment of acne. All of these are combined oral contraceptives having both estrogen and progestin. Each of these three has the same percentage of estrogen; however, their progestin percentage differs. These approved contraceptives are given as follows:
Ortho-Tri-cyclen: In this, the estrogen in combined with a progestin called norgestimate. It is available with different doses of progestin.
Estrostep: It uses estrogen combined with progestin called norethindrone. This pill is available with different doses of estrogen.
Yaz: This uses estrogen with a man-made progestin called drospirenone. This has, however, become unpopular with time because the Food and Drug Administration of United States has concluded that contraceptives containing drospirenone may have higher risks of bold clot that those containing other progestin. Beyas, Giyanvi and Yasmin are among the other brands that contain drospirenone
Customer review on use of contraceptives for acne
Most consumers were satisfied with use of oral contraceptive for treating their acne. It proved very effective and as some of the consumers put it, “magically and drastically” reduced their acne outbreaks. We did an analysis reviews by online users to see what they think about the treatment. Here is what they have to say:
What they like about the treatment
- Drastic improvement: Most consumers found the product to be very effective and noticed a drastic improvement in their skin and reduction in the frequency of acne breakouts.
- Texture improved: Many consumers were very happy with the product as they thought it improved the tone and texture of their skin specifically by curbing the oiliness. Some of them believed that their skin had never been better.
- Cystic acne: For many consumers it proved effective in treating cystic acne. This is important because most topical treatments are not able to clear cystic acne.
- Efficient: For a lot of consumers, oral contraceptives have been efficient in cases where no other acne treatment has been able to help. In fact it is mostly prescribed by doctors in cases where all other treatments have failed.
- Double benefit: For consumers who wanted birth control and acne prevention, it has proved doubly beneficial.
What they did not like about the treatment
- Gender specific: Oral contraceptives are only effective in cases of acne with women. Men in these cases are left with no solution, though contraceptives for treating acne in men are under experimental stage.
- Red pimples: A few consumers have complained that after using oral contraceptives, small red pimples started showing up on their faces when they were exposed to the Sun. Though it worked perfectly fine in winters.
- Not effective with scars: Though contraceptives can work wonders in reducing acne breakouts, some consumers were of the view that it is not very effective in reducing the scars of the acne developed . As such another medication must be used to deal with the scars.
Summary
As such oral contraceptives have emerged as a great solution to your acne problems.
Though not always successful, it has proven good results in most cases. When taken in accordance with the doctor’s advice it is not only very efficient but also goes out of its way to improve the texture of your skin.
Most consumers have recommended its use when other home remedies etc. do not help on your acne. Its working mechanism deals directly with the root cause of acne and it is definitely worth a try before you give up on your skin problems.