Oral Contraceptives and Acne

 

What is acne?

Acne, also called "zits" or "breaking out," usually consists of different types of bumps on the skin. The most common are pimples, blackheads, and whiteheads. Severe acne can cause deeper bumps, called cysts or nodules. Acne can appear on the face, neck, shoulders, chest, and upper back. Acne ranges from mild to very severe. Severe cases of acne can cause permanent scars.

How common is acne?

Acne is a common condition affecting about 17 million Americans. Acne occurs most often among teenagers - nearly 4 out of every 5 teens have acne. The condition usually first appears between the ages of 10 and 13. In most cases, acne lasts for about 5 to 10 years, then goes away on its own. However, some adults in their 20's, 30s, and even 40s get acne.

What causes acne?

Acne occurs when pores in the skin become clogged with a mixture of oil and dead skin cells. The oil (called sebum) is created by glands at the base of each pore. Normally, this oil travels up through the pore and out onto the surface of your skin. However, if too much oil is produced, it can cause the cells in the pore lining to make a plug at the skin's surface. Germs can grow below the plug, causing redness, swelling, and pimples. Blackheads form when the plug goes though a chemical process - they are not caused by dirt.

How do hormones affect acne?

Certain hormones produced by your body can make the skin glands more active, causing them to put out more oil. You are more likely to develop acne during times when your body makes larger amounts of the hormones, such as during puberty. This is why so many teenagers get acne.

Will using oral contraceptives make my acne better or worse?

Most women find that their acne improves when using oral contraceptives ("the pill"). The overall hormonal effect of the pill helps prevent acne from forming, which is why birth control pills often are used as a treatment for acne.

What can I do to prevent acne or keep it from getting worse?

In most cases, acne is caused by your hormones - not by dirt or oil or foods - which makes it difficult to prevent. It is important to know that washing or scrubbing your face will not help acne. In fact, scrubbing too hard or washing too often can actually make your acne worse. Also, do not squeeze your pimples or pick at your skin; this can cause acne to spread and could result in permanent scars. If you use make-up or sunscreen, choose oil-free products labeled "non-comedogenic" or "non-acnegenic."

What treatments are available for acne?

Mild to moderate acne can be treated with a variety of over-the-counter (nonprescription) products, such as lotions and creams containing benzoyl peroxide. These products come in different strengths, usually 2.5%, 5%, and 10%. Benzoyl peroxide might make your skin red or dry. If your skin starts to peel, try using a lower-strength formula or use it less often. Benzoyl peroxide can bleach your hair or clothing, so be careful when using it near your hair or in areas that will come in contact with your cloths.

A variety of acne treatments are available by prescription. Your doctor may prescribe antibiotics, either to be applied directly on the skin or to be taken orally, or retin A products. Some prescription drugs for severe acne can cause birth defects in babies, so avoiding pregnancy is very important if you are taking certain medications. Discuss this with your clinician.

For moderate to severe acne, birth control pills are often prescribed as a treatment. This approach can be especially useful if you also want to avoid pregnancy. None of the birth control pills available in the United States have been shown to be better than any other pills for the treatment of acne. Be sure to discuss the situation with your clinician - he or she can help you select the right treatment for your acne.

Lastly, be patient: Most acne treatments take several months to work. It is important to continue using the medication as recommended throughout the treatment period.