Does birth control cause acne? Experts debunk the biggest skin myths

From spot treatment to birth control to Accutane, Inderpreet Gill had tried dozens of skin-care products in hopes of clearing her painful acne.

But nothing worked permanently so it wasn’t a surprise for Gill, 27, to commonly wake up with pimples on her face.

The psychology graduate student at the University of Toronto dreaded going to school because she was scared of what people would think of her acne.

“I remember thinking, ‘I am the most unattractive person ever right now,’” Gill said. “I took pictures and I sent them to my old coworkers and friends from back home because I just felt so alone and just so awful about myself.”

Gill, who has struggled with acne over the last nine years, is one of 5.6 million Canadians who struggle with persistent acne problems — which is nearly 20 per cent of the population — according to the Canadian Dermatology Association.

There are a number of myths people believe about acne. Experts break down four of the most common ones.

Myth 1: Acne is always an external problem, not internal

Many believe skin-care products and makeup can cause acne. Although this may be true for some, acne is mostly an internal problem. 

Dr. Julia Carroll, a dermatologist at Compass Dermatology in Toronto, said acne forms when dead skin cells clog the pores, leading to a buildup of sebum. Sebum is the oil that is found in the glands on the face.

Bacteria within pores, called Cutibacterium acnes (C. acnes), can cause pore blockage and inflammation, seen as redness, swelling and pus. People may have a stickier kind of skin cell that will clog the pores as well.

More often than not, Carroll said, hormonal imbalances lead to acne.

“It’s just normal hormonal fluctuations that you might see in puberty or around a woman’s period,” said Carroll, who is also on staff at the University of Toronto medical school. “Some people’s skin environment is more sensitive to those hormonal changes than other people are, and that can lead to acne.”

Myth 2: Going on birth control will permanently clear skin

Taking the pill is sometimes just a temporary solution, Caroll said. When you use birth control, the hormones causing the acne are levelling out. But it is possible for the acne to come back for some people once they get off the pill because the underlying problem was not solved.

“It’s a treatment. It’s not a cure.”

Myth 3: Bad hygiene can cause acne

While good hygiene can help support other acne treatments, Carroll said, severe and persistent acne does not reflect poor hygiene habits. She added that blackheads are not dirt-filled pores. They are black because the oil in them is oxidized when exposed to the air.

“It’s important to let patients know that it’s not their fault and it’s not because they’re not doing something properly.” 

Carroll, who specializes in cosmetic dermatology, acne and rosacea, said that telling teenagers they need to wash their face more is not going to get to the bottom of the problem. It may just be something they are genetically prone to. Over-washing can also irritate the skin and increase inflammation, she said.

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