Do Birth Control Pills Cause Acne?

Duly Care
Jun 22
8 min read

Birth control pills are a popular option to prevent pregnancy for many women, and offer other benefits such as regulating menstrual cycles and reducing period pain. However, one question that often arises is: "Do birth control pills cause acne?" The relationship between birth control pills and acne is complex, as it depends on the type of pill, your body’s hormonal balance, and other factors.

In this blog post, we’ll explore how birth control pills can affect your skin, which types may help or worsen acne, and practical tips to manage breakouts. Let’s dive in!

Key Takeaways:

Acne is often caused by hormonal imbalances, particularly androgens, which increase oil production in the skin.
Birth control pills contain synthetic hormones (estrogen and progestin) that can influence acne by regulating androgen-caused sebum production.
Some birth control pills, depending on the formulation of the pill, improve acne by reducing androgen activity, while others may worsen it due to androgen-like effects.
Managing acne while on birth control involves choosing the right pill, maintaining a skincare routine, and consulting a doctor.

What is Acne and How is it Caused?

Acne is a skin condition that happens when hair follicles under your skin get clogged with oil and dead skin cells. This can lead to whiteheads, blackheads, pimples, or even painful cysts. While many people think of acne as a teenage problem, it can affect adults too, especially women, because of hormonal changes.

What Causes Acne?

Acne happens when your skin’s oil glands (sebaceous glands) go into overdrive, clogging pores and creating the perfect environment for breakouts. Here’s exactly what triggers acne and how each factor makes pimples form:

Hormonal Changes

Hormones are like your body’s messengers, telling different parts of your body what to do. One group of hormones called androgens (often called "male hormones," but they’re present in women too in smaller amounts) can make your skin’s oil glands produce too much oil (sebum). This extra oil mixes with dead skin cells and clogs your pores, leading to acne.

Women experience more hormonal fluctuations than men, during their menstrual cycle, pregnancy, or when starting or stopping birth control pills. These changes can trigger acne.

Bacteria

A type of bacteria called Cutibacterium acnes (C. acnes) naturally lives on your skin, but when pores get blocked by oil and dead skin, it multiplies rapidly. Your immune system detects this overgrowth and attacks it, leading to redness, swelling, and pus-filled pimples. Touching your face, not washing off sweat, or using dirty makeup brushes can introduce even more bacteria, making breakouts worse.

Dead Skin Cells

The skin constantly sheds dead cells, but sometimes they stick together instead of falling away. When these cells mix with excess oil, they form a plug inside hair follicles. If the pore stays open, it turns into a blackhead (oxidized oil). If it closes, it becomes a whitehead. Over time, these clogs can become inflamed, especially if bacteria get trapped inside. Using heavy skincare products or not cleansing properly can make pore blockages more likely.

Diet

What you eat influences acne because certain foods affect hormone levels and inflammation. High-sugar and processed carbohydrates (like white bread and sweets) spike insulin, which in turn boosts oil production. Dairy products, particularly skim milk, contain hormones that may overstimulate oil glands. While greasy foods don’t directly cause acne, they can worsen existing inflammation in some people.

Stress

When you're stressed, your body releases cortisol, a stress hormone that activates the oil glands to produce more sebum. Stress also weakens the skin’s ability to fight bacteria, making breakouts more likely. This is why exams, lack of sleep, or emotional stress often lead to sudden acne flares - even in adults.

Skincare & Makeup

Some skincare and makeup products contain ingredients that clog pores, leading to breakouts. Harsh cleansers can strip your skin, tricking it into producing even more oil to compensate. Dirty makeup brushes or sleeping in makeup can also trap bacteria and oil on your skin, making acne worse over time.

Genetics

If your parents had acne, you’re more likely to struggle with it too. Genetics influence how sensitive your oil glands are to hormones, how quickly your skin sheds dead cells, and even how strongly your immune system reacts to acne bacteria. While you can’t change your genes, the right skincare routine can help manage breakouts.

Medications

Certain medications, like steroids, lithium, or some birth control pills, can trigger acne as a side effect. Steroids boost oil production, while lithium alters skin cell turnover. Even some supplements (like can cause breakouts in some people by overstimulating oil glands.

Environment

Pollution, humidity, and sun exposure all play a role in acne. Pollution particles stick to your skin, clogging pores over time. Humid weather makes you sweat more, trapping oil and bacteria on your skin. While sun exposure might initially dry out pimples, it eventually leads to rebound oiliness and can worsen acne in the long run.

Friction & Pressure

Constant rubbing or pressure on your skin - from tight hats, phone screens, or even resting your chin on your hands - can irritate pores and trap sweat and bacteria. This type of acne, called acne mechanica, often shows up in areas where clothing or gear rubs against the skin.

Understanding Birth Control Pills

Birth control pills are oral contraceptives that contain synthetic versions of two hormones: estrogen and progestin. Birth control pills containing both estrogen and progestin work by reducing the levels of androgens (male hormones) in the body (with the exception of some progestins with androgenic properties). Since androgens cause excess sebum production, these hormones also help to regulate sebum production, further contributing to acne reduction.

Estrogen's role: Estrogen helps to increase sex hormone-binding globulin (SHBG), which binds to testosterone and reduces the amount of free testosterone in the body. This can help to reduce the effects of androgens on the skin.
Progestin's role: Progestins, on the other hand, can have varying effects. Some progestins are androgenic, meaning they can have effects similar to androgens, which can worsen acne. Other progestins, like drospirenone, are considered anti-androgenic and can help to reduce acne.

Types of Birth Control Pills

Combined Oral Contraceptive Pills: They contain both estrogen and progestin. These are the most common types and are often prescribed for acne.
Progestin-Only Pills: Also known as mini-pills, these contain only progestin and are typically used by women who cannot take estrogen.

Estrogen Dosages in Birth Control Pills

Birth control pills contain varying amounts of estrogen, which are categorized as:

Low-Dose (10-15 mcg): These pills are often recommended for women who are sensitive to hormones. The lower estrogen content may be less effective at counteracting acne-causing androgens.
Standard-Dose (20–35 mcg): This is the most common dosage in birth control pills. This moderate estrogen level typically provides the best balance for both contraception and acne control.
High-Dose (50 mcg): These are rarely used today and are typically prescribed for specific medical conditions. While they strongly suppress androgens and can improve acne, they carry higher risks of estrogenic side effects.

Your doctor can help you choose the right dosage based on your health needs and preferences.

Types of Progestins

Progestins are synthetic hormones that play a vital role in birth control pills. While they all serve the same basic function, different types of progestins can affect your body in distinct ways. These variations are classified by when they were developed and their unique chemical properties:

First-generation progestins, like norethindrone and norethynodrel, were the earliest progestins developed. They have mild androgenic (male hormone-like) activity, which means they can sometimes cause side effects like acne or hair growth.
Second-generation progestins, like levonorgestrel and norgestrel, are widely used and known for their strong progesteronic activity (mimicking natural progesterone). However, they also have mild androgenic activity, which can lead to side effects like acne in some women.
Third-generation progestins, like desogestrel and norgestimate, were developed to reduce androgenic side effects. They are less likely to cause acne or other androgen-related issues compared to second-generation progestins.
Fourth-generation progestins, like drospirenone and dienoges,t are the most recent progestins and have anti-androgenic properties, meaning they counteract male hormones. They are often prescribed to help with acne, excess hair growth, or other androgen-related symptoms.

The Relationship between Birth Control Pills and Acne

Birth control pills can either help or worsen acne, depending on their hormonal composition and how your body reacts to them. The type of progestin and the dosage of estrogen in the pill play a significant role in determining its effect on your skin.

How Birth Control Pills Can Improve Acne

Reducing Androgen Activity: Some progestins have anti-androgenic effects, meaning they counteract male hormones like testosterone. These progestins (e.g., drospirenone, cyproterone acetate) lower androgen levels in the body, which reduces oil production in the skin and prevents clogged pores. This can lead to fewer breakouts and clearer skin.
Regulating Hormonal Fluctuations: Birth control pills stabilize hormone levels, which can help reduce hormonal acne triggered by menstrual cycles. For example, many women experience breakouts before their period due to a drop in estrogen and a rise in androgens. Birth control pills can help balance these fluctuations.
Anti-Inflammatory Effects: Some progestins have mild anti-inflammatory properties, which can help reduce redness and swelling associated with acne.

How Birth Control Pills Can Worsen Acne

Progestins with Androgenic Effects: Not all progestins are created equal. Some progestins, like levonorgestrel and norethindrone, have androgenic effects, meaning they mimic male hormones. These progestins can increase oil production in the skin, leading to clogged pores and breakouts.
Low Estrogen Dosage: Estrogen helps counteract the effects of androgens. Pills with low estrogen doses (10–20 mcg) may not provide enough estrogen to balance the androgenic effects of certain progestins, potentially worsening acne.
Initial Adjustment Period: When starting a new birth control pill, your body may take 2–3 months to adjust to the hormonal changes. During this time, acne may temporarily worsen before improving.
Progestin-Only Pills: Progestin-only pills (mini-pills) lack estrogen entirely. Without estrogen to balance androgens, these pills are more likely to cause or worsen acne, especially if they contain progestins with androgenic effects.

How to Manage Acne While on Birth Control Pills

If you’re experiencing acne while on birth control pill, here are some practical steps to manage it:

Choose the Right Pill: If acne is a concern, opt for combination pills with progestins with low androgenic effects. Consult your doctor to find the best option for your skin and overall health.
Maintain a Consistent Skincare Routine
- Use gentle, gentle products that won’t clog pores (also known as non-comedogenic products).
- Incorporate ingredients like salicylic acid or benzoyl peroxide to target breakouts.
- Avoid over-washing or scrubbing, as this can irritate the skin.
Stay Hydrated and Eat a Balanced Diet
- Drink plenty of water to keep your skin hydrated.
- Eat a diet rich in fruits, vegetables, and whole grains to support skin health.
Consult a Dermatologist: If acne persists, a dermatologist can recommend treatments like topical retinoids, antibiotics, or hormonal therapies like birth control pills to address the root cause.

Conclusion

The relationship between birth control pills and acne is nuanced. While some pills can help clear your skin, others may trigger breakouts. The key is to choose the right pill for your body and work closely with a doctor to address any concerns. Remember, everyone’s skin is different, and what works for one person may not work for another.

Frequently Asked Questions (FAQs)

Do birth control pills cause acne?
Birth control pills can either improve or worsen acne, depending on their formulation and how your body reacts to them. Pills with progestins that have anti-androgenic properties often help reduce acne, while those containing progestins with androgenic effects may worsen it.
Which birth control pills are best for acne?
Pills containing progestins with anti-androgenic properties, such as drospirenone, cyproterone acetate, or desogestrel, are often recommended for acne-prone skin. These progestins counteract androgens, reducing oil production and breakouts.
How long does it take for birth control to affect acne?
It can take 2–3 months for your skin to adjust to a new birth control pill. During this time, acne may temporarily worsen before improving.
Can progestin-only pills cause acne?
Yes, progestin-only pills (mini-pills) lack estrogen, which helps balance androgens. If the pill contains progestins with androgenic effects, it may increase oil production and worsen acne.

Important

This blog, including its text, images, and infographics, is for educational purposes only and not a substitute for professional medical advice. For personalized advice, always consult a doctor.

References

UK National Health Service. Combined Contraceptive Pill. 2023. https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill
World Health Organisation. Contraception. Accessed on 14 March 2025. https://www.who.int/health-topics/contraception#tab=tab_1
Cochrane Database of Systematic reviews. Combined oral contraceptive pills for treatment of acne. 2007. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004425.pub3/full
American Journal of Clinical Dermatology. Optimal Management of Acne to Prevent Scarring and Psychological Sequelae. 2007. https://link.springer.com/article/10.2165/00128071-200102030-00002