Which contraceptive pill is best for acne?

Yes, a common side effect of the contraceptive pill is that it can help reduce or stop acne outbreaks. Acne can be caused by an imbalance in hormones, particularly androgens like testosterone, which increase the production of sebum (skin oil). This excess oil can clog pores, leading to acne outbreaks.

Many people with acne have normal androgen levels, but their skin is more sensitive to these hormones. The oestrogen in a combined pill helps to lower circulating androgen levels. Some pills also reduce sensitivity to androgens, lowering oil production, and helping to prevent clogged pores.

Combined oral contraceptive (COC) pills are the most commonly prescribed pill for acne. If COCs do not work for you, your doctor may suggest alternatives, such as co-cyprindiol which is often used for more severe cases of acne.

Combined oral contraceptive pill

Combined oral contraceptive (COC) pills contain synthetic versions of the hormones oestrogen and progestogen. Oestrogen can help decrease oil production in the skin. Progestogens can also limit the effect of testosterone on your skin, helping to control acne outbreaks.

Research suggests that progesterone-only contraception tends to trigger or worsen acne, which is why COCs containing both oestrogen and progestogen are usually preferred for acne treatment.

Your skin and body may respond differently from one contraceptive pill to another. You may need to try more than one type of pill, and we recommend you use a pill for at least 3 months to see how you get on with it.

If you feel the pill is not helping with your acne, your doctor can advise you on switching to a different pill that may suit you better. Alternatively, your doctor may suggest using acne treatments, such as creams or antibiotics, to improve your skin by reducing bacteria and promoting skin renewal.

Co-cyprindiol

Co-cyprindiol (Dianette) is a prescription-only medication that combines cyproterone acetate, a progestogen with anti-androgenic properties, and ethinylestradiol, an oestrogen. It is usually prescribed for women with severe acne when other treatments, such as topical therapies or antibiotics have not been effective.

Although co-cyprindiol is technically a contraceptive pill, it is not usually prescribed just for contraception due to a slightly higher risk of side effects compared with standard COCs. If you are taking co-cyprindiol for acne, you should not use another hormonal contraceptive at the same time, as this can significantly raise the risk of blood clots.

Guidance from the Medicines and Healthcare products Regulatory Agency (MHRA) emphasises that the benefits of co-cyprindiol for treating severe androgen-sensitive skin conditions outweigh the risks when prescribed appropriately. For example, the risk of developing breast cancer is only slightly higher - 17 or 18 women out of 10,000 treated with co-cyprindiol for five years in their early 20s may develop breast cancer by age 35, compared with 16 out of 10,000 not taking it. Similarly, the risk of a blood clot is 1 in 2,500.

If you are concerned about the possible risks, speak with your doctor.

Our doctors can prescribe a range of contraceptive pills to suit your needs.

It may take some time to see improvements in your acne after starting the pill. You may start to notice changes within 2 to 3 months, but the full results may take several months to a year. The National Institute for Health and Care Excellence (NICE) recommends reviewing first-line acne treatments after 12 weeks to assess effectiveness and decide whether to continue, adjust, or change the treatment.

You can use other acne treatments alongside the combined pill, including creams, gels, lotions, and antibiotics.

Antibiotic treatments, such as lymecycline or erythromycin, help reduce the bacteria that contribute to acne and can decrease inflammation. For more effective treatment of moderate acne, antibiotics are often combined with a retinoid. Retinoids prevent clogged pores and reduce inflammation, though they can cause redness or irritation at first.

Another option is benzoyl peroxide. This is an antimicrobial agent that helps reduce bacteria on the skin and can improve acne and mild scarring.

Important: Always discuss with your doctor before combining treatments, especially antibiotics and hormonal contraception, to ensure safety and effectiveness.