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Acne is an abnormality of the pilosebaceous follicle (the hair); androgenic hormones (male hormones) play a major role in the production and secretion of sebum.
Thus, depending on their androgenic dose, some contraceptives will improve acne, others will worsen it.

Le rôle des contraceptions orales sur l’acné

As far as "pills" are concerned, there are currently two main ones: the
estrogen-progestin oral contraceptives and progestin oral contraceptives.

To understand this, you need to know that estrogen-progestin contraceptives combine a synthetic estrogen (ethinyl estradiol (EE)) with a progestin. EEs are classified according to their dosage (50, 30, 20 or 15), which may vary during the cycle depending on the pill; they are known as mono-, bi- or triphasic pills.

More recently, a new estrogen, Estradiol Valerate (E2), has been commercialized.
Estrogens have an antiandrogenic activity and therefore have a rather "anti-acne" action, but it is their combination with progestogens that will ultimately determine whether or not a pill has a favourable effect on acne.

Thus the pills known as of 1st and 2nd generation and some of 3rd generation will tend to support the acne on the other hand others of 3rd generations and the 4th generations will improve it.

Why not give 3rd and 4th generation pills to all women?

The latest recommendations of the French National Authority for Health require that when oral contraception is required, the first-line prescription should be for 1st and 2nd generation pills, as these have a low risk (2 accidents per 10,000 users versus 4 accidents per 10,000 with the 3rd and 4th generations).
In any case, the contraindications of estrogen-progestin contraceptives must be respected: be careful in case of personal or family history of phlebitis or pulmonary embolism, a more thorough assessment of the coagulation will be necessary; smoking is also to be avoided (throw away your
packets of cigarettes !!! anyway it's not good for your health !).
Overweight, high blood pressure and migraines with aura are also to be taken into consideration.

Who can advise you on effective contraception?

Only your doctor can advise you on contraception, and he or she can change it if your acne worsens by offering you a new generation pill, provided that you have no contraindications.

Dr. Aurélie Acher - Dermatologist