Hands in the air if you’re on the pill – sorry if that just made a really awkward office moment. We’re guessing that’s a lot of you, as according to the National Health Statistics Report, 62% of women in the USA (who are of reproductive age) are taking or using some form of contraception – that’s 20.8 million women, which is HUGE! Yet a lot of women (ourselves included) don’t fully understand the real side effects of contraception and the individual side effects of the varying forms; from the combined pill to the IUD coil.
Even if you’re aware of the common effects, like potential weight gain, mood swings, plus the impacts it can have on your skin, it can be easy to forget and single out contraception as the main cause of the problem. So we’re giving you the FULL lowdown on how the most common method of contraception, the combined oral contraceptive pill (COC), affects your skin. We spoke to two board-certified OBGYNs, Dr. Rebecca Booth, author of The Venus Week: Discover the Powerful Secret of Your Cycle… At Any Age, and Dr. Mary Jane Minkin, a professor at the Yale University School of Medicine. We also reached out to the experts at Flo, the world’s biggest women’s health platform, to help you make a fully informed decision when you’re choosing whether you want to use contraception.
How does contraception affect your skin?
Dr. Booth explains “For women, fertility is dependent on a fluctuation of hormones, so a steady level of hormones induced by combination contraception pauses fertility, but the consistent estrogen component can stabilize and suppress negative changes that affect skin such as blemishes, unwanted facial hair, and enlarged pores. Estrogen can sometimes increase melanin (what gives your skin color), so some women may notice increased areas of pigmentation known as melasma. Hormone birth control methods that don’t contain estrogens, such as progestin-containing IUDs, or the progestin subdermal implant have little measurable effect on the skin.”
Dr. Minkin adds, “All forms of contraception suppress ovulation and stimulation of ovarian function. However, what most women don’t realize is that the ovary makes testosterone, as well as estrogen, and it’s the testosterone from the ovary that tends to give women acne.”
Dr. Booth explained, “The most common form of hormonal birth control is known as ‘combination contraception.’ This involves combining two hormones: estrogens and progestins to temporarily pause the fertile cycle with 21 to 28 days of a steady amount of hormones, for example, most oral birth control pills, the contraceptive patch and contraceptive vaginal rings.”
How the combined pill affects your skin
Flo outlined how the combined pill affects the skin (get ready for some serious science talk), and explained that the combined pill works to “Decrease the number of androgenic hormones produced in the ovaries and adrenal gland. They also limit the quantity of biologically active circulating testosterone by binding it with sex hormone-binding globulin. Finally, estrogen markedly decreases oil production in the sebaceous glands.” In simple terms, this means your skin will produce less oil so your pores will remain unblocked and are less likely to flare up and breakout.
The contraception types the experts recommend:
Combination pill, patch or ring: Dr. Booth and the experts at Flo agreed that the COC could have a positive impact on your skin. Dr. Booth told us, “The combination hormonal methods (those that contain both estrogen and progesterone-like hormones) such as the combination pill, patch or ring have long been used to stabilize blemishes, reduce unwanted facial or body hair, and reduce pore size. Women who have tried a healthy diet, regular skin cleansing, and gentle exfoliation, but have persistent blemishes, perimenopausal rosacea, or cystic acne will often get improvement with combination contraception.”
Yaz, Ortho Tri-Cyclen, and Estrostep: If you’re looking for a pill to help improve acne, Flo recommends first consulting with your doctor as they’ll be able to assess your history, skin, and hormone levels to find a pill that’s best suited for you. Although, you’re most likely to be prescribed Yaz, Ortho Tri-Cyclen, and Estrostep, as Flo explains these are the “three forms of COC that are FDA approved” as they can reduce inflammation and help combat breakouts. However, Flo adds that if you have normal or sensitive skin, you should be wary of using the combined pill, “Combined contraceptive pills can increase sun sensitivity of the skin. Consult with your doctor if your skin is prone to hyperpigmentation as it can increase pigmentation in the skin.”
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Yasmin and Yaz: Dr. Minkin also recommends Yaz, “The best for the skin in general are pills that contain the progestin Drospirenone (Yasmin and Yaz), which not only help prevent ovulation, but the drospirenone acts directly at the level of the hair follicles in the skin where the oily stuff is made, by blocking testosterone directly at the follicle. So it’s a double benefit. And the progestin components of the various pills vary, and some do have some testosterone type activity.”
The most common side effect of the pill is melasma
One of the most common side effects of contraception is a skin condition called melasma. Dr. Booth explained that “Melasma is a skin condition that results in dark spots and patches on the skin caused by an increase in the body’s melanin – a natural substance that gives color to the skin and hair. This condition is common during pregnancy and usually resolves gradually after giving birth. Some women, however, may have dark patches that last for years. Estrogen-containing combination contraception may also rarely cause melasma, especially in women with a family history of the problem.” Dr. Minkin adds that “Estrogen is the culprit in melasma – the brown pigmentation of the skin from estrogen.”
How to prevent melasma
Dr. Booth says the best way to prevent melasma is to wear sunscreen, she suggests, “At least SPF 15 for daily inside and outside use, and SPF 30 for significant outside sun exposure. Wear a wide-brimmed hat every day when you are outside for significant periods of time and use gentle exfoliation with plant enzymes and a gentle physical exfoliant as part of your skincare regimen.” Dr. Minkin also agrees, “It’s best prevented by using a pill with as low a dose of estrogen as possible, and by staying away from the sun.”
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How to treat melasma
Dr. Booth told us that “In addition to sun protection and increasing cell turnover with gentle exfoliation, to treat melasma, use moisturizing products that reverse or block the process of pigment formation.” We love the Ren Skincare Ready Steady Glow Daily AHA Tonic, $32, as it has lactic acid and azelaic acid precursors (normally available only by prescription), which gently exfoliate and boost cell renewal. We’re also obsessed with Drunk Elephant’s C-Firma Day Serum, $80, which contains antioxidant-rich, brightening agent vitamin C that helps lighten the dark patches in the skin, correcting uneven tone.
Many products are formulated with a class of molecules known as tyrosinase inhibitors, chemicals that block an enzyme needed to maintain the pigment melanin – the cause of melasma. Examples include resveratrol, a powerful phytoestrogen and antioxidant that you can find within Caudalie Resveratrol Lift Night Infusion Cream, $76 or the VENeffect Firming Phyto-Lift Serum, $195.
Dr. Booth continued to say that, “While estrogen may contribute to pigmentation of the skin, phytoestrogens do the very opposite – blocking melanin production, making them very useful with regard to melasma.” Topical skin lighteners such as hydroquinone, tretinoin, and tranexamic acid found in Lytera 2.0, $155 (only available via prescription) can be very effective in treating it.
Other methods of contraception
If you don’t want to start using the combined contraceptive pill or you’re currently taking it and are looking to change, there are tons of other contraception that have very few negative side effects. Dr. Minkin told us, “Any non-hormonal contraception will not affect the skin, so for example, a very effective method with no hormones at all is the Paragard IUD [a tiny device that is surgically inserted into the uterus] – a small amount of copper acts locally, to kill sperm that is thinking about entering the uterus! Plus, it has no skin-related side effects.”
Dr. Minkin adds that “All barrier methods of contraception are also advisable such as skin-condoms and diaphragms, as they have no negative side effects. Finally, The Mirena IUD, which is coated with progestogen is another great option. However, very little progestogen gets absorbed into the bloodstream, but there’s a small amount of absorption, which is rarely a skin issue, but remotely possible.”
What we’ve learned from the experts:
After all that info, here’s a quick recap of what we’ve learned from Dr. Minkin, Dr. Booth, and the experts at Flo:
- The combined pill is highly recommended to help with breakouts, acne, enlarged pores, and unwanted facial hair.
- Flo outlined the three forms of COC that are FDA approved, which they recommend; Yaz, Ortho Tri-Cyclen, and Estrostep.
- The most common side effect of hormonal contraception is melasma, a skin condition that results in dark spots and patches of uneven tone. The easiest way to reduce melasma is to wear sunscreen daily. To treat existing melasma, we’d recommend exfoliating the skin regularly (twice a week) combined with the use of brightening treatments.
- If you don’t want to take the combined pill, there are other methods of contraception that have little impact on the skin, such as the IUD coil or barrier contraception, like a diaphragm or condom.
We also strongly advise seeking out a healthcare professional when considering taking any form of contraceptive. It is important to find one that will be compatible with your lifestyle and your body. Let us know if you guys have any questions in the comments below.