All About Acne: Cystic acne, Roaccutane, Myths about acne, Acne cures, Australia

Alternative therapies

Home » Medical Treatment » Hormonal agents
	Win it

Hormonal agents

These tablets decrease oil or sebum production. They are used in women whose acne doesn’t respond to topical treatments or oral antibiotics. They may be especially useful in women over 25 years or those experiencing premenstrual flare-ups of acne.

The pill can treat acne by blocking the stimulatory effect that androgens (male hormones) have on the sebaceous glands of the skin.

Most females will think about the pill as a contraceptive but it can also help some women to control their acne.

Taken daily, the hormones in the oral contraceptive pill prevent your ovaries from ovulating (releasing eggs). Pregnancy is prevented because there are no eggs to fertilise. The pill also causes changes in the lining of the uterus and the mucus of the cervix, which also reduces the chances of pregnancy.

The pills with proven benefits in acne are the new low dose pills containing 20mg ethinyloestradiol and 100mglevonorgestrel, such as Loette and Microgynon 20.

These low dose pills are associated with fewer side effects than higher dose pills. When used alone, low dose pills are usually only indicated for mild to moderate acne, but could be used in combination with other treatment options for more severe forms of acne.

Oral contraceptive pills containing 2mg cyproterone acetate (an anti-androgen) along with ethynyloestradiol (eg, Brenda, Estelle 35ED, Diane, Juliette) have also proven useful.

Side effects such as mood changes, depression, changes in libido, fluid retention and an increased risk of deep vein thrombosis are also more commonly associated with this type of oral contraceptive pill.

Other contraceptive pills that have been shown to generally improve acne include those containing the progestogens desorgestrel (eg, Marvelon), gestodene (eg, Femoden) and drosperinon (eg, Yasmin). Spironolactone (eg, Aldactone), a non-contraceptive anti-androgen, is also used for acne on its own or in combination with the pill, particularly in females with excessive body hair (hirsutism).

Some points to consider:

If you are using the pill as an acne treatment, it will need to be taken for at least six months. It is often prescribed for prolonged periods to control acne. The pill can suppress acne until its natural resolution, given in 8-12 per cent of females, acne can continue into the late 20s and even 30s;

Common side effects of the oral contraceptive pill include nausea, vomiting, abdominal pain, headaches including migraines, breast tenderness/enlargement and vaginitis, including thrush;

You should still continue to cleanse, treat and moisturise your skin whilst on the pill;

You should expect to see an improvement in your acne after being on the pill for 8 to 12 weeks. Your skin should be less greasy, with fewer spots;

Your pimples should continue to improve from 3 to 12 months;

The pill can be taken for as long as acne and/or contraceptive treatment is needed. If you stop treatment, you may find that your acne returns, although not as severely as before. As you get older, the chance of acne returning is reduced;

If you are diabetic, suffer from migraine, are an epileptic, are overweight, a heavy smoker or suffer from high blood pressure, your doctor may wish to discuss whether to put you on the pill;

You will also need to discuss if there is a family history for breast cancer as the pill may not be appropriate in these cases; and

The pill can reduce incidence of ovarian and uterine cancer, pelvic inflammation, some diseases of the breast, iron deficiency anaemia and rheumatoid arthritis.

Taking the oral contraceptive pill

Having chosen a convenient dose time, for example after breakfast or after dinner, try and stick to it. During the first 14 days of the first cycle only, additional non-hormonal methods of contraception must be used;