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Everything You Need to Know About Birth Control and Acne

Can the pill make every day a good skin day? We found out how birth control can totally change your skin
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If you've got adult acne, you've probably tried every product imaginable, along with altering your diet, drinking more water, and every other voodoo-like trick on the internet. (Raise your hand if you, too, have rubbed banana peels on angry, inflamed skin.)

Here's a little not-so-secret insider tip: For some, the most valuable skin care product isn't a skin care product at all. It's a pill. THE pill, to be exact. The same birth control pill that eases cramps and keeps your cycle on schedule is also linked to clear skin.

But according to Dr. David Lortscher, MD, dermatologist and founder of Curology, an online prescription service for dermatologist-level skin care, not all birth control is created equal. A recent study authored by Lortscher found that while some methods do significantly quell acne, others actually make it worse. We got the nitty-gritty on the link between acne and the pill (and its medical device counterpart, the IUD) from Lortscher and Dr. Shehla Admani, MD, a dermatologist at University of California, San Diego. Here's everything you need to know about going on the pill for acne -- and what happens when you go off.

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Is the Pill Magical Fairy Dust for Acne?
It can be -- for some. Like this user on imgur, who documented the first five months of her face transformation on birth control. Her before and after pictures are a pretty convincing argument in favor of using birth control to tame breakouts.

If you're new to the acne battlefield, one of the first questions a dermatologist will ask is if you're on birth control. That's because for a lot of women, that little packet of once-daily pills is a godsend. In fact, a 2014 study found that the birth control may be better than oral antibiotics at clearing skin long term.

Though not everyone experiences this kind of about-face. Your results largely depend on which birth control you choose and the ultimate wild card in the war against acne: your genetics.

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How Does This Hormone Sorcery Work?
Acne begins with androgens, a group of hormones that includes testosterone. When this group of hormones is triggered (which can happen for many different reasons, including increased stress, your period and lack of sleep), your skin becomes more inflamed and starts to produce more sebum, the oil in your pores. Dead skin cells and dirt mix with the oil to create a blockage, causing even more oil to back up. Because of the plug, bacteria get trapped under the skin. And just like that, a pimple is born.

Many birth control pills contain forms of estrogen and progesterone, which can block or lower the androgens, keeping your oil production from going into overdrive.

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Can Birth Control Help MY Type of Acne?
Whether you have hormonal acne (around the chin and mouth area), bacteria-based acne (which can happen anywhere, but isn't typically associated with the painful, deep spots that crop up around your period) or cystic acne, which never seems to come to a head, Lortscher says that essentially all acne can be treated with birth control. "Pretty much any acne is driven by hormones, which is why eight-year-olds don't have acne," says Lortscher. He says that anyone who has the P. Acnes bacteria also likely has hormonal imbalances driving oil production. And, get this: the oil feeds the bacteria, which then creates an even bigger mess. It's literally a vicious cycle.

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The Best Birth Control for Acne
Saying that birth control treats acne comes with a really, really important-to-note asterisk. Only some birth controls treat acne. Others, like those that mimic progesterone, may make it worse.

A study that Lortscher and Admani authored analyzed over 2,000 women on birth control, and found that a combination of estrogen and progesterone were most effective forms of birth control for acne. That includes brands like Yaz, Ocella and Ortho Tri-Cyclen. NuvaRing also reportedly improved acne, though not as much as the combination oral pills.

Curology has a handy interactive guide where you can type in your brand of birth control to see where it falls on the acne improvement scale.

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