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Looking for a solution to hormonal acne that doubles as contraception? FDA-approved combination oral contraceptives (COCs) like Yaz, Estrostep Fe, Ortho Tri-Cyclen, and Beyaz are effective options for managing moderate acne. These pills combine ethinyl estradiol (estrogen) with a progestin to reduce androgens, helping to lower oil production and prevent clogged pores. Most users see results within six months of consistent use. Here's a quick breakdown of the options:
- Yaz: Reduces acne lesions and water retention; suitable for ages 14+.
- Estrostep Fe: Includes iron supplements; effective for ages 15+.
- Ortho Tri-Cyclen: Treats various acne types; approved for ages 15+.
- Beyaz: Similar to Yaz but includes folate, ideal for those planning pregnancy.
Each option has unique features and potential side effects, like nausea, headaches, or an increased risk of blood clots. Your healthcare provider can help determine which is best for your needs.
1. Yaz (Drospirenone/Ethinyl Estradiol)
Composition and How It Works
Yaz contains 3 mg of drospirenone and 0.02 mg of ethinyl estradiol in a 28-day cycle, with 24 active pills and four placebos. This combination includes a synthetic estrogen and a progestin that helps counteract androgens and minimize fluid retention. The estrogen component boosts the production of sex hormone-binding globulin (SHBG), which binds free testosterone. Meanwhile, drospirenone directly blocks androgen receptors, reducing sebum production and inflammation. These combined effects make Yaz effective for managing acne.
Acne Treatment Effectiveness
Yaz is FDA-approved for treating moderate-to-severe acne in females aged 14 and older who have started menstruating and also need contraception. Clinical trials over six 28-day cycles showed that 15–21% of participants achieved "clear" or "almost clear" skin based on the Investigator's Static Global Assessment. Most users notice significant improvements by the sixth cycle.
Other Benefits
In addition to acne treatment, Yaz provides reliable contraception and may ease symptoms of premenstrual dysphoric disorder (PMDD). Its anti-mineralocorticoid properties can also help reduce bloating and water retention during the menstrual cycle.
Potential Side Effects and Risks
Common side effects include nausea, headaches, breast tenderness, mood changes, and breakthrough bleeding. A critical safety concern is the increased risk of blood clots associated with drospirenone. This risk is higher for smokers over 35 and for those with clotting disorders, high blood pressure, or migraines with aura. To maximize its acne benefits, Yaz should be taken daily at the same time and used consistently for at least six months.
2. Estrostep Fe (Norethindrone/Ethinyl Estradiol Ferrous Fumarate)
Composition and How It Works
Estrostep Fe is a triphasic oral contraceptive that combines two active hormones: norethindrone acetate (a type of progestin) and ethinyl estradiol (an estrogen). Each pack contains 21 active hormonal pills, followed by 7 ferrous fumarate (iron) tablets. What sets it apart is its triphasic design, where the estrogen dose changes throughout the cycle to more closely align with natural hormonal patterns. This approach helps regulate androgen levels, reducing testosterone and, consequently, sebum production. The result? Fewer blackheads, whiteheads, and inflammatory acne. The iron tablets included in the pack help replenish iron lost during menstruation, making the formulation practical for overall health.
Effectiveness for Acne
Estrostep Fe is FDA-approved for treating moderate acne in females aged 15 and older who have started menstruating and are also seeking contraception. Clinical studies show that by the sixth cycle of use, there is a noticeable reduction in both inflammatory and non-inflammatory acne lesions, with maximum results typically appearing within a year. Additionally, a review of 31 clinical trials confirmed that Estrostep Fe is just as effective at treating acne as other FDA-approved options like Yaz and Ortho Tri-Cyclen.
Beyond Acne Treatment
Estrostep Fe offers more than just acne relief and contraception. The ferrous fumarate tablets help prevent iron deficiency anemia, a common issue during menstruation. Its triphasic design also promotes consistent and predictable menstrual cycles, giving users greater control over their periods.
Possible Side Effects and Risks
Like many oral contraceptives, Estrostep Fe may cause some side effects, including nausea, breast tenderness, headaches, and breakthrough bleeding. More serious risks, such as blood clots, stroke, or heart attack, are rare but more likely in smokers over 35 or those with high blood pressure. To get the best results, take one pill daily at the same time for all 28 days (21 hormonal pills followed by 7 iron pills). Consistent use over at least six cycles is recommended to achieve optimal contraceptive and acne treatment benefits.
3. Ortho Tri-Cyclen (Norgestimate/Ethinyl Estradiol)
Composition and Mechanism
Ortho Tri-Cyclen is a combined oral contraceptive that includes two hormones: norgestimate (a type of progestin) and ethinyl estradiol (an estrogen). Each monthly pack contains 21 active pills with hormones and 7 placebo pills without hormones. Its triphasic design adjusts the norgestimate dosage throughout the cycle while keeping the estrogen dose steady, mimicking the body’s natural hormonal changes. This combination reduces ovarian androgen production and increases levels of sex hormone–binding globulin, which decreases free testosterone - one of the main contributors to acne. This mechanism explains its effectiveness in treating acne.
Effectiveness for Acne
Ortho Tri-Cyclen is FDA-approved for treating moderate acne, especially for individuals who haven’t responded to topical treatments. Studies show meaningful improvement in acne after six months of consistent use. A meta-analysis of 31 clinical trials reported a 37.3% reduction in acne lesions within three months, with further improvements seen at six months. Additionally, around 15–21% of participants achieved “clear” or “almost clear” skin ratings after six cycles, although some users may need up to a year to see full results.
Additional Benefits
In addition to its acne treatment benefits, Ortho Tri-Cyclen provides effective birth control and helps regulate menstrual cycles, often leading to lighter, more predictable, and less painful periods. Long-term use of combined oral contraceptives has also been linked to a reduced risk of endometrial and ovarian cancers. For individuals dealing with conditions like PCOS or hormone-driven acne, this pill can help stabilize hormonal fluctuations that contribute to oily skin and acne breakouts. Telehealth platforms such as Oana Health can incorporate Ortho Tri-Cyclen into customized treatment plans, addressing acne along with other concerns like unwanted facial hair or weight management.
Common Side Effects and Risks
Some common side effects include nausea, breast tenderness, breakthrough bleeding, and mild headaches, particularly during the first few cycles. Users may also notice slight weight changes or shifts in libido. While serious side effects are uncommon, the pill does carry an increased risk of blood clots, stroke, and heart attack, especially in individuals who smoke, are over 35, have uncontrolled high blood pressure, or experience migraines with aura. Because of the estrogen content, healthcare providers screen patients for potential risks and advise them to watch for warning signs like sudden leg pain, chest pain, or severe headaches. To ensure effectiveness, it’s important to take the pill daily at the same time.
4. Beyaz (Drospirenone/Ethinyl Estradiol/Levomefolate)
Composition and Mechanism
Beyaz combines drospirenone 3 mg (a type of progestin), ethinyl estradiol 0.02 mg (an estrogen), and levomefolate calcium 0.451 mg (a folate supplement). Its hormone formula matches Yaz, with the bonus of added folate. The drospirenone and ethinyl estradiol combination reduces ovarian androgen production and boosts sex hormone-binding globulin levels, which helps lower free testosterone - a key factor in acne development. While the levomefolate doesn’t address acne directly, it helps maintain folate levels, which can lower the risk of neural tube defects if pregnancy occurs soon after stopping the pill.
Effectiveness for Acne
Thanks to its hormone combination, Beyaz is effective for managing acne. Although it doesn’t have FDA approval specifically for acne treatment, its formula is identical to Yaz, which is approved for this purpose. A meta-analysis of 31 studies found that acne lesions dropped by 55% after six months of treatment, with improvements often noticeable within three to six months. However, achieving the full benefits may take up to a year. Reviews suggest that most combined oral contraceptives work similarly for acne, so the choice often hinges on side effects and individual preferences rather than significant differences in effectiveness.
Additional Benefits
Beyaz offers more than just acne relief. It serves as a reliable contraceptive and helps regulate menstrual cycles, often resulting in lighter, more predictable periods. Its 24/4 pill regimen (24 active pills followed by 4 inactive ones) generally leads to shorter and lighter withdrawal bleeding compared to the traditional 21/7 packs. Drospirenone’s anti-androgenic and mild diuretic effects can also ease hormonal symptoms like bloating and premenstrual discomfort. The built-in folate supplementation is especially beneficial for women planning to conceive shortly after stopping the pill. Telehealth platforms, such as Oana Health, often include Beyaz in tailored treatment plans for hormone-related issues.
Common Side Effects and Risks
Common side effects of Beyaz include nausea, breast tenderness, headaches, breakthrough bleeding, and mood changes, particularly during the first two to three months. These symptoms usually improve with continued use. However, drospirenone may carry a higher risk of venous thromboembolism compared to other progestins. Like all estrogen-containing contraceptives, Beyaz has serious risks, including blood clots, stroke, and heart attack. These risks are higher in people who smoke, are over 35, have uncontrolled high blood pressure, or experience migraines with aura. Because drospirenone has potassium-sparing properties, healthcare providers are cautious when prescribing it alongside medications like ACE inhibitors, ARBs, or spironolactone. To maximize its benefits, consistent daily use is essential.
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Best BIRTH CONTROL for HORMONAL ACNE| Dr Dray
Pros and Cons
FDA-Approved Birth Control Pills for Acne: Side-by-Side Comparison
When considering FDA-approved treatments for acne, it's essential to weigh the benefits and potential downsides of each option. The four commonly prescribed medications - Yaz, Estrostep Fe, Ortho Tri-Cyclen, and Beyaz - share a common mechanism: they lower testosterone levels, which helps reduce acne. However, each has unique features that may make it more or less suitable depending on your needs. Here's a closer look at what each offers:
Yaz is approved for treating moderate-to-severe acne in females aged 14 and older. It’s particularly noted for reducing acne lesions and may also help with water retention thanks to its drospirenone component. On the flip side, it carries a higher risk of blood clots and may cause side effects like nausea or mood changes.
Estrostep Fe is another FDA-approved option for acne. It includes iron tablets, which can help prevent anemia during menstruation. Research shows it can lead to noticeable improvements in acne lesions. However, the iron component is solely a supplement and doesn’t address acne itself, and the medication is limited to individuals aged 15 and older.
Ortho Tri-Cyclen, approved for moderate acne in those 15 and older, is effective across various types of acne lesions. Studies suggest its results are on par with other combination pills. That said, some users may experience headaches or breast tenderness as side effects.
Beyaz combines the acne-fighting properties of Yaz with added levomefolate, which supports folate levels and may reduce the risk of neural tube defects for those planning a pregnancy. Like Yaz, it carries a heightened blood clot risk due to drospirenone and may also be more expensive because of the folate addition.
| Medication | Pros | Cons |
|---|---|---|
| Yaz | • FDA-approved for acne in individuals aged 14+ • Reduces acne lesions • May decrease water retention |
• Increased risk of blood clots • Potential for nausea and mood changes • Unsuitable for smokers or those with clotting disorders |
| Estrostep Fe | • FDA-approved for acne treatment • Noticeable lesion improvement • Includes iron tablets to prevent anemia |
• Iron does not treat acne directly • May cause breakthrough bleeding • Restricted to ages 15+ |
| Ortho Tri-Cyclen | • Approved for moderate acne in individuals aged 15+ • Effective across various acne types • Comparable to other combination pills |
• Possible headaches and breast tenderness • Contains nonhormonal placebo pills • May not suit hormone-sensitive conditions |
| Beyaz | • Similar acne benefits as Yaz • Added folate for pregnancy planning • Reduces acne lesions |
• Increased blood clot risk from drospirenone • Potential gastrointestinal side effects • Higher cost due to folate addition |
Important Notes
All these medications also serve as contraceptives. For acne improvements, consistent use over six months is typically needed. Studies and clinical observations confirm that these formulations are effective for managing acne. Ultimately, the choice depends on factors like your medical history, personal preferences, and budget. Just remember: while combination pills (estrogen and progestin) can improve acne, progestin-only pills might worsen it.
Conclusion
FDA-approved birth control pills like Yaz, Estrostep Fe, Ortho Tri-Cyclen, and Beyaz have been shown to provide similar improvements in acne. These medications often lead to a noticeable reduction in acne lesions within six months, with the full benefits typically becoming clear by the one-year mark. While they differ in aspects such as the type of progestin, dosage schedules, and additional components like iron or folate, studies suggest these variations don't significantly affect their effectiveness in treating acne.
When choosing the right pill, consider factors like your medical history, lifestyle, and overall health goals. It's also important to evaluate potential risks, such as blood clotting, possible side effects, and affordability. Your healthcare provider can help guide you through these considerations to find the option that best suits your needs.
If you're looking for personalized acne or hormonal health solutions, Oana Health offers convenient telehealth services. Their licensed medical professionals provide science-based, prescription treatments for acne, PCOS, and other hormonal concerns. With free shipping and a simple online consultation, you can receive tailored recommendations and treatments designed to fit seamlessly into your lifestyle.
FAQs
How do birth control pills help treat acne?
Birth control pills can play a role in reducing acne by helping to balance hormone levels. They work by lowering androgens, a type of hormone that can trigger excess oil production in the skin. With less oil, pores are less likely to clog, which means fewer breakouts.
This approach is particularly helpful for hormonal acne, which often shows up around the jawline and chin. Beyond tackling acne, these pills can also help regulate menstrual cycles, offering a dual benefit for those who choose this option.
What side effects can birth control pills cause when used for acne treatment?
Using birth control pills to address acne can come with potential side effects. Common issues include nausea, breast tenderness, spotting between periods, and mood swings. While rare, more severe complications such as blood clots, stroke, or elevated blood pressure can also occur.
Talking to a healthcare provider about your medical history and any concerns is essential to decide if this option is suitable for you.
What is the best birth control pill for someone who wants to get pregnant soon?
If you're thinking about getting pregnant in the near future, you might want to consider a birth control method with a lower hormonal impact, like the progestin-only pill. These pills are generally easier to discontinue, helping your body transition back to its natural cycle sooner. That said, it's always a good idea to speak with a licensed healthcare provider to find the option that's safest and most suitable for your individual needs and plans.
