Hormonal acne still there on the pill - what are the options?
The combined pill helps many women with hormonal acne, but is not always effective. If acne around the jawline and chin persists on the pill, the main options are spironolactone, which blocks the effect of male hormones on the skin, adding prescription creams, or isotretinoin.
Which pill?
Forms of the combined pill that also block male hormones, such as Yasmin, are particularly effective for acne. The progesterone-only "minipill" and some coils can make acne worse, and changing to another form of contraception may help. Contraception is prescribed and monitored by your GP.
Spironolactone
Spironolactone works by blocking the effects of male hormones (androgens) on the skin, reducing oil production. It is particularly helpful for acne concentrated around the jawline and chin. Most women notice a benefit after 2 to 3 months, and it can be taken long term. It needs blood tests before and during treatment, and you must not become pregnant while taking it.
Other options
- Winlevi: a topical medicine similar to spironolactone that works by blocking male hormones in the skin. Since it works on the skin it has much less risk of side effects than a tablet and does not require blood monitoring, however it may not be as effective.
- Other creams: a topical retinoid or benzoyl peroxide alongside hormonal treatment.
- Isotretinoin: for moderate or severe acne, or acne causing scarring.
Hormonal acne on the pill?
I can assess whether your acne is hormonal and recommend the right treatment. Spironolactone can be prescribed and followed up entirely remotely.
Related Articles
- What treatments are effective for hormonal acne?
- Spironolactone treatment
- When should I consider isotretinoin for my acne?
- What causes acne?
