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Acne from Birth Control Pills
May 2000

Q. The first week after I finish my cycle and start my birth control pills, my skin develops acne. Presently, I am taking Tricyclin, the miracle acne pill, and want to switch in order to alleviate my acne. Because of lack of funds, I cannot afford to experiment with different products. My question is if acne is due to a change in sexual steroid levels, then why can't I find out which birth control pills contain less of these ingredients thus decreasing acne? Also, I have noticed that my tricyclic pills cause me to be moody at the beginning of each increasing dose. Would Ortho-Cyclin be a good alternative? Help, I am so confused with all of the contradictory information and would like to know all I can about different pills.

A. This is very frustrating because I know the answer, but I cannot find a web site for you to go and find out more on your own. Even the excellent Planned Parenthood site wasn't helpful.

Let me start by saying most pills contain two types of hormones: an estrogen and a progestin. The difference between the pills are based on the effects of the different types of estrogens and progestins and the different doses of the medications. A woman who has increasing acne on the pill needs to take a pill that has more estrogen and less progestin. Tables are available that show what the relative dose of the two hormones are in each pill, making it fairly easy to switch. Similarly, moodiness can usually be controlled by adjusting the relative does of the estrogen and progestin. Some women can find no birth control pill they tolerate.

Unfortunately, it can take several months on any one pill to know if your body "likes" it (in other words, it can take awhile for your body to adjust to the pill). Your lack of funds should not be a major obstacle. Most doctors have free samples of medications just for this purpose. They can give you a free sample of the pill for a few months to see how you do on it. If you do well, you will be able to then get the prescription. If not, you can switch pills.

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