Why acne can persist on contraception
Evidence last assessed 2026-10-14.
In short
- What the research shows
- Combined contraception reduces acne on average, slowly: partial at 3 months, clearest around 6 months.
- What it doesn't show
- Trials were mostly in women without the condition, and it is no reason to switch.
- Skin and hair
See studies and method
What the evidence says
Combined contraception reduces acne on average, but slowly: in pooled trials, combined pills had cut acne lesions by about a third at 3 months and by about half at 6 months, compared with about a quarter on placebo. Progestin-only methods work differently: in one large study of women's own reports, the implant, the injection and the hormonal IUD left acne worse on average.
A Cochrane review of 31 trials (12,579 participants) found that combined pills reduced acne lesion counts, severity and self-assessed acne compared with placebo, with few consistent differences between pill types. A pooled analysis found mean lesion reductions of 37.3% at 3 months and 55.0% at 6 months on the pill, against 24.5% and 28.6% on placebo. A retrospective study of 2,147 women's own reports found that the implant, the Depo injection and the hormonal IUD worsened acne on average, while the pill and the ring improved it.
What this does not show
The trials were mostly in women without the condition; with a higher androgen drive, the average improvement they measured may overstate yours. The finding on progestin-only methods comes from one study of women's own reports, looking back, not from trials. Changing method is a clinical decision with contraceptive consequences. This supports a conversation about the specific progestin, never a switch on its own. The 3-month and 6-month marks are trial averages, not a prognosis for your skin.
Sources, as Neta holds them
Arowojolu AO, Gallo MF, Lopez LM, Grimes DA. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2012;(7):CD004425. doi:10.1002/14651858.CD004425.pub6
Systematic review · 12,579 participants
Koo EB, Petersen TD, Kimball AB. Meta-analysis comparing efficacy of antibiotics versus oral contraceptives in acne vulgaris. J Am Acad Dermatol. 2014;71(3):450-9. doi:10.1016/j.jaad.2014.03.051
Systematic review
Lortscher D, Admani S, Satur N, Eichenfield LF. Hormonal contraceptives and acne: a retrospective analysis of 2147 patients. J Drugs Dermatol. 2016;15(6):670-4. https://jddonline.com/articles/dermatology/S1545961616P0670X/
People compared with each other · 2,147 participants