Yes, the pill helps clear acne, too; but is it right for you?
Every day, young women file into the student health center at Stanford University and ask for prescriptions for a medication they’ve never tried–and can’t quite remember the name of.
“They call it the pill for acne,” explains Robyn Tepper, chief of medical services at the health center. “And we know what they’re talking about.”
Just about every physician in the country does.
Since being marketed on television and in fashion magazines as the only birth-control pill “that helps your skin look better too,” Ortho Tri-Cyclen has become a must-have for many acne-conscious young women. It is, so far, the only birth-control pill that has been approved by the Food and Drug Administration for the treatment of moderate acne.
A hit among teens and twentysomethings, the drug and the publicity surrounding it have been credited with raising awareness of birth-control pills–and even encouraging more women to speak with their physicians about trying them.
“I think it’s good for women’s health,” says Diane Lamotte, a senior pharmacist at the University of California-Santa Cruz’s Cowell Student Health Center, who fills an average of five prescriptions a day for the drug.
But some health professionals say they have mixed feelings about Ortho Tri-Cyclen’s remarkable success, worrying that not all women are making the best birth-control decisions because of their obsession with pimple-free skin.
“It’s not a bad pill, but it wouldn’t necessarily be my first choice for someone starting on birth-control pills,” says Tepper. “For women that smoke or have migraine headaches or other issues, I might choose a pill that has lower (levels of) estrogen in it.”
But it hasn’t been easy to convince the throngs of women who are making pilgrimages to reproductive health centers that they should consider other birth-control options. Many teens don’t want to hear that one birth-control pill doesn’t necessarily fit all, reasoning that if Ortho Tri-Cyclen was advertised during episodes of television’s “Dawson’s Creek,” it must be good for them.
The phenomenon has been mind-boggling to clinicians, many of whom report that the medical advice they’ve offered to some patients has been completely ignored.
A decade ago, “patients certainly didn’t ask for things by name,” says Dr. Robert Latta, director of the student health center at San Jose State University. “They would ask for the pill or some kind of contraception, and then they would leave the recommendation up to you.”
But now many patients seem less interested in discussing the potential side effects of specific brands of birth-control pills than in buying what Madison Avenue tells them to, some physicians believe.
“You feel like Cosmopolitan can have more credibility than you,” says Tepper, whose clinic added Ortho Tri-Cyclen to its offerings this school year because of the growing student demand.
Although the product has been sold as a birth-control pill since 1992, it has just been in recent years that sales have skyrocketed. Before the FDA approved it for the treatment of moderate acne in 1996, Ortho Tri-Cyclen was the seventh most popular birth-control pill. In 1998, after intensive marketing on prime-time television shows and in magazines popular with teens, it was No. 1, according to IMS Health, a health-care information company based in Plymouth Meeting, Pa.
“Women who are of reproductive age would like to have nice-looking skin,” explains Abbe Schiffman, manager of public affairs for the drug’s manufacturer, Ortho-McNeil Pharmaceutical.
Many physicians have long believed that taking birth-control pills helps reduce or prevent pimples. But before Ortho-McNeil could make its claims in advertising, it had to get FDA approval.
In clinical testing, Ortho-McNeil’s Ortho Tri-Cyclen–one of several formulations made by the company–was found to alleviate mild to moderate acne, with 8 out of 10 women studied reporting some improvements in their skin. Although other birth-control pills, including others manufactured by Ortho-McNeil, are thought to be just as successful at warding off acne, none will be allowed to carry that claim until their makers carry out the research to prove it.
Generally, the estrogen in birth-control pills is thought to decrease the level of other hormones in the body that contribute to the development of acne-producing agents. But Ortho-McNeil says its pill is different from others because it contains a patented brand of progestin called Norgestimate, which other manufacturers will not have access to until the company’s patent expires. Progestin is the second hormone present in birth-control pills, and it is thought to interfere with the acne-reducing benefits of estrogen. But Norgestimate does not have that effect, says Dr. Joel Lippman, vice president of clinical trials for Ortho-McNeil.
The drug does come with some caveats. Ortho Tri-Cyclen is recommended by the FDA as an acne treatment only for women 15 or over with mild to moderate acne who have reached menstruation. Patients should have no known contraindications to birth-control pills and should be unresponsive to topical acne medication. And like any other birth-control pill, Ortho Tri-Cyclen can cause minor side effects, says Lippman, such as headaches, nausea, weight gain and irregular bleeding. And it does not provide protection against sexually transmitted diseases.
“It’s not the first step in acne treatment,” says Dorothy Furgerson, medical director of Planned Parenthood Mar Monte, which serves Santa Clara County, Calif. “But if a woman wants to be on birth-control pills for contraception and if she has acne problems, it would be a good choice.”
Despite all the hype surrounding it, Ortho Tri-Cyclen should not be considered a magic bullet, physicians say. The drug has not been proven effective at clearing up severe acne, and individual results tend to vary.
It’s hard to keep up with the Pill rumor mill, especially with so many formulations on the market. We’ve got the lowdown on what’s fact — and what’s not.
The rumor: After you go off the Pill, it’s harder to get pregnant.
True. Compared with condom users, Pill users take twice as long to conceive after stopping contraception — about eight months on average, according to a recent British study. Why the lag? It takes time for hormones to bounce back into balance, because the Pill prevents pregnancy by suppressing those hormones that signal the release of an egg, says Andrew M. Kaunitz, M.D., professor of obstetrics and gynecology at the University of Florida in Jacksonville. But remember that this finding is just an average. There are plenty of women who get pregnant the month after they stop taking the Pill, experts say.
The rumor: The Pill helps your skin.
True. Oral contraceptives (OCs) slash acne by more than 52 percent after nine months, according to a recent study from the University of Texas Medical Branch at Galveston. They help lower your body’s level of testosterone, a hormone that stimulates oil production. Although some Pill brands have been FDA-approved to treat acne (like Ortho Tri-Cyclen), most OCs will treat your pimples just as effectively, even though they don’t have the official okay.
The rumor: The Pill makes you moody.
Maybe. Most Pill users report fewer mood swings and less depression during their menstrual cycle than nonusers, according to more than 80 studies. Still, some women who have a history of depression or severe PMS may be “progesterone sensitive” — that is, vulnerable to Pill-triggered mood changes, says Kaunitz. If you suspect the Pill is bringing you down, talk to your doctor about switching to a brand with less synthetic progestin (such as Levlite).
MORE TRUTHS ABOUT THE PILL
The rumor: Taking the Pill decreases your risk of endometrial and ovarian cancer.
True. Protection from both endometrial cancer and ovarian cancer begins the first year you take OCs, reducing your risk by at least 10 percent. The benefit increases up to 80 percent after 12 years of use and lasts for up to 30 years after you quit the Pill. Although the exact mechanism isn’t known, experts believe that the Pill protects against these cancers by reducing the number of times you ovulate in your lifetime.
The rumor: It increases your risk of breast cancer.
False. While in the past, small studies linked the Pill to an increased risk of breast cancer, a recent large-scale study of more than 9,000 women published in the New England Journal of Medicine clearly found that the Pill doesn’t raise breast cancer risk.
However, the one cancer the Pill may increase your risk for is cervical cancer, particularly if you have human papilloma virus (HPV) — a sexually transmitted infection that at least 80 percent of sexually active women will get at some point and that is responsible for almost all cases of cervical cancer. Research has shown that women with HPV who take the Pill for more than five years have a 50 percent increased risk for this disease. The reason isn’t yet known, but one theory is that OCs may promote the rate at which the HPV infection progresses to cancer. Sounds scary, but know this: Your best protection against cervical cancer is not to go off the Pill, experts say, but to get an annual Pap — the test that’s responsible for reducing the number of cervical cancer deaths by 70 percent over the past 50 years. “It detects precancerous changes early, when problems are easy to treat,” Kaunitz says.
The rumor: The Pill puts a curse on your libido.
Usually false. The majority of women say the Pill kicks their desire into high gear (possibly due to a positive hormone effect and/or liberation from pregnancy worries). But 6 percent of Pill users do notice a cooling in passion. For these women, the combo of estrogen and progestin in their Pill has reduced their body’s level of testosterone (which fuels libido) by too much. Switching to a Pill with less estrogen (such as Mircette) usually helps lust levels go back to normal.
The rumor: The Pill saps your body of nutrients.
True. According to two recent studies, Pill takers have significantly lower levels of vitamins B6 and B12, nutrients essential for keeping nerve cells and red blood cells healthy — compared with women not using OCs. Experts suspect that the Pill’s hormones interfere with how your body metabolizes these nutrients. Unless you’re a vegetarian, you’re probably getting enough B vitamins — found in fish, poultry, meat and eggs — regardless of what the Pill depletes. You can also get 100 percent of your daily vitamin B needs with a highly fortified cereal like Total. Just to be safe, take a daily multivitamin.
The rumor: The Pill causes you to pile on the pounds.
False. There’s no proof that the Pill adds pounds, according to more than 40 studies. But some types may trigger a preperiod water-weight gain of up to five pounds. Good antibloat brands: Yasmin and Tri-Norinyl, which contain a synthetic progestin that acts like a diuretic.
The rumor: With perfect use, the Pill is 99 percent effective.
False. If you’re overweight, the Pill may not protect you as much as you think. Researchers from the Fred Hutchinson Cancer Research Center in Seattle found that overweight and obese women have a significantly higher risk of pregnancy while on the Pill than women whose weight is in the healthy range. “We aren’t sure exactly why, but overweight women may metabolize the Pill hormones too quickly, which lowers its protection,” says David Grimes, M.D., an obstetrician and gynecologist at Family Health International in Durham, North Carolina. But the Pill still offers more protection — even if you’re overweight — than condoms (95 percent versus about 90 percent). Still worried? Ask your doctor about the IUD — a plastic device that is inserted into your uterus and releases a synthetic progesterone hormone that prevents pregnancy for five to 10 years. “It’s an effective option for overweight women because weight doesn’t affect its performance,” says Grimes.
The rumor: The Pill lowers your risk for heart disease.
False. Although last fall a study from Wayne State University in Detroit found that women who take OCs have a lower risk of heart disease, two months later, the authors had to retract their findings due to invalid data. Such protection would’ve been great, but there was no real evidence, says Grimes. In fact, 20 years ago, when many OCs had very high levels of estrogen, the opposite was true: Women over 35 who took them increased their risk for high blood pressure and other heart problems. Today, the Pill causes heart problems only if you smoke. Otherwise, you can safely use it up until menopause.
Who Knew? Weird Ways the Pill Affects…
They may swell due to the estrogen in OCs, upping your risk of gum disease. So commit to twice-a-day flossing and brushing, plus regular cleanings.
The Pill’s steady dose of hormones helps your vocal cords fluctuate less, leading to a stronger, clearer voice.
The amount of oxygen-rich blood pumped to muscles during exercise lowers by 5 percent when taking some OCs. But that’s no excuse to kick off your sneakers. Most of us will never notice this slight decrease during our workouts.
They may get slightly fuller (thanks to the estrogen in the Pill), but not to the extent that you would notice a difference in your weight.
- Student Life Archives (2001-2008)
- Ortho Tri-Cyclen
- Can Birth Control Cause Depression?
- Birth Control Basics
- What Is Depression?
- Is There a Link Between Birth Control Pills and Depression?
- What You Should Do If You’re Depressed
- The Takeaway
- Ortho Evra Information
Student Life Archives (2001-2008)
When Rosalind Early considered taking birth control, everyone warned her that she might gain weight on the pill.
“I heard that sometimes you can gain weight on birth control,” said Early, a senior who wanted to regulate her periods. “So I thought ‘I’ll stay off it, because I don’t want to put on the pounds.’”
Then Early heard about Yasmin, a new birth control pill rumored to make women lose weight.
“I would definitely take the pill that makes you lose weight,” said Early. “If you’re on birth control and you lose five pounds-bonus!”
Yasmin, an oral contraceptive made by Berlex Laboratories which appeared on the market in 2001, has experienced enormous popularity on college campuses nationwide. In September, Berlex reported that five percent of new oral contraceptive prescriptions were for Yasmin. At least 300,000 women in the United States are currently taking the new pill.
Yasmin contains the progestin drospirenon, unique among oral contraceptives. Unlike all other birth control pills on the market, drospirenon is not derived from testosterone. Researchers say testosterone may cause fluid retention and make women gain weight.
Berlex hopes drospirenon will prevent the bloating and weight gain women sometimes experience while taking birth control.
In an initial study in Contraception magazine, women who took Yasmin lost an average of two pounds after using the pill for six months. However, women later regained the weight.
Despite its growing popularity, Student Health Services does not offer the pill. OB/GYN Nurse Practitioner Anita Bowen said she has reservations about the pill’s effectiveness at weight loss.
“To be honest, I don’t really think it’s a weight loss pill,” said Bowen. “Basically, people have to eat to gain weight. You can’t gain weight just by taking a pill. I just think this whole weight loss thing is going to come crashing down.”
Bowen also mentioned a study that linked Yasmin to blood clots. She said the study was small and has not been replicated, but “until I find out more information, I probably won’t stock it.”
Bowen said Health Services does stock a variety of oral contraceptives. She can prescribe the pill Ortho Tri-Cyclen, for example, which in studies has not caused women to gain weight.
Sophomore Shannon Romines originally took birth control to help her complexion.
“I wanted to go on birth control for my skin, but I was really worried about gaining weight,” said Romines.
Romines was enthusiastic about the studies promoting Yasmin’s side effect of weight loss, even after hearing that the drug has not been approved for that purpose.
“I would definitely consider taking this pill,” said Romines. “It sounds like a perfect combination-especially when I’m trying to combat the effects of Center Court.”
Berlex is continuing to research Yasmin to prove its effect on weight loss. If the company can better document this effect, the Food and Drug Administration may approve Yasmin as a weight loss aid.
This decision can’t happen soon enough for Early.
“It’s a way to lose weight that doesn’t make you feel guilty,” said Early.
This entry was posted on Friday, October 11th, 2002 at 12:00 pm and is filed under News. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
The following serious adverse reactions with the use of COCs are discussed elsewhere in labeling:
- Serious cardiovascular events and stroke
- Vascular events
- Liver disease
Adverse reactions commonly reported by COC users are:
- Irregular uterine bleeding
- Breast tenderness
Clinical Trial Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
The safety of ORTHO-CYCLEN was evaluated in 1,647 healthy women of child-bearing potential who participated in 3 clinical trials and received at least 1 dose of ORTHO-CYCLEN for contraception. Two trials were randomized active-controlled trials and 1 was an uncontrolled open-label trial. In all 3 trials, subjects were followed for up to 24 cycles.
Common Adverse Reactions ( ≥ 2% of subjects)
Adverse Reactions Leading to Study Discontinuation
Serious Adverse Reactions
breast cancer (1 subject), mood disorders including depression, irritability, and mood swings (1 subject), myocardial infarction (1 subject), and venous thromboembolic events including pulmonary embolism (1 subject) and deep vein thrombosis (DVT) (1 subject).
The safety of ORTHO TRI-CYCLEN was evaluated in 4,826 healthy women of child-bearing potential who participated in 6 clinical trials and received at least 1 dose of ORTHO TRI-CYCLEN for contraception. Two trials were randomized active-controlled trials and 4 were uncontrolled open-label trials. In 3 trials, subjects were followed for up to 24 cycles; in 2 trials, subjects were followed for up to 12 cycles; and in 1 trial, subjects were followed for up to 6 cycles.
breast cancer (1 subject), carcinoma of the cervix in situ (1 subject), hypertension (1 subject), and migraine (2 subjects).
The following additional adverse drug reactions have been reported from worldwide postmarketing experience with norgestimate/ethinyl estradiol. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Infections and Infestations: Urinary tract infection;
Neoplasms Benign, Malignant and Unspecified (Incl. Cysts and Polyps): Breast cancer, benign breast neoplasm, hepatic adenoma, focal nodular hyperplasia, breast cyst;
Immune System Disorders: Hypersensitivity;
Metabolism and Nutrition Disorders: Dyslipidemia;
Psychiatric Disorders: Anxiety, insomnia;
Nervous System Disorders: Syncope, convulsion, paresthesia, dizziness;
Eye Disorders: Visual impairment, dry eye, contact lens intolerance;
Ear and Labyrinth Disorders: Vertigo;
Cardiac Disorders: Tachycardia, palpitations;
Vascular Events: Deep vein thrombosis, pulmonary embolism, retinal vascular thrombosis, hot flush;
Arterial Events: Arterial thromboembolism, myocardial infarction, cerebrovascular accident;
Respiratory, Thoracic and Mediastinal Disorders: Dyspnea;
Gastrointestinal Disorders: Pancreatitis, abdominal distension, diarrhea, constipation;
Hepatobiliary Disorders: Hepatitis;
Skin and Subcutaneous Tissue Disorders: Angioedema, erythema nodosum, hirsutism, night sweats, hyperhidrosis, photosensitivity reaction, urticaria, pruritus, acne;
Musculoskeletal, Connective Tissue, and Bone Disorders: Muscle spasms, pain in extremity, myalgia, back pain;
Reproductive System and Breast Disorders: Ovarian cyst, suppressed lactation, vulvovaginal dryness;
General Disorders and Administration Site Conditions: Chest pain, asthenic conditions.
Read the entire FDA prescribing information for Ortho Tri-Cyclen (Norgestimate and Ethinyl Estradiol)
Can Birth Control Cause Depression?
Depression is one of the most common reasons women stop taking birth control pills. Despite this, research can’t explain the connection. If you experience depression while you’re on birth control pills, should you stop taking the pills? Here’s more on this controversial topic.
Birth Control Basics
Birth control pills contain hormones. These hormones change how your reproductive organs work in order to prevent pregnancy. Combination pills contain man-made versions of the female hormones estrogen and progesterone. These hormones prevent the release of an egg from the ovary, or ovulation. They also thicken your cervical mucus, which makes it hard for sperm to travel to your uterus and fertilize an egg.
Low-dose progesterone birth control pills, known as minipills, also change cervical mucus. Minipills take prevention one step further by thinning the lining of the uterus. This makes it difficult for implantation to occur.
The side effects of birth control are generally mild. These may include:
- spotting or irregular bleeding
- sore breasts
- a headache
- changes in libido
Many women also report weight gain and depression or mood swings.
Which Birth Control Is Right for You?
What Is Depression?
Depression is more than a temporary case of the blues. It’s a mood disorder characterized by long-term feelings of sadness and disinterest. Depression can interfere with daily life. The symptoms range in severity and may include:
- persistent sadness
- persistent anxiety
- feelings of hopelessness or pessimism
- decreased energy
- difficulty concentrating
- a loss of interest in hobbies
- reduced libido
- increased or decreased appetite
- suicidal thoughts
- suicide attempts
- digestive problems
It’s difficult to know why depression happens. The following are often thought to be causes:
- the environment
In some cases, depression can be linked to a traumatic event. In many cases, there’s no obvious cause.
Is There a Link Between Birth Control Pills and Depression?
Depression and mood swings are commonly reported side effects of birth control pills. Researchers have been unable to prove or disprove a link. The research is often conflicting.
A pilot study showed that depression is the most common reason women stop using birth control pills. It also found women using combination birth control pills were “significantly more depressed” than a similar group of women not taking the pills.
By contrast, a more recent study published in the Archives of Gynecology and Obstetrics (AGO) concluded that depression isn’t a common side effect of birth control pills. This study maintained that the link between the two is unclear.
Signs of Depression
Despite the lack of a definite link, many women report feeling depressed while taking birth control pills. According to the AGO study, this may be due to “the inconsistent use of the word depression.” This could also be due to variance in pill formulations
The perceived connection may also be due to a large number of women with depression. Approximately 12 million women in the United States experience clinical depression each year. Although exact numbers can’t be confirmed, it’s likely that many of those women take birth control pills. In some cases, the timing of depression may be a coincidence.
One study showed birth control pills may improve mood swings. The study used data from 6,654 non-pregnant, sexually active women ages 25 to 34 taking hormonal contraception. These women had fewer symptoms of depression and were less likely to report a suicide attempt than women using less effective contraception or no contraception.
Even though the evidence is contradictory, many drug manufacturers list depression on birth control package inserts as a possible side effect. For example, the physician’s insert for the combination pills Ortho Tri-Cyclen and Ortho-Cyclen lists mental depression as a side effect likely to be caused by the drug.
What You Should Do If You’re Depressed
Depression is serious and shouldn’t be taken lightly. If you’re experiencing the symptoms of depression, ask your doctor for a referral to a mental health professional. Your symptoms may be relieved through therapy or antidepressant medications.
If you’re in a depressive crisis or feeling suicidal, call 911, go to your local emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
To date, research hasn’t proven an undeniable link between birth control pills and depression. Still, the anecdotal evidence is strong. You know your body better than anyone. If you’re on birth control pills and experience depression symptoms for the first time, call your doctor. You should also call your doctor if previous depression symptoms worsen. Your doctor can help you decide if you should stay on your current pills, try another formulation, or use another form of contraception that doesn’t contain hormones.
Ortho Evra Information
On November 10, 2005, Ortho McNeil, a division of Johnson & Johnson, warned millions of women using Ortho Evra that the birth control patch exposes them to significantly higher doses of hormones and may put them at greater risk for blood clots and other serious side effects than previously disclosed. According to the warning, women using Ortho Evra will be exposed to about 60 percent more estrogen than those using typical birth-control pills because hormones from patches get into the bloodstream and are removed from the body differently than those from pills.
This warning comes after the Food and Drug Administration has received twenty-one reports of life-threatening blood clots and other ailments associated with Ortho Evra birth control patch use. The contraceptive patch, manufactured by Ortho-McNeil, has been aggressively marketed to consumers and doctors as a convenient alternative to oral birth control pills. Approximately 4 million women have used the Ortho Evra Patch since it went on sale in 2002. Earlier this year The Associated Press reported that patch users die and suffer blood clots at a rate three times higher than women taking the pill.
Reports show that the deaths of at least seventeen young American women over the past two years may be related to Ortho Evra patch use. The first fatality publicly blamed on the Ortho Evra patch came in April 2005, when a Manhattan fashion student collapsed in a city subway station. An autopsy found a blood clot had moved into the victim’s lung, and the medical examiner ruled that the clot was a side effect of the birth control device. FDA records show that seventeen patch users between the ages of 17 and 30 have suffered fatal heart attacks, blood clots and possible strokes since August 2002.
The Ortho Evra patch is linked with an increased risk of DVT (Deep Venous Thrombosis) and PE (Pulmonary Embolism), which can lead to stroke, hemorrhage, heart attack and death. Evidence shows that the risk of blood clots and stroke associated with Ortho Evra is significantly higher than with oral contraceptive pills. The incidence of embolisms and thrombotic injuries in phase III trials of Ortho Evra was six times greater than the incidence of such events in oral contraceptives using the hormone levonorgestral.
The Food and Drug Administration has received 9,116 reports of adverse reactions to the patch in a 17 month period, as compared to 1,237 adverse reports associated with the oral pill Ortho Tri Cyclen over six year period. During a 12 month period, 44 serious injuries or death have been linked to Ortho Evra, whereas only 17 such reports were linked to Ortho Tri-Cylcen in a similar time period. Ortho Tri-Cyclen has six times the number of users as Ortho Evra. Reports that were obtained by the Associated Press under the Freedom of Information Act indicate that in 2004 when 800,000 women were using the Ortho Evra patch, the risk of dying or suffering a survivable blood clot while using the device was roughly three times higher than while using birth control pills. Many of the patch’s victims are in their late teens and twenties who are otherwise completely healthy.
Blood clots are a known risk from hormonal birth control because estrogen promotes blood coagulation. But the FDA knew before the patch’s introduction to the market that the incidence of nonfatal blood clots was three times higher with the patch than with the Pill. Clots typically form in the legs and can cause serious injury and death if they travel to the heart, lungs or brain.
Dear Dr. Donohue: I can’t seem to get a straight answer from anyone. I am in my early 40s and still suffer from acne. I have used every antibiotic over the last 20 years of treatment. Now nothing works. My dermatologist put me on Ortho Tri-Cyclen. Will the pill clear the skin right away, or will it make it worse before it gets better? — C.G.
Dear C.G.: We have to take a side trip to understand why Ortho Tri-Cyclen, a birth-control pill, is used in acne treatment.
Male hormones spur oil glands to up their production of oil. Women do make male hormones. With even a slight excess of male hormones, a woman’s oil glands become glutted with oil. The duct for oil drainage to the skin becomes plugged with sloughed-off duct cells. This is a prescription for acne. Soon the swollen gland entertains bacteria that add to the mayhem. The gland bursts and a pimple forms from oil irritation and bacterial contamination.
Ortho Tri-Cyclen, approved for acne treatment, neutralizes the influence of male hormones on oil glands. The pill does not clear acne now on the face. It might not take hold for two to four months. During that time, acne can flare, not from the medicine but from the natural course of acne cycles.
Don’t despair. Eighty-three percent of women who take Ortho Tri-Cyclen for acne find it an effective medicine.
You might have tried all the antibiotic medicines for acne, but have you tried all acne medicines? Retin A, Azelex, Differin, Tazorac and Accutane are not antibiotics, but they are quite capable of controlling acne. The latter two medicines cannot be used during pregnancy. If you are unfortunate enough to fall into the group of 16 percent who do not respond to Ortho Tri-Cyclen, there are many backup drugs for you.
Dear Dr. Donohue: Does handshaking spread germs? — L.B.
Dear L.B.: Hands acquire a patina of germs as a person goes through daily activities. They serve as a major source for the spread of germs. The cold virus is spread more by hand-to-hand contact than it is through sneezing or coughing.
Handshaking is one of the few acts of politeness left in society. Washing hands frequently through the day can diminish the chances of acquiring infections from observing the handshake custom.
Write to Paul Donohue, M.D., P.O. Box 5539, Riverton, NJ 08077-5539.