Birth control and acne is an important subject to think about. We know that testosterone receptors, the enzymes that make testosterone active in the tissue, is a critical part of acne, and we know that certain birth control pills are helpful in blocking these androgen receptors.
There is lots of controversy about Yaz and Yazmin, which are these birth control pills that have progesterone, which block testosterone receptors. The controversy revolves around a class action lawsuit in the United States regarding possible increased risk of blood clotting.
We know that the birth control pill has a small risk of inducing DVT (deep venous thrombosis) clotting on the calves. Why is this important? These clots can spread into the lungs, which could be fatal. It's important to emphasize that the risk is very low.
There are genetic factors that run in families, which can show a risk in clotting. We know, for example that those who have been on the pill for several months without problem, are extremely unlikely to have any clotting problems from continued use. To appreciate the relative scale, normal acne pills have 5 episodes of DVTs per 100,000 women per year, compared to Yaz and Yamzin with 9 per 100,000 per year. Yes, there is an increase, but it's very manageable and I think that we find them to be very effective, especially in adult women who have acne.
One more thing I'd like to comment on. Mothers particularly are terrified about Accutane, or isotretinoin. Among some, there's a reputation that Accutane is a bad drug, that their child should not even consider using. I think that this drug is certainly one that needs to be used appropriately, and monitored closely by people with the right experience using it. It is, however, a life-changing medication with very low risks if appropriately monitored.