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Using birth control for acne is generally regarded as a safe treatment. It has been used for decades to control pregnancy, so the overall safety record is well established. There are three oral contraception pills approved by the FDA for acne treatment.
Generally seen as a last-ditch treatment after other treatments for acne like creams and antibiotics have failed, hormone replacement treatments are effective but drastic: altering the hormonal balance of a human body is always something that should be taken very seriously.
CBD, or Cannabidiol, is an extract of the cannabis plant that has been showing promise in treating a number of conditions, including epilepsy and acne. Unfortunately, at this time it is impossible to tell if it is safer in the long-term than birth control because there have been very few studies into the effects of CBD vs birth control for acne.
That is not the whole picture, however, and CBD remains a viable acne option for many people because of its tolerability and lack of side effects.
Combination oral contraceptives, or birth control pills, are a treatment that prevents pregnancy by altering the hormone levels of a female body to halt ovulation. During a normal ovulation cycle, mature ovaries produce androgens, a sex hormone.
When levels of androgens increase, the production of sebum, or skin oil, increases. Excess sebum causes pores to get blocked and fill with dead skin cells and bacteria. This leads to acne.
Many birth control pills contain estrogen and progestin. When taken in the correct quantities, they reduce the levels of androgens and therefore reducing the production of sebum. Acne is either wiped out or significantly reduced.
The FDA has approved three combination oral contraceptives for the treatment of acne. These types of birth control pills contain both progestin and estrogen. Treatments with just progestin are known to make acne worse.
Ortho Tri-Cyclen: One successful hormonal birth control treatment is called Ortho Tri-Cyclen. It is a combination of estrogen and a synthetic progestin norgestimate. It is approved for use in females over the age of 15 and only when the patient also wants oral contraceptives as well as acne treatment.
Estrostep: This treatment is a combination of estrogen and norethindrone.
YAZ: This treatment uses estrogen and drospirenone. Drospirenone is thought to increase the risk of blood clots compared to other progestins.
All three seem to treat acne similarly, so the user may choose between them depending on their tolerability and risk factors. Side effects can include breast tenderness, weight gain, mood changes, and occasionally acne itself.
Long term effects are relatively rare, though the estrogen and progesterone treatment should not be used for very long periods.
A change in hormones is one of the biggest causes of female acne. The cycle of menstruation alters the levels of estrogen significantly during the month, producing changes in the sebum production in the skin and acne. This is why hormone replacement treatments work.
They flatten the estrogen cycle so there are no big changes in oil production. Hormone treatment is effective against acne in most women. It is only recommended to women who want to have the prophylactic effects of Hormone Replacement Therapy (HRT) as well.
If someone is too young (below the age of 15), wants to ovulate normally, or cannot alter their estrogen levels because of health issues, they should not use the treatment. Using birth control for acne is suitable for mild to severe acne, and so can help people avoid the scarring that severe acne brings. Cannabidiol (CBD) is only suitable for mild to moderate acne.
The jury is out on whether using birth control for acne or CBD is safer. The almost complete lack of scientific literature is troubling to anyone who wants a firm evidence base for their treatments. There has been some study, but what is known regarding CBD and sebum production has mostly been established in a laboratory, not on people. Anecdotal evidence is out there but it remains to be anecdotal.
One lab study found that CBD actively regulates sebum production in the skin, producing sebostatic and anti-inflammatory effects. Anti-inflammatories are useful for reducing the symptoms of acne, like itching and redness. The sebostatic effect means less sebum and less blocked pores which in turn means less acne.
One small study looked at 3% cannabis seed extract cream on volunteers and found it to be safe and significantly effective in clearing acne. Many more small studies on a variety of conditions have found CBD to be a very well tolerated drug, with few side effects.
It can look like there is a lot of study going into CBD and acne, but it should be highlighted at this point that a lot of the science is of questionable quality. Rarely are double-blind control trials conducted, and almost never on a large scale.
Compared to the rigorous testing that birth control acne treatments have undergone, CBD is almost completely unknown. Medical treatments have an understandably strict testing regime, following a series of scandals like thalidomide. CBD does not come close to the standards of testing that are now required.
That being said, CBD presents few risks. It is well known to be highly tolerable and when side effects do occur, they are usually very mild and short term and never serious. CBD can be an ideal treatment but make sure you can legally use it before you try it. The legality of CBD can be confusing for some.
If you are too young, do not want to engage in a contraceptive regime, or do not want to mess with your ovulation cycles, alternatives like CBD to reduce acne could seem appealing. Antibiotics are best avoided unless they are absolutely necessary (severe acne is a good reason to take them), many anti-inflammatories are uncomfortable or intolerable in the long term, so lots of people are looking for viable alternatives.
Due to the lack of scientific data, it is impossible to make proper recommendations about CBD. If you are curious, all the data that does exist is freely available on the web. Your conclusion will likely be the same as this article’s: it looks good to try but there is not quite enough evidence to know for sure how effective it will be.
If you are living in a state or country that prohibits CBD, it is recommended that you avoid it and look for alternatives. Where it is legal, please seek professional medical advice from your doctor before using it. They will be able to coordinate CBD use with other treatment options to give you the best chance of getting rid of your acne safely.