Dianette (Co-cyprindiol) for Acne

Dianette (Co-cyprindiol) for Acne

Who co-cyprindiol is for, how it works, how long it takes, its side effects and blood clot risk, and how it fits with other acne treatments.

Part of our acne health guides.

What co-cyprindiol is

Co-cyprindiol is the generic name for a tablet containing cyproterone acetate 2mg, which blocks the effect of androgens (male-type hormones), and ethinylestradiol 35 micrograms, an oestrogen. Dianette is the best-known brand. It reduces the effect of androgens on the skin's oil glands, so less oil is produced and fewer spots form.

It also works as a contraceptive while you take it, but it isn't licensed for contraception alone, and it mustn't be taken with another hormonal contraceptive.

Who it is for

Co-cyprindiol is licensed for women of reproductive age with:

• moderate to severe acne linked to androgen sensitivity, with or without oily skin, and/or excess hair growth (hirsutism)
• only once treatment with creams or gels, or a course of antibiotic tablets, hasn't worked

It isn't a first treatment for acne, it isn't used just for contraception, and it isn't suitable for men. Acne that follows your cycle, sits along the jawline or comes with irregular periods may have a hormonal driver; see adult and hormonal acne.

How it works and how long it takes

You take one tablet a day for 21 days, then have a 7-day break, starting on the first day of your period. It takes at least 3 months for acne to improve, so it's worth giving it time before judging it. Some women notice their skin looks a little worse in the first few weeks.

Blood clots and who shouldn't take it

Co-cyprindiol isn't suitable if you:

• have had a blood clot, stroke or heart attack, or have a condition that raises your clot risk
• get migraines with aura
• smoke and are 35 or over
• have high blood pressure that isn't controlled
• have had breast cancer, a meningioma (a usually non-cancerous brain tumour), a liver tumour or severe liver disease
• are pregnant or breastfeeding

Other side effects

The most common side effects (in more than 1 in 100 women) are nausea, stomach pain, weight gain, headache, low or changed mood, and breast pain or tenderness. They're most likely in the first few months and often settle. Tell your prescriber if you've had depression, and get advice if your mood drops.

Using it with creams and gels

Co-cyprindiol is often used with an acne cream or gel, because they work in different ways: the tablet reduces oil, and the cream or gel unblocks pores and kills bacteria. NICE supports combining a hormonal pill with a topical treatment. Common pairings include:

• adapalene (Differin), also available together as co-cyprindiol with adapalene gel
• benzoyl peroxide (Acnecide)
• a combined gel such as Epiduo or Duac

Remember that retinoids such as adapalene must not be used in pregnancy, and co-cyprindiol also provides contraception while you take it correctly.

How long you can take it

For as long as your acne needs it, with regular reviews. Its product information says the need to continue should be reviewed periodically. Once acne is under control, it is usually stopped; if you still need contraception, a standard combined pill with a lower clot risk is usually recommended instead. Acne can come back after stopping, so a cream or gel such as adapalene helps keep it clear.

Is Dianette still available?

Yes. Dianette and generic co-cyprindiol are still licensed in the UK. After a European safety review in 2013, their use was restricted to moderate to severe acne and hirsutism in women, after other treatments have failed, rather than as a contraceptive.