Can the Pill Clear Up Acne?
Women fed up with bad skin are betting that it can.
Women and Acne: The Painful Truth continued...
Acne, in fact, is caused not by dirt or oil, but by bacteria called P.
acnes that live on everyone's skin. During puberty, the body produces
higher levels of androgens, which can overstimulate the skin's oil-producing
(sebaceous) glands, resulting in a greater amount of the oily substance called
sebum. The more sebum, the more likely it is that a hair follicle will become
clogged, resulting in follicular plugs called comedones. These clogged
follicles allow P. acnes to proliferate. Some people are hypersensitive
to P. acnes, says Guy Webster, MD, PhD, vice chairman of the department
of dermatology at Jefferson Medical College in Philadelphia. These people have
excessive immune responses to the bacteria -- similar to an allergic reaction
-- and this results in acne.
But hormones, too, can be the cause. According to Debra Jaliman, MD,
clinical instructor of dermatology at Mount Sinai School of Medicine in New
York City, some women are genetically prone to having more drastic hormone
swings, higher levels of androgens, and oil glands that are more sensitive to
hormones. "When hormone levels stay stable, it's easier on the skin. When
they fluctuate a lot, that's when the skin breaks out." Hence, those pesky
pre-period breakouts with which women are so familiar.
Studying the Pill
That's another reason some scientists believe the birth control pill and
other hormone-controlling drugs can treat acne. The only birth control pill
studied for this purpose is Ortho Tri-Cyclen, but according to Jaliman, any
formulation that contains a low amount of androgen can be used to treat
In a study published in the November 1997 issue of the Journal of the
American Academy of Dermatology, researchers looked at the effectiveness of
Ortho Tri-Cyclen in treating acne. Evaluating 247 women, scientists found that
93.7% of the Pill-taking group showed an improvement, while only 65.4% of the
placebo group had such skin-clearing results.
Still, those results, while they sound promising, can be deceiving, says
Jaliman. "Improvement does not mean total clearing. To a patient, if
they're improved but not clear, they're still not happy," says Jaliman,
who, in her practice, has seen mixed results with the Pill.