Does anyone know of a good birth control pill that will help reduce ace?

Question

My daughter is 17 and constanlty breaking out with hormonal acne and her periods are very irregular, anything the dermatologist gives her does not help and makes the acne WORSE!!!

Answer 1

Which pills have higher progestin side effects or cause more acne and hair growth?
Each progestin has a different potency, milligram per milligram, in terms of progesterone effect to stop menstrual bleeding or androgen effect to stimulate acne and hair growth. However you must remember that a higher potency progestin may be used in a much smaller milligram dose and thus be equivalent to a larger milligram dose of a less potent progestin. For example, desogestrel is a very potent and androgenic progestin but its usual oral contraceptive dose is 0.15 mg instead of 1.00 mg for norethindrone. Its progestin potency compared to norethindrone would be 0.15 X 9.0 = 1.35 times. For androgenicity, it would be 0.15 X 3.4 = .51 or half as androgenic as a pill containing 1 mg of norethindrone.

Progestin Potency of Different Oral Contraceptive Progestins* Progestin Progestational Activity
(relative to 1 mg of norethindrone) Androgenic Activity
(relative to 1 mg of norethindrone)
norethindrone 1 mg 1.0 1.0
norethrindrone acetate 1 mg 1.2 1.6
ethynodiol diacetate 1 mg 1.4 0.6
levonorgestrel 1 mg 5.3 8.3
dl-norgestrel 1 mg 2.6 4.2
norgestimate 1 mg 1.3 1.9
norelgestromin 1 mg** 1.3 1.9
desogestrel 1 mg 9.0 3.4
drospirenone 1 mg 1.5 0.0

* - From Table 2 in Dickey RP: Individualizing oral contraceptive therapy. OBG Management Supplement October 2000, p 5.
** - Not yet tested but it is the major active metabolite of norgestimate

The pills that are likely to cause worse acne and hair growth side effects are those pills high in androgenicity and low in estrogen content. Such pills might include:

Loestrin® 1.5/30
Loestrin® 1/20 Fe
Estrostep® Fe
Levlen®
Alesse®
Ovral®
Norlestrin® 1/50
Keep in mind that MOST women on these above pills DO NOT have acne problems, just those that have a tendency toward androgenicity.



What pills would be better for ...?
In order to classify an oral contraceptive as an estrogen dominant, progestin dominant or androgenic pill, you must multiply the actual dose of the components times the relative potency of that component. Keep in mind that these are relative classification and do not always hold from one woman to another. For different oral contraceptive side effects, you might consider switching to the pills indicated in the table below to minimize those side effects. Current Pill Problems and Choice of Pill to Switch To Side Effect/Problem Principal Pill Suggestions

Acne higher estrogen, lower androgen potency Yasmin®, Demulen® 1/50, Othro-Tri Cyclen®, Ortho-Cyclen®, Yasmin®, Brevicon®, Modicon®, Necon®, Ortho Evra®, Mircette®
Break-through bleeding higher estrogen, higher progestin potency, lower androgen potency Yasmin®, Demulen® 1/50, Zovia® 1/50E, Ovcon® 50, Desogen®, Ortho-Cept®, Estrostep® Fe, Loestrin® 1/20
Absent or too light menstrual flow higher estrogen, lower progestin potency Ortho-Cyclen®, Ovcon® 35, Brevicon®, Modicon®, Necon® 1/50, Norinyl® 1/50, Ortho-Novum® 1/50, Necon® 1/35, Norinyl® 1/35, Ortho-Novum® 1/35,
Depression lower progestin potency Ortho Evra®, Ovcon® 35, Ortho-TriCyclen®, Othro-Cyclen®, Brevicon®, Modicon®, Necon® 1/35, Alesse®, Levlite®, Tri-Levlen®, Triphasil®, Trivora®
Moodiness or irritability lower progestin potency Ortho Evra®, Ovcon® 35, Ortho Tri-Cyclen®, Othro-Cyclen®, Brevicon®, Modicon®, Necon® 1/35, Alesse®, Levlite®, Tri-Levlen®, Triphasil®, Trivora®
Headaches (not menstrual migraines) lower estrogen, lower progestin potency Ortho Evra®, Alesse®, Levlite®,
Breast soreness lower estrogen, lower progestin potency Yasmin®*, Ortho Evra®, Alesse®, Levlite®, Loestrin® 1/20 Fe, any lower estrogen pill than currently on
Weight gain lower estrogen, lower progestin potency Yasmin®*, Ortho Evra®, Alesse®, Levlite®, Loestrin® 1/20 Fe, any lower estrogen pill than currently on
Severe menstrual cramps higher progestin potency Yasmin®, Desogen®, Ortho-Cept®, Mircette®, Loestrin® 1.5/30, Demulen® 1/35, Zovia® 1/35E, Demulen® 1/50, Zovia® 1/50E
Endometriosis or endometriosis prevention lower estrogen, higher progestin potency, higher androgen potency Loestrin® 1.5/30, Loestrin® 1/20 Fe, LoOvral®, Levlen®, Levora®, Nordette®, Demulen® 1/35, Zovia® 1/35,
(used either continuously with zero days of placebo pills or with only 4 days of placebo pills for prevention)

* - The progestin has anti-water retention properties





Where can I get free or discounted birth control pills?
Planned Parenthood organizations and your local county Public Health Department often provide birth control pills on an ability to pay discounted scale. If you qualify, they may even be free. Look up in the yellow pages phone directory for the Planned Parenthood or Public Health Department for the county you live in. Give them a call and ask about the costs of pills. If you are in college either full or part time, you may also be qualified to use the student health facility and often they provide oral contraceptives at cost or a discount.

When your doctor prescribes a given oral contraceptive, most of the time they indicate it can be filled with a generic equivalent. If not, ask the doctor to please do that or ask the nurse to have a prescription rewritten for a generic equivalent. There are sources on the Internet that will except mailed-in prescriptions and the cost of a generic equivalent is often in the $12-15 range. I have not used them but you may want to check out Hocks Drugs or use a search engine to look for "discount birth control".

Answer 2

Ortho Tri-Cyclen cleared by FDA for acne treatment:

Answer 3

any of the low progesterone ones, such as Yasmin.