While we’d love to give you a clear-cut answer about whether birth control will improve or worsen your skin health, most experts say it varies from person to person. Although birth control often gets a good wrap when it comes to clearing acne, that’s not always the case for everyone. “All medications, including oral contraceptive pills, can have unintended effects—some good and some not so good—on the body,” says gynecologist Kiarra King, MD. “Each person’s body and physiologic make up will determine how they respond to any given medication.”
It can improve or worsen acne
If you’re interested in trying birth control to help clear up your skin, it might involve a bit of trial and error. “Some pills will clear up the skin. Others will make it worse. The same pill that clears up one woman’s skin may make the next woman’s skin worse,” says gynecologist Carolyn DeLucia, MD. “There is no simple or exact science to the effect of birth control pills on skin.” However, she notes that sometimes the hormone drospirenone, which is similar to spironolactone, is found in birth control pills. Drospirenone is often used to treat hormonal acne, so a pill with this hormone in the mix is more likely to be beneficial for the skin.
Nanuet, NY dermatologist Heidi Waldorf, MD explains that whether birth control pills improve or aggravate acne hinges on “the type of estrogen and presence or absence of progesterone.” Dr. King explains that the estrogen component of birth control, including birth control pills, the patch and the ring, can “stimulate an increase in sex hormone-binding globulin (SHBG). SHBG can bind up excess androgens/testosterone in a person’s blood, which ultimately can lead to clearer, smoother, acne-free skin for some users.”
DeLucia says, “the important fact to understand is that the hormone that is used as a synthetic progesterone is actually a chemical that has androgenic factors. That means that the body sees it as a male steroid, like testosterone.” She notes that an elevation of testosterone in women boosts the chances of acne. “When a pill uses a hormone that is more androgenic, it will increase the chances of acne. When a birth control pill contains a synthetic progesterone that is less androgenic, it may help to clear up acne.”
Another factor that contributes to birth control’s effect on skin is that many of them impede the cycle of hormones that a woman typically experiences each month. “A pill that stays the same dose all month long, and is referred to as monophasic, will make the skin more clear. By simply alleviating the fluctuation of hormones, the skin will react less,” explains Dr. DeLucia.
It may be beneficial for anti-aging
“Any estrogen treatment—birth control pills used for birth control or as hormone replacement therapy—will prolong the presence of estrogen in the skin,” says Dr. Waldorf. “Due to this, birth control can sometimes “reduce some of the signs of aging.”
It can make you more prone to melasma
Melasma is common among pregnant people due to the elevated estrogen and progesterone levels, says Dr. King. She explains that the same phenomenon can occur while taking birth control. “The new hormonal environment that exists after starting birth control pills and other contraceptives (progestin IUD, implant, vaginal ring or patch) can also be responsible for skin hyperpigmentation known as melasma,” says Dr. King.
Birth control isn’t right for everyone
Dr. Waldorf points out that not everyone should be on birth control. “For some, it can increase the risk of deep vein thrombosis and pulmonary embolism. For others who have had estrogen and progesterone receptor-positive breast cancers, it’s contraindicated because of the risk of stimulating breast cancer cells.”
Be sure to talk to your gynecologist about your health history and any current conditions before starting on birth control.