How Birth Control Affects Your Skin

Is your contraceptive (birth control method) affecting your skin?

Our menstrual cycles are ultimately a result of fluctuations in our sex hormones. Fluctuations in these hormones bring about the changes that allow for ovulation and preparation of the endometrial lining in case you conceive, but these changes can also result in skin as well as hair changes. Manipulation of these hormones with hormonal contraceptives (birth control methods) understandably leads to skin as well as hair changes, some being more desirable than others.

Birth control items

So to understand how these “sex hormones” affect the skin and hair we have to outline the effects of each.

Cells in the skin and hair follicles contain receptors, which bind hormones leading to certain cellular changes. Oestrogen decreases oil production & keeps hair in its growth phase for longer.

Androgens (a group of hormones that includes testosterone) increases the skins oil production and causes hair follicles in certain parts of the body to produce hair that is coarse and dark, while also potentially causing hair loss from the scalp in some women.

So as you can imagine we want more oestrogen and less testosterone. So here’s where the hormonal contraceptives have their day. Oestrogen found in methods with both oestrogen and progestin—like the pill—can suppress the ovaries’ production of androgens, and increase the amount of a protein called sex hormone binding globulin (SHBG) which binds free androgen in the blood so that they can’t bind the receptors on the skin or hair.

But it’s not that simple…

Not all hormonal birth control is the same. Aside from the categories of combined versus progestin-only, the specific type of progestin varies between methods, with altered hair and skin effects. Some progestins are more androgenic (likely to activate the androgen receptors) leading to those unwanted side effects of increased oil production and excessive hair growth, while others are  anti-androgenic (block the androgen receptors) preventing the unwanted effects.

Birth control, mirena

While oestrogen then seems like the simple solution, oestrogen increases the production of melanin (the pigment which gives your skin colour) causing some women to develop and perhaps complain of darkening of the skin especially over the cheeks and forehead as well as the upper lip which we call melasma.

The specific hormone, dosage, and route can all impact whether someone has beneficial or unwanted side effects.

Progestin-only contraceptives

Implant (implanon)- Contains progestin called etonogestrel.

IUD (Mirena)- levonorgestrel.

The injection (depoprovera)- progestin

All these to varying degrees have been associated with acne as a result of an increased sebum production. Hairloss and excess hair growth on the face (hirsuitisim) can also occur once again dependant on the androgenic extent of the progesterone.

Combined hormonal contraceptives (oestrogen and progestin)

The pill- Generally well documented to improve acne and hirsutism. Pills that contain anti-androgenic progestins (drospirenone and cyproterone acetate) may improve acne more than pills with androgenic progestins.

The patch

The ring (Nuvaring)

Birth control, the pill

So while you are likely to have improvement in acne with the oestrogen containing methods, remember that oestrogen can cause increased sensitivity to the sun (photosensitivity) and may cause melasma.  Oestrogen can also increase your risk of blood clots especially deep vein thrombosis and its for this reason it should not be used in smokers >35 years of age.

There are so many options for birth control, there’s no reason why you shouldn’t be able to have your pick and make sure that your concerns beyond just pregnancy prevention are met. Discuss your options with your doctor to tailor your choice to what you need.

Remember when starting a new method of birth control allow for a three month window for your body to adjust to the new hormones. After this period if you have unwanted side effects or haven’t seen an improvement in your areas of concern, discuss with your doctor. Remember what worked for your friend won’t necessarily work for your and vice versa, so be an active participant in seeking out the best method of contraception for you. Talk it out, figure out what works for you, and say hello to clear, hormonal-acne-free skin.

Follow Lauren Knight for more skincare concern articles: @derm.discovered 

Wellness in the City
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