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Oral contraceptives are a common treatment for managing PCOS-related skin issues like acne and excess hair growth. They work by balancing hormones, specifically reducing androgen levels, which are often elevated in PCOS. This hormonal adjustment can lead to clearer skin, reduced oil production, and less unwanted hair growth. FDA-approved options for PCOS-related acne include Ortho Tri-Cyclen, Estrostep FE, and Yaz, each with unique benefits and considerations. While effective, these treatments address symptoms rather than the root causes of PCOS, making a holistic approach important. Results typically appear within 2–3 months, but stopping treatment may cause symptoms to return. Telehealth platforms like Oana Health make accessing these treatments more convenient by offering personalized care and medication delivery.
How Oral Contraceptives Improve Skin in PCOS
Lowering Androgen Levels in PCOS
Oral contraceptives can help address PCOS-related skin problems by reducing androgen levels in the body. Combined oral contraceptives increase the production of sex hormone-binding globulin (SHBG), a protein that binds to excess testosterone, effectively limiting its influence on the skin. Additionally, these contraceptives block the activity of 5α‐reductase in hair follicles and skin. This enzyme is responsible for converting testosterone into dihydrotestosterone (DHT), a more potent androgen. By reducing androgen activity, oral contraceptives can lead to clearer skin and less unwanted hair growth.
This drop in androgen levels also helps control sebum production, which plays a major role in improving skin clarity.
Effects on Oil Production and Acne
With lower androgen levels, the sebaceous glands are less stimulated, which means less sebum is produced. This reduction in oil production minimizes clogged pores, a key factor in acne development. Research indicates that 30–40% of women with PCOS experience acne, and treatment with oral contraceptives can lead to a 30–60% reduction in inflammatory lesions. In fact, 50–90% of cases show significant improvements within 3–6 months of starting treatment.
However, it’s worth noting that progestin-only pills may aggravate acne symptoms. For this reason, combined oral contraceptives containing both estrogen and progestin are typically recommended for managing PCOS-related skin concerns.
When to Expect Skin Improvements
Most women begin to see improvements in acne within 2 to 3 months of starting oral contraceptives, though some may notice changes in just a few weeks. It’s not uncommon to experience a temporary flare-up as the body adjusts to the new hormonal balance. To speed up results, doctors may suggest combining oral contraceptives with topical treatments or antibiotics for better and faster skin clearing.
FDA-Approved Oral Contraceptives for PCOS-Related Acne
Main FDA-Approved Brands and Types
When it comes to treating moderate acne in women with PCOS, only three combination oral contraceptives have received FDA approval. These medications are specifically approved for women aged 14 or 15 and older who have started menstruating and also need contraception.
Ortho Tri-Cyclen was the first birth control pill to gain FDA approval for acne treatment. It combines ethinyl estradiol with norgestimate, a third-generation progestin known for its low androgenic activity.
Estrostep FE pairs ethinyl estradiol with norethindrone acetate and includes ferrous fumarate (iron). Its varying estrogen doses throughout the cycle can help some women better manage their symptoms.
Yaz contains ethinyl estradiol and drospirenone, a fourth-generation progestin. Studies suggest Yaz may be more effective than norgestimate at reducing acne. However, the FDA has highlighted a higher risk of blood clots with drospirenone-containing pills compared to those with other progestins. Other drospirenone options include Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, and Zarah.
A 2016 review of over 2,147 patients found that drospirenone-based contraceptives were the most effective for acne, outperforming norgestimate and desogestrel, and showing significantly better results than levonorgestrel and norethindrone.
The differences in skin benefits among these FDA-approved options come down to the type of progestin they contain.
Different Types of Progestin Explained
The progestin type in oral contraceptives plays a major role in their effectiveness for PCOS-related acne. Progestins are grouped into generations based on their development timeline and chemical structure.
- First and second-generation progestins, like levonorgestrel and norethindrone, have higher androgenic activity, which can worsen acne and unwanted hair growth.
- Third-generation progestins, such as norgestimate and desogestrel, have much lower androgenic activity, making them a better option for improving skin.
- Fourth-generation progestins, like drospirenone, take it a step further by actively blocking androgen receptors. This not only prevents worsening of androgen-related symptoms but also helps reduce them. Drospirenone is chemically similar to spironolactone, a medication often used to combat androgen effects.
These newer progestins also work by reducing gonadotropin-releasing hormone (GnRH) pulsatility, which lowers luteinizing hormone levels and, in turn, decreases overall androgen production in the body.
Here’s a quick comparison of these FDA-approved options:
Comparison Table of FDA-Approved Options
| Brand Name | Active Ingredients | Progestin Generation | Key Benefits | Common Considerations |
|---|---|---|---|---|
| Ortho Tri-Cyclen | EE/norgestimate | Third | First FDA-approved for acne; low androgenic activity | Generally well-tolerated; triphasic dosing |
| Estrostep FE | EE/norethindrone acetate/ferrous fumarate | First | Includes iron; variable estrogen doses | Higher androgenic activity than newer options |
| Yaz | EE/drospirenone | Fourth | Strong anti-androgenic properties; highly effective for acne | Higher risk of blood clots; requires monitoring |
While these pills differ in composition, studies haven’t shown significant differences in their effectiveness for treating acne. The choice often comes down to individual factors like side effects, existing health conditions, and specific PCOS symptoms.
It’s also worth noting that doctors sometimes prescribe other birth control options for acne, even if they’re not FDA-approved for this purpose. The goal is to find a combination that works for your unique needs while minimizing side effects.
Long-Term Skin Benefits and What to Consider
Continued Reduction in Acne and Hair Growth
Using oral contraceptives over time can lower testosterone levels, which reduces oil production in the skin. This often results in clearer skin and less noticeable hair growth for many women. While existing hair may remain, new growth tends to be finer and less visible. However, if treatment is stopped or altered, these skin benefits can change.
What Happens After Stopping Treatment?
Although some benefits may linger, stopping oral contraceptives can trigger hormonal shifts. For women with PCOS, this often means the return of symptoms like acne. Hormonal adjustments after discontinuation may cause temporary acne flare-ups due to increased androgen levels. Dr. Jenna Beckham, an obstetrician and gynecologist, notes, "Depending on their history and how long they've been on birth control pills, some patients will [notice a] change in their cycle". Research shows that post-pill acne affects about 47% of women, typically appearing within the first six months after stopping and sometimes lasting up to a year. It can take two to three menstrual cycles for hormones to stabilize, so if you're planning to stop oral contraceptives, consider focusing on skincare at least four weeks beforehand.
Limits of Oral Contraceptives for PCOS
While oral contraceptives are effective at managing surface symptoms of PCOS - like acne and excess hair growth - they don’t tackle the root causes, such as insulin resistance or chronic inflammation. These medications work by masking symptoms rather than curing the condition. Once the pill is discontinued, many women find their symptoms intensify because the synthetic hormones were suppressing the underlying issues. Additionally, long-term use of oral contraceptives may pose risks, including cardiovascular concerns and potential changes in bone density, especially with very low-dose options containing less than 30 μg of ethinyl estradiol. To enhance overall PCOS management, combining oral contraceptives with a nutrient-rich diet, regular physical activity, and stress management is highly recommended.
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Getting Prescription Treatments Through Telehealth with Oana Health
Personalized Hormonal Care Through Telehealth
When it comes to managing PCOS-related skin issues like acne, Oana Health makes it simple to access personalized care through telehealth. Forget the hassle of long doctor visits - Oana Health connects you with science-based, prescription treatments tailored specifically to your hormonal needs. It all starts with a quick 5-minute online visit where you provide your medical history and discuss your health concerns. From there, licensed physicians review your information and prescribe effective oral contraceptives designed to address acne, excess oil, or other skin problems tied to PCOS. The goal? Treatments that work with your lifestyle and directly target your unique skin challenges.
Easy Treatment Delivery
Once prescribed, your medication is delivered straight to your doorstep - completely free of charge. No more pharmacy trips or worrying about running out of your prescription. Oana Health also offers automatic refills and ongoing support, so you can stay consistent with your treatment without interruptions.
By combining telemedicine with compounding pharmacy services, Oana Health provides affordable options that are often more accessible than traditional healthcare. This streamlined process ensures you can focus on your well-being without the usual hurdles.
Complete Care for PCOS Symptoms
PCOS isn’t just about skin - it’s a condition that affects many aspects of health. Oana Health takes a comprehensive approach, offering treatments for a variety of symptoms like weight management, insulin resistance, unwanted hair, hair loss, and mental health challenges. These solutions aim to improve overall well-being while addressing the complexities of PCOS.
For example, if you’re using oral contraceptives for acne but also dealing with unwanted facial hair or thinning hair, Oana Health might recommend treatments like Eflornithine, Spironolactone, Oral Minoxidil, or Topical Spironolactone. This one-stop platform simplifies managing multiple symptoms, making it easier to stay on track.
To find the best treatments for your needs, start by taking the quick PCOS quiz on the Oana Health website. This short assessment helps identify the treatments that align with your specific symptoms, offering a personalized path to better skin and overall health.
Best BIRTH CONTROL for HORMONAL ACNE| Dr Dray
Key Points About Oral Contraceptives and PCOS Skin Benefits
Oral contraceptives can help improve skin clarity for women with PCOS by tackling one of the hormonal imbalances behind acne and oily skin. Specifically, they work to lower androgen levels, which can decrease the overactivity of sebaceous glands responsible for breakouts.
It’s important to note that results, such as reduced acne, often take a few months to appear. Consistent use is necessary to maintain these benefits, as stopping treatment typically leads to the return of PCOS-related symptoms .
Oana Health makes accessing these treatments easier through telehealth consultations with licensed physicians. After the consultation, prescribed treatments are conveniently delivered straight to your home.
FAQs
How do birth control pills help improve acne and reduce excess hair growth in women with PCOS?
Birth control pills can play a role in improving acne and reducing unwanted hair growth for women dealing with PCOS. They help regulate hormones by lowering androgen levels, which are often higher than normal in PCOS and contribute to these issues. These pills typically combine estrogen and progestin, which work together to reduce androgen production in the ovaries. Additionally, they boost levels of a protein called sex hormone-binding globulin (SHBG). SHBG binds to free testosterone in the bloodstream, reducing its impact on the skin and hair.
This hormone regulation can result in clearer skin and a noticeable decrease in excess hair growth (hirsutism). For many women with PCOS, birth control pills prescribed by a healthcare provider can be an effective way to manage these symptoms.
What side effects can oral contraceptives have when used to treat PCOS-related skin concerns?
Oral contraceptives can help address PCOS-related skin problems like acne, but they might come with some side effects. Commonly reported issues include nausea, mood changes, breast tenderness, headaches, spotting, and bloating. Some individuals may also notice weight changes or experience abnormal uterine bleeding.
In rare instances, these medications might lead to more serious concerns, such as reduced insulin sensitivity, higher blood pressure, or an increased risk of blood clots. While severe complications like thromboembolic events are uncommon, it’s crucial to consult a healthcare provider to discuss your medical history and any concerns before beginning treatment. Pay close attention to how your body reacts and promptly report any unusual symptoms to your doctor.
What should I know before stopping oral contraceptives for PCOS, and how could it impact my skin?
If you're thinking about stopping oral contraceptives for managing PCOS, it's important to know how this might impact your body. Coming off the pill can temporarily disrupt your menstrual cycle and may bring back PCOS-related symptoms like acne or irregular periods. Skin issues, in particular, might become more noticeable as your hormones begin to rebalance.
To ease this transition, it's a good idea to talk to a healthcare provider before making any changes. They can work with you to develop a tailored plan to manage your symptoms and support your skin health. With the right guidance, you can navigate this adjustment more comfortably and reduce the likelihood of significant symptom flare-ups.
