Dermatologist Dr Dray on the best BIRTH CONTROL PILLS for HORMONAL ACNE. Does acne get worse after stopping birth control? What are the side effects of birth control pills for acne? Do birth control pills cause acne? Do birth control pills cause melasma. #acne #acnetreatment #dermatologist
Hey guys in today’s video i’m gonna be telling you everything you need to know about taking birth control pills for acne if you’re new here welcome my name is andrea i’m a board certified dermatologist i would love it if you would subscribe to my youtube channel and hit the thumbs up it really helps my videos out a lot birth control pills are frequently prescribed
For acne and women especially women whose acne flares with their period oral contraceptive pills as they’re called are birth control pills combine two types of hormones estrogen and progesterone how do they work well they influence the normal cycles of hormone fluctuations in our body that govern the menstrual cycle suppressing ovulation so that’s how they work
To prevent pregnancy as contraceptives they block the ovulation step so how the heck do they work to treat acne well when women’s hormone profiles fluctuate they change from a more female predominant pattern of estrogens and progesterones to a more male predominant pattern of androgens or testosterone and androgens influence the skin quite a bit and cause the
Oil glands to make more oil and they cause the skin to become a little bit thicker and the skin cells to become stickier so you’re more prone to clogging of the pores excessive oiliness and that’s really what underlies flares of acne around the period the menstrual cycle hormonal acne for whatever reason hormonal acne seems to often affect the jawline the chin
The neck but it really can happen anywhere any type of acne however really can be influenced by these changes in hormones the pills need to be the type that are combined oral contraceptive pills there are a variety of other contraceptives on the market that just use one type of hormone progesterone like the progesterone only pill and also there are some implant
Implantable contraceptives that release progesterone these actually can worsen acne so a lot of people say why did my acne get so horrible when i went on birth control well it may have been that you were not on a combined oral contraceptive pill that combined estrogen and progesterone you may have been on a method that was progesterone only and in that case yes
The acne can get worse so in order for the acne to see benefit from taking a birth control pill it needs to be one that combines both estrogen and progesterone there are actually three brands of oral contraceptive pills on the market that are fda approved for the treatment of acne in women these include ortho tricyclin estrostep and yaz so these are the three
Brands that get the fda seal of approval for the treatment of acne and women however any combined oral contraceptive pill will also benefit acne by the same mechanism it doesn’t necessarily have to be one of these three so your physician may prescribe another brand what’s called off label meaning it’s not fda approved but they know it’s going to help anyway who
Is a good candidate for combined oral contraceptive pills to treat acne well women whose acne flares with the menstrual cycle but truthfully any female who has acne can benefit from having a conversation about whether or not oral birth control pills are right for them because while your acne may not necessarily flare with your periods there is always an underlying
Hormonal component governing oiliness skin cell stickiness that may benefit from a combined oral contraceptive pill there’s also an endocrine disorder called polycystic ovary syndrome i know a lot of you guys deal with that and in that disease those women suffer from acne and also hirsutism these are skin signs that can benefit from the use of oral contraceptive
Pills for sure you absolutely want to discuss this with your treating healthcare provider your family medicine doctor or internist gynecologist or your dermatologist have a conversation if birth control pills are going to be right for you for the treatment of your acne who should not be prescribed birth control pills for their acne if you have a history of blood
Clots it’s contraindicated because the estrogen in birth control pills does increase the risk of clotting and for people with a history of clotting or some sort of underlying blood clotting disorder then it is contraindicated if you don’t have a history of blood clots the risk is very very very very low and we encourage people to um you know if you’re going to
Be on a long trip and sedentary that it’s good to get up and move around just as a general precaution that’s just a good measure to reduce the risk of clotting a sign of a blood clot would be a sudden one-sided swelling of either your arm or your leg redness warmth discomfort that would be those are clues that you might have a blood clot and in that situation
Immediately call your health care provider and you know tell them about it and and if you can’t get a hold of them you know you might actually even want to consider going to the urgent care or emergency room because blood clot is nothing to to to mess around with but in people who are otherwise healthy and don’t have any history of clot blood clots you know it’s
Very very very low low risk issue the other group of people who birth control pills are contraindicated for because of the risk of blood clotting is people who smoke so if you smoke it’s not you know good to be on birth control it is too risky with the blood clot thing if you smoke as a side note please please please please please do everything in your power to
Try and stop smoking also if you have a history of migraines birth control is not going to be a good option for you as well so those are the you know kind of absolute contra indications definitely talk about it with your with your doctor how long does it take to see results when you start taking birth control for your acne as with anything in the skin nothing
Happens overnight some people say they see an improvement in one month so you know some patients report that or at any rate they notice that their skin is less greasy however for the most part it takes at least three months six months typically for you to really start seeing results so you have to be on it for a good while before you really start to appreciate
The skin benefit of the reduced oiliness reduce pore clogging and overall improvement in the acne what are the side effects of birth control pill most commonly you can expect to experience some nausea bloating and breast tenderness this is these are very common side effects the good news is they typically for the most part go away after three months so the first
Three months can be the most uncomfortable um but then those side effects typically subside if you’re having nausea with taking birth control pills a tip is to take the pills in the early evening and then make sure you have breakfast the following morning that can help quite a bit with the nausea some people have issues with headaches and one thing that can
Actually help is some birth control pill packs they have a hormone free week and that week you know you’re not you’re taking either placebo pills or you’re not taking you know you’re just not taking anything for a week and that’s typically when people have what’s called a withdrawal bleed that you know as a period um but a way if you’re having headaches sometimes we
Tell patients to skip that that placebo week and just move on to the next pack of pills um so that would can reduce the headache symptoms um birth control pills that has have drospirone in them like yeahs those birth control pills address prone has a bit of a diuretic effect and that can actually end up helping mitigate symptoms of bloating and breast tenderness
Other side effects that are pretty common are changes in mood some people claim they don’t feel quite like themselves they’re more moody some people feel as though their mood is improved some people report a change in their libido there’s actually a study that looked at this and about 64 of people on birth control pill say there’s no change in their libido 22 had
An increase in libido and 15 had a decrease in their libido and you know that can be something that people just you know are not okay with obviously and that might be a reason why you end up not wanting to stay on birth control but that is another symptom that sometimes resolves on its own another potential side effect that you guys might be worried about because
This is a skincare channel is melasma melasma is classically referred to as the mask of pregnancy dark brown patches on cheeks foreheads really anywhere on this on the skin and we call it the mask of pregnancy because it shows up during pregnancy but any hormones that you take that have estrogen in them can trigger melasma it’s not always going to happen it’s
Not a guarantee you take that you take birth control pills you’re going to get melasma but if you have melasma it certainly can worsen that and if you’ve never had melasma you might start seeing some hyperpigmentation there was a study done in the 60s 70s that showed that it happened with about 29 but if you actually look at that study back then they were using
Uh combined pills with a much higher dosage of estrogen so it’s not you know that’s not as commonly used anymore so it’s less less risky but it certainly is a potential side effect the melasma does go away albeit slowly when you stop the birth control pill in a way to reduce that the risk of the melasma of course is to protect your skin using a broad spectrum
Sunscreen spf 30 or higher every single day including when you’re indoors because the uv that comes through window glass remember can drive melasma and there are studies showing that sunscreens with iron oxides can be preventative and helpful for people with melasma because they block out visible light that likewise can contribute to you to melasma so use a tinted
Mineral sunscreen for example that can be a great option for at least reducing that risk all right but probably one of the most pressing questions that i get is do i have to be on birth control forever to maintain good control of my acne you don’t you do not but do you realize that birth control pills they’re not a cure for acne they merely address the hormonal
Component of acne and that’s what yields the improvement when you stop the birth control pills you absolutely can see a return of your baseline acne however we don’t usually just prescribe birth control pills i mean we don’t that’s not like a first line treatment for acne for anybody it’s just give them a pack of birth control pills and be like hey see you later
There needs to be other treatments started ideally at the same time topicals that take time to work but by the time you get to a point where things have improved you know you may be able to transition to just topicals and not worry about the acne returning when you stop the birth control pills for example the topical that pretty much every acne patient should be
On in my opinion or benefits from most acne patients do is going to be a topical retinoid uh you know that might be prescription uh tretinoin or over-the-counter adaptolene not only do retinoids help in reducing oiliness but they also help improve the skin cell turnover within the pore kind of helping with that stickiness issue reducing pore clogging and they
Can help reduce flares of acne down the road so you know it wouldn’t just be like you’re just being prescribed birth control pills there would be something something else and then of course the lifestyle factors really play a major role in acne we have learned so much more about acne as a disease and the lifestyle factors are increasingly more obvious that they
Play a role in disease severity managing your stress is really important when you are stressed out that raises cortisol levels which influence oiliness and skin cell stickiness as well so coping with stress and finding out ways to cope with stress and mitigating your stress is actually really important in your journey to improving your hormonal acne or any type of
Acne getting good sleep is imperative seven to nine hours is really what adults need to have their skin properly heal and for good immune health i mean it’s just very very important also when you’re sleep deprived the stress hormones they get kicked up that further aggravates acne and then your diet we have learned uh over the past few years that diet really does
As it turns out play a major role in the severity of acne or at least it seems to specifically diets that are high glycemic diets uh you know diets that are center around processed sugary foods um and you know don’t have enough fruits and vegetables and for some people it’s dairy you know there is definitely a connection between dairy and acne specifically milk
Consumption and acne so really you know reducing the burden of inflammatory foods in your diet favoring fruits vegetables whole food things that aren’t as processed and are you know have a lower glycemic burden if you will can definitely help i have a video all about acne and diet and i have a video about sugars and skin i want you guys to check that out to inform
Yourself about the types of foods that really can actually benefit your skin and kind of help in your acne journey now eating this way isn’t going to cure the acne but it can help in reducing total body inflammation helping you with blood sugar control and helping with the acne long term exercise is also super important because exercise helps uh in reducing total
Body inflammation that contributes to acne and it also helps us handle sugars better in terms of our our blood sugar and response to that and insulin hormones that affect the oil gland as well and um exercise also releases stress and stress again will worsen acne so it’s kind of a nice you know there are multiple benefits of exercise so getting in some exercise
Daily is also really important practicing gentle skin care not using her scrubs overly drying cleansers it’s simply not realistic to expect that you are going to be on birth control pills for the rest of your life regardless of what your plans are for for pregnancy down the road you may want to want to conceive at some point so obviously you’re going to have to
Stop uh you know or you may who knows decide that you don’t want to take birth control pills anymore people you know they have mixed feelings about taking them people don’t like taking pills every day there is a good chance that you will not be on it forever do you have to worry about your acne flaring when when you stop yes that is a potential problem that you
Will encounter when you stop but having other treatments on board topicals and addressing the lifestyle factors they really reduce the risk that this is going to happen for you when you stop last but not least definitely see a board-certified dermatologist you guys i know i emphasize that all the time but now more than ever you know if you have been a bit you
Know feeling a little bit disenfranchised with dermatology for your acne definitely give it a second thought because we now for the first time have more acne medications at our disposal than we have ever had before newer treatments specifically uh treatments that can help with hormonal acne for a while now we’ve had topical dapsone aka axone which is proving
Itself to be beneficial for women with hormonal acne we also of course have another hormonal medication we’ve had for years and used to treat acne spironolactone that likewise can help by addressing the hormonal fluctuations that contribute to acne but now we’ve got also at our armamentarium a new topical i’m really excited about it just became available this
Year it is a topical medication called classicaterone uh aka winleby that um actually is a topical anti-androgen so instead of having to take a birth control pill or a hormonal pill this addresses that hormonal issue just within the skin so you don’t have to expose yourself to the systemic side effects it’s still a very very new medication so i don’t want to give
You false hope that it’s like the end-all be-all but that’s showing promise so that’s another reason to revisit the dermatologist to see if you might be a candidate for this there’s also minocycline foam minocycline as you guys know from my videos is an oral antibiotic we don’t like to prescribe oral antibiotics for a prolonged period of time there are risks but
This is nice and that you know you don’t expose yourself to those risks systemically it’s very well tolerated it has a nice anti-inflammatory properties and might be a good option for you and we’ve got new uh retinoids at our disposal these days too we have altrina lotion and we have a cleaf i’ve got videos on these uh much less irritating or seeming to be much
Less irritating than older older retinoids that we typically prescribe for for acne so definitely see a board-certified dermatologist even if you’ve seen one in the past i did find that the treatments were helpful we do have newer treatments on the horizon these days that you know might make a difference especially in the case of hormonal acne for a lot of people
Contraceptive pills are simply not an option because they don’t uh you know it’s against their uh culture or religion for having birth control pills there’s still other options that definitely can help the hormonal acne beyond birth control pills um so you know don’t feel like if you have hormonal acne this is your only option but it can definitely help it’s not
A cure and it’s not first-line treatment we wouldn’t just prescribe anybody we wouldn’t just prescribe birth control pills i hope this video was helpful to you guys if you liked it give it a thumbs up share it with your friends and as always don’t forget sunscreen and subscribe i’ll talk to you guys tomorrow bye you
Transcribed from video
Best BIRTH CONTROL for HORMONAL ACNE| Dr Dray By Dr Dray