What Is It?
Often known by its brand name, Estrostep®, this is a birth control pill that is also approved to treat acne. It works by regulating male hormones in the female body. Less male hormones in the body normally lead to less acne.
Strength of Evidence
Average 63% reduction in acne after 24 weeks
- Sun, X., Qian, F., He, Y., Gu, X. & Di, W. Safety and efficacy of combined oral contraceptive ethinyl estradiol/drospirenone (YAZ) in Chinese women: a single-arm, open-label, multicenter, post-authorization study. Adv Ther 37, 906–917 (2020).
- Pande, S., Deshmukh, G., Dhoot, D. & Andhorikar, N. An open-label, prospective, comparative, double-arm clinical trial to evaluate the safety and effectiveness of minocycline extended-release formulation compared with minocycline immediate-release formulation in the management of patients with papulopustular acne. Indian J Drugs Dermatol 6, 76 (2020).
- Jaisamrarn, U. & Santibenchakul, S. A comparison of combined oral contraceptives containing chlormadinone acetate versus drospirenone for the treatment of acne and dysmenorrhea: a randomized trial. Contracept Reprod Med 3, 5 (2018).
- Koo, E. B., Petersen, T. D. & Kimball, A. B. Meta-analysis comparing efficacy of antibiotics versus oral contraceptives in acne vulgaris. Journal of the American Academy of Dermatology 71, 450–459 (2014).
- Palli, M. B. A., Reyes-Habito, C. M., Lima, X. T. & Kimball, A. B. A single-center, randomized double-blind, parallel-group study to examine the safety and efficacy of 3mg drospirenone/0.02 mg ethinyl estradiol compared with placebo in the treatment of moderate truncal acne vulgaris. J Drugs Dermatol 12, 633–637 (2013).
- Plewig, G., Cunliffe, W. J., Binder, N. & Höschen, K. Efficacy of an oral contraceptive containing EE 0.03 mg and CMA 2 mg (Belara) in moderate acne resolution: a randomized, double-blind, placebo-controlled Phase III trial. Contraception 80, 25–33 (2009).
- Leyden, J. et al. A systemic type I 5 alpha-reductase inhibitor is ineffective in the treatment of acne vulgaris. J Am Acad Dermatol 50, 443–447 (2004).
- Sator, P.-G., Schmidt, J. B. & Hönigsmann, H. Clinical evidence of the endocrinological influence of a triphasic oral contraceptive containing norgestimate and ethinyl estradiol in treating women with acne vulgaris. A pilot study. Dermatology 206, 241–248 (2003).
- van Vloten, W. A., van Haselen, C. W., van Zuuren, E. J., Gerlinger, C. & Heithecker, R. The effect of 2 combined oral Contraceptives containing either drospirenone or cyproterone acetate on acne and seborrhea. Cutis 69, 2–15 (2002).
- Worret, I., Arp, W., Zahradnik, H. P., Andreas, J. O. & Binder, N. Acne resolution rates: results of a single-blind, randomized, controlled, parallel phase III trial with EE/CMA (Belara) and EE/LNG (Microgynon). Dermatology 203, 38–44 (2001).
- Vartiainen, M., de Gezelle, H. & Broekmeulen, C. J. Comparison of the effect on acne with a combiphasic desogestrel-containing oral contraceptive and a preparation containing cyproterone acetate. Eur J Contracept Reprod Health Care 6, 46–53 (2001).
- Dieben, T. O., Vromans, L., Theeuwes, A. & Bennink, H. J. The effects of CTR-24, a biphasic oral contraceptive combination, compared to Diane-35 in women with acne. Contraception 50, 373–382 (1994).
- Monk, B. E. et al. Efficacy of low-dose cyproterone acetate compared with minocycline in the treatment of acne vulgaris. Clinical and Experimental Dermatology 12, 319–322 (1987).
- Miller, J. A. et al. Anti-androgen treatment in women with acne: a controlled trial. Br J Dermatol 114, 705–716 (1986).
- Carlborg, L. Cyproterone acetate versus levonorgestrel combined with ethinyl estradiol in the treatment of acne. Results of a multicenter study. Acta Obstet Gynecol Scand Suppl 134, 29–32 (1986).
High side effects and adverse reactions
Acne.org's Real World Take
All oral contraceptives appear to clear the skin about the same amount. Some people report cessation of acne symptoms and others see partial relief. However, messing with hormones is messing with hormones and it’s best to proceed with caution. But if you’re looking to take the birth control pill anyway, one of the benefits is clearer skin.