[Evaluation of cutaneous risks of the Pill]

Despite the fact that about 150 millions women must have taken hormonal contraceptives all over the world since the 1960s, the risk/benefit ratio of this birth control method has yet not been reliably assessed. The side effects of the pill on the skin do not pertain, in general, to those (like thrombo-embolism or, perhaps, breast cancer) which might be life-threatening, but they are probably more frequent and may have a potential to alter the quality of life of women who use it. The aim of this paper is to review the dermatological effects of hormonal contraceptives from the point of view of everyday prescribing, with the emphasis on the quality of life of patients. The reported side effects of the pill are therefore classified according to their real or probable frequency, not to their severity or the theoretical importance of their mechanisms. As it would be unwise to speak of the risks without consideration for the benefits, an attempt is made to compare the dermatological safety profile of oral contraceptives to that of other birth control methods (barrier contraceptive methods, intrauterine devices, etc.) on the one hand; on the other hand, one insists upon the fact that the pill in itself may have health benefits, general (reduction in the incidence of some cancers) or dermatological (e. g. an effect on acne).