Can birth control cause acne? Here’s how hormonal contraceptives can impact your skin

For many of us, acne can be a real drain on confidence. But know that you’re not alone. In reality, pimples are very common, affecting around 85% of people aged 12 to 24 and up to 15% of women in their 30s and 40s in the United States.

It can be frustrating to think your birth control could be the root cause of your acne. But while we know that certain types of hormonal birth control can make acne worse, others can help to clear up your skin. Keep reading to find out how hormonal birth control can cause acne and what you can do if you think it might be behind your breakouts.

Key takeaways

• Birth control can cause acne if it contains hormones.
• Hormonal birth control either contains the hormone progestin on its own or a combination of progestin and estrogen, and both of these hormones can impact the skin.
• For some people, progestin-only birth control can make acne worse (like hormonal intrauterine devices, the implant, or the mini pill), while types with progestin and estrogen can improve it (like the combined birth control pill, the vaginal ring, and the patch).

Can you get acne from birth control pills? 

A number of types of hormonal contraception can make acne worse, not just birth control pills. “Essentially any form of birth control that contains hormones can potentially cause acne, including the pill, birth control patches, the birth control shot, vaginal rings, the implant, and hormonal IUDs [intrauterine devices],” says Flo expert Dr. Katharine Claire DeGeorge, associate professor of family medicine, University of Virginia, Virginia, US. 

Let’s look a little closer at the hormones in question and how they impact the skin. Hormonal birth control contains either progestin (a synthetic form of progesterone) or a combination of estrogen and progestin. “For example, oral contraceptives (birth control pills) can contain either a single medication, a progestin [known as the mini pill], or a combination of an estrogen and a progestin [known as combined birth control pills],” says Dr. DeGeorge. “The progestin is responsible for what is called ‘androgenic’ effects, and that can include acne.”

This is because androgens — a family of hormones that include testosterone — are the most important hormones for regulating the production of an oily substance in your skin called sebum. Although sebum is essential for keeping the skin moisturized, too much of it can clog your pores and cause acne.

As Dr. DeGeorge explains, progestin can have androgen-like effects that lead to an increase in sebum and hormonal acne. Meanwhile, estrogen counters the effects of testosterone (one of the androgens), which can help to reduce sebum and improve acne.

For example, one study found that progestin-only birth control — including hormonal IUDs, the injection, and the implant — made women’s acne worse. Meanwhile, contraceptives that had estrogen and progestin — including the vaginal ring and combined birth control pills — made it better. However, it’s important to know that everyone is different, and your skin’s reaction to a particular type of birth control may be unique to you.

Why do some people get acne from birth control?

“The same product can cause hormonal acne in one person and fix acne in another,” says Dr. DeGeorge. “It all comes down to getting the balance of hormones in an individual’s body just right.” 

This is because we all have a different balance of hormones to start with. “Any given individual will have slightly different levels of circulating hormones, so finding the right balance of how much estrogen and progestin a person needs can be tricky,” says Dr. DeGeorge. “Too much progestin, and you can get acne; too little progestin and too much estrogen, and you can get symptoms like spotting and nausea. Not to mention they have to be in a certain balance to prevent pregnancy!”

She adds, “Many people end up trying multiple formulations of birth control pills until they find one with the right balance of hormones for them.”

What else could be causing acne? 

Acne is caused by the pores of your skin becoming clogged with sebum, skin cells, or bacteria, and so any of the following can trigger it:

• Hormonal changes that make the skin oilier, for example, the changes that happen during puberty, your period, pregnancy, or stress
• Greasy or oily beauty products
• Heavy sweating and humidity
• Getting dirt on the skin through touching or rubbing it
• Certain medications, including certain types of hormonal birth control and steroids

With so many possible causes, you might be wondering how you can tell if your acne is caused by hormonal birth control or something else. “There is no way to know 100%, but if the acne starts or worsens after a new medication is started, it could very well be the medication,” says Dr. DeGeorge. “The best way to know is to stop or switch the medication in that case.” Make sure you speak to your doctor before stopping your medication or starting something new. 

If you’re struggling to figure out what’s causing your breakouts, remember, your doctor is there to help you. They may decide to connect you with a dermatologist (a doctor who specializes in the skin) to help you find out what’s going on.

However, it’s important to know that, frustratingly, sometimes acne doesn’t have a clear cause. “Some people just have a genetic predisposition for acne, and no matter what they do, they are going to get it,” says Dr. DeGeorge. 

But don’t let this dishearten you. There are many ways you can treat acne, from topical treatments to oral medications and skin therapies. You can find plenty of products at your local drugstore, with more available by prescription. “You can use a gentle cleanser twice a day to remove dirt and oils and apply topical products that include retinoids, benzoyl peroxide, and/or salicylic acid,” adds Dr. DeGeorge. “There are also nonhormonal pills you can take to treat acne if topical treatments aren’t doing the trick.” Don’t hesitate to discuss your concerns with your doctor, who can advise the best course of treatment for you. For example, some medications used to treat acne are best avoided if you’re pregnant.

How to treat acne caused by birth control

If your doctor thinks that your breakouts could be a side effect of taking hormonal birth control, they may suggest switching up your contraception. “The best way to treat acne caused by birth control is to change the balance of hormones being delivered by the contraception if possible,” says Dr. DeGeorge. 

“So that might mean switching to a different oral contraceptive with a different balance of hormones,” she continues. “For acne caused by other more long-term methods of birth control, like IUDs, implants, or birth control shots, you may need to switch to a different type of birth control. Combined oral contraceptive pills tend to be the best contraceptive method for clearing up acne because they reduce testosterone levels.” Find out more about the pill as acne treatment. 

But if you’re not keen on taking the pill, it’s not your only option. As we’ve seen, by countering testosterone, estrogen is your acne-busting friend. So any other method that gives you an even flow of estrogen and progestin, such as the vaginal ring or birth control patch, can be worth giving a try. The birth control patch in particular can have a higher dose of estrogen than the pill, making it a good solution for some people.

However, it’s worth nothing that some women and people who have periods may not be able to take extra estrogen — for example, if you are breastfeeding or have a history of blood clots or heart problems. If this is the case, don’t feel discouraged, as there are a number of nonhormonal therapies you can try.  

Remember, everyone is different, and finding what works for you might be a case of trial and error. If acne is getting you down, know that there are many different treatments you can try with the help of your doctor.