Combined oral contraceptives (COCs) are approved for treatment of acne. A few of them even have FDA approval for acne treatment. If there is a noticeable cyclic activity to acne breakouts, such as right before the start of the menstrual cycle, then hormones may be contributing to the acne. Androgens, “the male hormone”, stimulate sebum production in the skin causing follicles to accumulate debris, forming comedones. These comedones can be open or closed, forming whiteheads or blackheads, respectively. In this way, androgens stimulate acne. Balancing the hormones can be key to controlling acne flare ups for young women. COCs decrease the amount of circulating androgen thus decreasing sebum and acne stimulation.
As a contraceptive method, COCs fail at a rate of 8% with typical use and at a rate of 0.1% with perfect use. COCs are available in different formulations with varying amounts of estrogen and progestin. COCs are also used in the treatment of other medical conditions such as premenstrual dysphoric disorder (PMDD), dysmenorrhea, abnormal uterine bleeding, and polycystic ovarian syndrome (PCOS).
Kirstie Cunningham, MD, FACOGPresident, Metro Health and Wellness, LLC