Dianette

Dianette is a prescription-only tablet containing two active ingredients — cyproterone acetate and ethinylestradiol — also known together as co-cyprindiol. It is prescribed for women with moderate to severe acne that hasn't responded adequately to other treatments such as topical creams or antibiotic tablets. Dianette works by reducing the amount of androgens (male hormones) in the body. Androgens stimulate the skin's oil-producing glands, leading to blocked pores and acne — by reducing androgen levels, Dianette helps to reduce excess oil production and clear the skin. As it contains oestrogen, Dianette also acts as an effective contraceptive when taken correctly. It is only suitable for women of reproductive age and is not prescribed solely for contraception. A consultation with one of our prescribers at Access Doctor is required before it can be prescribed.

Start taking Dianette on the first day of your period. Take one tablet every day for 21 consecutive days, then have a 7-day tablet-free break — during which you will usually have a withdrawal bleed. After the 7-day break, start the next pack regardless of whether your bleed has finished. Take each tablet at the same time every day to maintain its effectiveness, especially if you are also relying on it for contraception. If you miss a dose, take it as soon as you remember — but if you are more than 12 hours late, your contraceptive protection may be reduced and you should use additional contraception such as condoms for the next 7 days.

Dianette is not a quick-fix treatment — it needs time to regulate your hormone levels and reduce oil production in the skin. Most women begin to notice an improvement in their acne within 4 to 8 weeks, but the full benefit is typically seen after at least 3 months of consistent use. It is important to continue taking it as directed for at least 3 months before assessing how well it is working. Your skin may temporarily appear worse during the first few weeks — this is normal and usually settles.

Like all combined hormonal contraceptives, Dianette can cause side effects in some women, though many tolerate it very well. The most commonly reported ones include nausea, headaches, breast tenderness, mood changes, and mild weight gain — mostly caused by water retention — particularly in the first 2 to 3 months. These often improve as your body adjusts. More seriously, Dianette carries a slightly higher risk of blood clots (deep vein thrombosis or pulmonary embolism) compared to some other combined pills. Signs of a blood clot include sudden leg pain or swelling, chest pain, shortness of breath, or sudden severe headache. If you experience any of these, stop taking Dianette immediately and call 999 or go to your nearest A&E.

Dianette is not suitable for everyone. It should not be taken by women who have a history of blood clots, stroke, heart attack, or migraines with aura, or by those with severe liver disease, uncontrolled high blood pressure, or certain types of cancer. It is also not suitable for women who smoke and are aged 35 or over, as this significantly increases the risk of blood clots and cardiovascular problems. If you have any of these risk factors, speak to your clinician at Access Doctor, who can advise on safer alternative acne treatments for you.

Dianette is intended for the treatment of acne and should be used for as long as is clinically necessary, under regular medical review. Once your acne has cleared successfully, you should consider switching to a standard combined contraceptive pill if you still require contraception, as Dianette carries a slightly higher risk profile than many standard pills and is not recommended for long-term use purely as a contraceptive. Your clinician at Access Doctor will carry out regular reviews to assess your ongoing need for treatment.

Dianette does not permanently affect fertility. Your natural hormone cycle will usually return to normal within 1 to 3 months of stopping, and most women find their periods and fertility return fairly quickly. However, if you have been taking Dianette primarily for acne, be aware that your acne may return after stopping the treatment, particularly if the underlying hormonal cause hasn't changed. Speak to your clinician at Access Doctor about a plan for maintaining your results after stopping Dianette.

No — Dianette must not be taken during pregnancy or while breastfeeding. If you discover you are pregnant while taking Dianette, stop taking it immediately and contact your GP. Dianette contains hormones that could theoretically affect a developing baby, particularly in the early stages of pregnancy. It is also not suitable while breastfeeding, as hormones can pass into breast milk. If you need acne treatment during pregnancy or breastfeeding, your GP can advise on the safest alternatives available to you.

No. Dianette should never be taken alongside another hormonal contraceptive, such as the combined pill, the mini-pill, a contraceptive patch, ring, injection or implant. Doing so effectively doubles your oestrogen exposure and further increases the risk of a blood clot. If you are currently using another hormonal method, tell your prescriber before starting Dianette so they can advise you on how to switch over safely.

The most important risk to be aware of is an increased chance of developing a blood clot (venous thromboembolism), a recognised class effect of oestrogen-containing hormonal treatments that has been reviewed by the MHRA and the European Medicines Agency. This risk is higher if you are over 35, smoke, have a family history of blood clots, or have an upcoming operation or a period of reduced mobility. Seek urgent medical attention if you develop leg pain or swelling, sudden breathlessness, chest pain, a severe headache, vision changes, or difficulty speaking, as these can be signs of a clot.

If you miss a pill, take it as soon as you remember, then continue the rest of the pack as normal. However, if you are more than 12 hours late taking a tablet, your contraceptive protection may be reduced, and you should use an additional method such as condoms for the next 7 days. If you have missed pills and are unsure whether you are still protected, or if you have had unprotected sex, speak to your prescriber or pharmacist for advice.

Dianette is a prescription-only medicine (POM), so a prescription is required and it can't be bought over the counter. You can get it from Access Doctor after a short online consultation with a GPhC-registered prescriber. The process is simple: complete the online consultation questionnaire about your skin and medical history, a prescriber reviews your answers to confirm the treatment is suitable for you, and once approved your order is dispensed by our UK pharmacy and dispatched to your address. To start, use the "Start Free Consultation" button on this page (accessdoctor.co.uk/consultation/acne) — the available strengths, pack sizes and prices are shown as you complete your order.