Hormonal Contraceptives and Acne: A Retrospective Analysis of 2147 Patients.

Abstract

INTRODUCTION: Although hormonal contraceptives may help acne or worsen it, there is limited evidence on the effects of many commonly prescribed agents. The present study evaluates patient-reported effect on acne from 2147 patients who were utilizing a hormonal contraceptive at the time of their initial consultation for acne.<BR /> METHODS: At the time of initial consultation for acne, each of 2147 consecutive patients using hormonal contraception provided her assessment of how her contraceptive had affected her acne. The Kruskal-Wallis test and logistic regression analysis were used to compare patient-reported outcomes by contraceptive type.<BR /> RESULTS: Depot injections, subdermal implants, and hormonal intrauterine devices worsened acne on average, and were inferior to the vaginal ring and combined oral contraceptives (COCs; <em>P</em> &le; .001 for all pairwise comparisons), which improved acne on average. Within COC categories, a hierarchy emerged based on the progestin component, where drospirenone (most helpful) &gt; norgestimate and desogestrel &gt; levonorgestrel and norethindrone (<em>P</em> &le; .035 for all pairwise comparisons). The presence of triphasic progestin dosage in COCs had a positive effect (<em>P</em> = .005), while variation in estrogen dose did not have a significant effect (<em>P</em> = .880).<BR /> CONCLUSIONS: Different hormonal contraceptives have significantly varied effects on acne, including among types of COC.<BR /><BR /> <em>J Drugs Dermatol</em>. 2016;15(6):670-674.