The Short Answer
Some hormonal birth control methods can improve acne; others may trigger or worsen breakouts. The effect depends on the type of hormones involved, the delivery method and your individual skin. There is no single "best" option - but understanding how different methods interact with your skin can help you and your doctor find the right fit.
Why You Might Break Out When You Start Birth Control
An initial breakout (sometimes called a "purge") is common in the first 4–6 weeks of starting or switching birth control. This happens because:
- Your body needs time to adjust to new hormone levels
- Hormonal shifts can temporarily increase oil production before they stabilise
- Skin cell turnover may speed up, pushing existing clogged pores to the surface faster
This doesn't mean it's the wrong method. Most initial breakouts clear up within 2–3 months. If your skin hasn't improved by month 6, that's the time to talk to your prescriber about an alternative.
Key Takeaways:
- Combined (estrogen + progestin) methods are most likely to help acne
- Progestin-only methods may worsen breakouts in some people
- Non-hormonal methods (copper IUD, barriers) have no direct effect on skin
- Skin changes often take 2–6 months to stabilise after starting or switching
If you want to track how your skin changes across your cycle, a period tracking app can help you spot patterns over time.
How Hormones and Acne Are Connected
Acne is driven largely by androgens - hormones like testosterone that increase sebum (oil) production, which can clog pores and fuel breakouts.
Hormonal birth control can shift this balance in two ways:
Reducing Androgen Activity
- Combined pills raise sex hormone–binding globulin (SHBG), which binds free testosterone
- Less free testosterone means less sebum and, often, fewer breakouts
- Some progestins (e.g. drospirenone, chlormadinone) also have anti-androgenic properties
Increasing Androgen-Like Activity
- Certain progestins (e.g. levonorgestrel, norgestrel) have mild androgenic effects
- In some people this can increase oil production and trigger breakouts, especially in the first months
Estrogen itself helps regulate oil glands and supports skin barrier function. That's why combined methods (which contain estrogen) tend to be more skin-friendly than progestin-only methods.
Which Methods May Help Acne
Combined Oral Contraceptives (the Pill)
The most studied option for acne. Pills containing anti-androgenic progestins - such as drospirenone, norgestimate or desogestrel - have the strongest evidence for reducing breakouts. Three brands are FDA-approved specifically for acne treatment in the US, though other combined pills can also help.
Combined Patch and Ring
These deliver estrogen + progestin through the skin or vagina. Limited data exist, but the hormonal mechanism is similar to the combined pill, so comparable skin benefits are plausible.
Which Methods May Trigger Breakouts
Progestin-Only Pill (Mini-Pill)
Without estrogen to raise SHBG, some people experience increased oiliness and breakouts.
Hormonal IUD (e.g. Mirena, Kyleena)
Releases progestin locally. Most users see no skin change, but a subset reports new or worsened acne - particularly in the first 6 months.
Implant (e.g. Nexplanon)
Contains etonogestrel. Acne is listed as a common side effect in clinical trials, though many users experience no change.
Injectable (e.g. Depo-Provera)
Contains medroxyprogesterone acetate. Some people notice increased breakouts; others see improvement. Evidence is mixed.
Non-Hormonal Methods and Skin
Copper IUD, condoms, diaphragms and fertility awareness methods contain no hormones and do not directly affect acne - positively or negatively. If you're managing acne through skincare or dermatology treatment, a non-hormonal method keeps your skin routine as the only variable.
At a Glance: Method Comparison
May Help Acne
- Progestin type: Anti-androgenic (drospirenone, norgestimate, desogestrel)
- Estrogen: Combined pills (contain estrogen)
- Methods: Combination pill, patch, ring
May Worsen Acne
- Progestin type: Androgenic (levonorgestrel, norethindrone at higher doses)
- Estrogen: Progestin-only methods (no estrogen)
- Methods: Mini-pill, hormonal IUD, implant
What to Expect: Timeline
First 1–4 Weeks
- Your body adjusts to new hormone levels
- An initial breakout ("purge") is common and normal
- Don't switch methods yet - give it time
Months 2–6
- Skin typically stabilises by month 3
- If acne persists past 6 months, discuss alternatives with your provider
- Track your skin alongside your cycle - patterns often emerge
Switching Methods
Changing from one hormonal method to another can cause a temporary hormonal shift. Give your skin time to adjust before judging the new method.
Acne After Stopping Birth Control
Many people experience a breakout after stopping hormonal birth control - sometimes called "post-pill acne." This happens because your body resumes its natural androgen production, which was suppressed by the pill.
Post-pill acne typically peaks 3–6 months after stopping and resolves within 6–12 months. If it doesn't improve, or if it's severe, a dermatologist can help.
If you're thinking about stopping, understanding how long birth control stays in your system can help you plan your skincare transition.
What you can do:
- Start a consistent skincare routine before stopping
- Introduce a gentle retinoid or salicylic acid cleanser
- Track your skin changes so you can spot what's hormonal vs. routine
Choosing a Method When Acne Matters to You
Every person's priorities are different. Acne is one factor alongside effectiveness, convenience, side effects and personal preference. A few things to consider:
- If clear skin is a high priority - a combined pill with an anti-androgenic progestin (e.g. drospirenone) has the strongest evidence.
- If you want a long-acting method - weigh the small acne risk of a hormonal IUD or implant against the convenience. Many users have no skin issues at all.
- If you have a history of hormonal acne - mention it to your prescriber. They can steer toward lower-androgen options.
- If you're already treating acne with a dermatologist - coordinate care. Some acne medications (e.g. isotretinoin) have their own contraception requirements.
For a broader look at birth control side effects, see our complete guide. You can also explore different birth control options to compare methods side by side.
When to Seek Medical Advice
Talk to a doctor or dermatologist if:
- Acne is severe, painful or leaving scars
- Breakouts started or significantly worsened after starting a new method and haven't improved after 3–6 months
- You're considering switching birth control primarily because of skin changes
- You notice other hormonal symptoms alongside acne (irregular periods, excess hair growth, hair thinning) - these could point to an underlying condition like PCOS
- You want to stop birth control and are concerned about post-pill acne
This article is for informational purposes only and does not replace medical advice. If you have specific concerns about acne or birth control, consult your healthcare provider or dermatologist.
Frequently Asked Questions
Can birth control clear up acne?
Yes - combined hormonal methods, especially pills with anti-androgenic progestins like drospirenone or norgestimate, can significantly reduce acne. Some are FDA-approved specifically for this purpose.
Does the hormonal IUD cause acne?
It can. A small percentage of hormonal IUD users report new or worsened acne, most often in the first six months. The majority of users see no skin change.
Will I break out when I stop taking the pill?
Possibly. If the pill was keeping androgens in check, stopping it may lead to a temporary acne flare. This usually resolves within 6–12 months.
How long does it take for birth control to improve acne?
Most people notice improvement within 2–3 months. Full results may take 4–6 months. If you don't see any change after 6 months, the method may not be the right fit for your skin.
Is progestin-only birth control bad for acne?
Not always, but progestin-only methods lack the estrogen that raises SHBG and suppresses androgens. Some people are more sensitive to this than others.
Can I use acne medication alongside birth control?
In most cases, yes. Topical retinoids, benzoyl peroxide and antibiotics are generally compatible. If you're prescribed isotretinoin, your doctor will discuss specific contraception requirements.
Which birth control is best for acne-prone skin?
Combined pills with drospirenone, norgestimate or desogestrel have the most evidence for improving acne. Your prescriber can recommend based on your full health profile.
Spot the Pattern
Breakouts often follow your cycle. Track your skin alongside your period in the bloom app - so you and your provider can see what's hormonal.