Hormonal contraceptives for acne management

Acne vulgaris affects 42 million people, more than half of whom are women older than 25 years. Treatment for acne includes oral and topical antibiotics, retinoids, and hormonal therapy in the form of oral contraceptives (OCs). OCs reduce acne lesions by increasing estrogen levels and sex hormone-binding globulins, and by decreasing free testosterone and androgen levels. Several studies have shown that drospirenone, a progestin available in certain OCs, minimizes the potential negative effect the progestin has on acne. Women with moderate acne vulgaris who seek contraception and teenagers with acne who refuse antibiotics or in whom topical antibiotics are ineffective might be candidates for drospirenone-containing OCs.