Hormonal Contraceptives: Part I- Formulations and Physiological Effects on the Skin

The skin synthesizes hormones and expresses hormone receptors. Androgens are steroid hormones that interact with the skin and play a role in the development of acne, hirsutism, and hair loss. Estrogens and progestogens are steroid hormones found in the skin that may affect sebum production and hair growth by lowering androgen levels, as well as incompletely understood interactions with the skin's structures. Thus, oral contraceptive pills (OCPs) containing estrogen and progestogen have potential benefits in treating conditions commonly seen by dermatologists. In part 1 of this continuing medical education article (CME), we discuss the effects of androgens, estrogens, and progestogens on the skin and hair and characterize available hormonal oral contraceptives, their routes of administration, hormonal compositions, and potential adverse effects. This two-part CME is intended to serve as a guide to dermatologists for both selecting among OCPs and further understanding their interactions with the skin and hair.