Combined oral contraceptives (COCs), better known to most people as birth control pills, target the hormonal component of acne, helping to stabilize the monthly fluctuation of hormones during the menstrual cycle. This results in lower skin oil production, and in turn, less acne. They are normally effective in reducing symptoms of acne to a significant degree. However, they come with risks, and so many women choose to forgo taking COCs if the sole purpose is treating acne. However, there are two times when COCs tend to make more sense:
1. When contraception is also a goal. If an acne-prone woman is sexually active and does not want to become pregnant, taking a COC can kill two birds with one stone, preventing pregnancy and clearing acne at the same time.
2. When treating poly-cystic ovary syndrome (PCOS). Acne + irregular menstruation + excessive hair growth can mean PCOS may be present. In this case, the default treatment is normally COCs, which can not only reduce acne, but can also help clear up PCOS.