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Contraception and the dermatologist
Kelly H Tyler1, Matthew J Zirwas
1Division of Dermatology, Ohio State University, Columbus, Ohio, USA. hoskins.kelly@gmail.com
Journal of the American Academy of Dermatology
|January 22, 2013
Summary
Dermatologists utilize contraceptives for acne treatment and managing teratogenic medications. Combined oral contraceptives often improve acne, but progestin type influences effectiveness, and some long-acting contraceptives may worsen acne.
Area of Science:
- Dermatology
- Endocrinology
- Pharmacology
Background:
- Contraceptives play a crucial role in dermatological practice, particularly concerning acne management and patient safety during teratogenic treatments.
- Understanding the dermatological implications of various contraceptive agents is essential for effective patient care.
Purpose of the Study:
- To outline the key instances where dermatologists encounter contraceptives: acne treatment, contraception for teratogen use, and counseling on acne-exacerbating contraceptives.
- To review the efficacy of combined oral contraceptives (COCs) for acne and discuss factors influencing their effectiveness, such as progestin content.
- To highlight the role of long-acting reversible contraceptives (LARCs) in women on teratogenic medications and their potential impact on acne.
Main Methods:
- Literature review and synthesis of current clinical guidelines and research on contraceptives and their dermatological effects.
- Analysis of the hormonal components of COCs and LARCs, focusing on progestins and their androgenic or anti-androgenic activity.
- Clinical considerations for prescribing and counseling patients regarding contraceptive use in the context of dermatological conditions.
Main Results:
- Most modern COCs demonstrate a beneficial effect on acne, with variations in efficacy linked to the specific progestin component.
- LARCs are recommended as first-line contraception for women on teratogenic medications.
- Certain LARCs containing progestins can potentially exacerbate acne, necessitating careful patient selection and counseling.
Conclusions:
- Dermatologists must be knowledgeable about the dual role of contraceptives in treating acne and preventing pregnancy with teratogenic drugs.
- The choice of progestin in COCs significantly impacts their efficacy for acne treatment.
- Careful consideration of LARC formulations is needed to avoid worsening acne in patients requiring contraception for teratogen use.
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