Hormonal Contraceptives and Dermatology

Overview

Journal Am J Clin Dermatol

Specialty Dermatology

Date 2020 Sep 7

PMID 32894455

Citations 7

Authors

Natalie M Williams

Michael Randolph

Ali Rajabi-Estarabadi

Jonette Keri

Antonella Tosti

Affiliations

Soon will be listed here.

Abstract

Hormones play a significant role in normal skin physiology and many dermatologic conditions. As contraceptives and hormonal therapies continue to advance and increase in popularity, it is important for dermatologists to understand their mechanisms and dermatologic effects given the intricate interplay between hormones and the skin. This article reviews the dermatologic effects, both adverse and beneficial, of combined oral contraceptives (COCs), hormonal intrauterine devices (IUDs), implants, injections, and vaginal rings. Overall, the literature suggests that progesterone-only methods, such as implants and hormonal IUDs, tend to trigger or worsen many conditions, including acne, hirsutism, alopecia, and even rosacea. Therefore, it is worthwhile to obtain detailed medication and contraceptive histories on patients with these conditions. There is sufficient evidence that hormonal contraceptives, particularly COCs and vaginal rings, may effectively treat acne and hirsutism. While there are less data to support the role of hormonal contraceptives in other dermatologic disorders, they demonstrate potential in improving androgenetic alopecia and hidradenitis suppurativa.

Citing Articles

How Hormonal Balance Changes Lives in Women with Psoriasis.

Cassalia F, Lunardon A, Frattin G, Danese A, Caroppo F, Belloni Fortina A J Clin Med. 2025; 14(2).

PMID: 39860587 PMC: 11766064. DOI: 10.3390/jcm14020582.

Effects of depot medroxyprogesterone acetate, the copper IUD and the levonorgestrel implant on testosterone, sex hormone binding globulin and free testosterone levels: ancillary study of the ECHO randomized clinical trial.

Hofmeyr G, Singata-Madliki M, Batting J, Balakrishna Y, Morroni C BMC Womens Health. 2024; 24(1):167.

PMID: 38459552 PMC: 10921651. DOI: 10.1186/s12905-024-02990-8.

Frontal Fibrosing Alopecia and Reproductive Health: Assessing the Role of Sex Hormones in Disease Development.

Roman A, Petca R, Dumitrascu M, Petca A, Ionescu Miron A, Sandru F J Pers Med. 2024; 14(1).

PMID: 38248773 PMC: 10817300. DOI: 10.3390/jpm14010072.

Early discontinuation of the IMPLANON® and associated factors in Ethiopia, systematic review and meta-analysis.

Figa Z, Chekole T, Tarekegn D, Mahamed A, Bekele E Heliyon. 2023; 9(6):e15972.

PMID: 37251447 PMC: 10220320. DOI: 10.1016/j.heliyon.2023.e15972.

Effects of peroral hormonal contraception on cardiovascular system: analysis of selected cardiovascular parameters in an adolescent cohort; a pilot project.

Pirek O, Budinskaya K, Novakova Z Physiol Res. 2023; 71(S2):S203-S210.

PMID: 36647908 PMC: 9906664. DOI: 10.33549/physiolres.934997.

References

Louw-du Toit R, Perkins M, Hapgood J, Africander D . Comparing the androgenic and estrogenic properties of progestins used in contraception and hormone therapy. Biochem Biophys Res Commun. 2017; 491(1):140-146. PMC: 5740213. DOI: 10.1016/j.bbrc.2017.07.063. View

Raudrant D, Rabe T . Progestogens with antiandrogenic properties. Drugs. 2003; 63(5):463-92. DOI: 10.2165/00003495-200363050-00003. View

Thorneycroft I . Evolution of progestins. Focus on the novel progestin drospirenone. J Reprod Med. 2002; 47(11 Suppl):975-80. View

Toyoda M, Morohashi M . Pathogenesis of acne. Med Electron Microsc. 2001; 34(1):29-40. DOI: 10.1007/s007950100002. View

Lynn D, Umari T, Dunnick C, Dellavalle R . The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016; 7:13-25. PMC: 4769025. DOI: 10.2147/AHMT.S55832. View

Collier C, Harper J, Cafardi J, Cantrell W, Wang W, Foster K . The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2007; 58(1):56-9. DOI: 10.1016/j.jaad.2007.06.045. View

Thiboutot D . Acne: hormonal concepts and therapy. Clin Dermatol. 2004; 22(5):419-28. DOI: 10.1016/j.clindermatol.2004.03.010. View

Katsambas A, Dessinioti C . Hormonal therapy for acne: why not as first line therapy? facts and controversies. Clin Dermatol. 2010; 28(1):17-23. DOI: 10.1016/j.clindermatol.2009.03.006. View

Rabe T, Kowald A, Ortmann J . Inhibition of skin 5 alpha-reductase by oral contraceptive progestins in vitro. Gynecol Endocrinol. 2000; 14(4):223-30. DOI: 10.3109/09513590009167685. View

10.

Lortscher D, Admani S, Satur N, Eichenfield L . Hormonal Contraceptives and Acne: A Retrospective Analysis of 2147 Patients. J Drugs Dermatol. 2016; 15(6):670-4. View

11.

Schramm G, Heckes B . Switching hormonal contraceptives to a chlormadinone acetate-containing oral contraceptive. The Contraceptive Switch Study. Contraception. 2007; 76(2):84-90. DOI: 10.1016/j.contraception.2007.03.014. View

12.

Piyasirisilp R, Taneepanichskul S . A clinical study of transdermal contraceptive patch in Thai adolescence women. J Med Assoc Thai. 2008; 91(2):137-41. View

13.

Suwanmalee O, Taneepanichskul S . A clinical study of transdermal contraceptive patch in Thai women. J Med Assoc Thai. 2007; 89 Suppl 4:S1-4. View

14.

Harel Z, Riggs S, Vaz R, Flanagan P, Dunn K, Harel D . Adolescents' experience with the combined estrogen and progestin transdermal contraceptive method Ortho Evra. J Pediatr Adolesc Gynecol. 2005; 18(2):85-90. DOI: 10.1016/j.jpag.2004.11.016. View

15.

Wieder D, Pattimakiel L . Examining the efficacy, safety, and patient acceptability of the combined contraceptive vaginal ring (NuvaRing). Int J Womens Health. 2010; 2:401-9. PMC: 2990910. DOI: 10.2147/IJWH.S6162. View

16.

Brucker C, Karck U, Merkle E . Cycle control, tolerability, efficacy and acceptability of the vaginal contraceptive ring, NuvaRing: results of clinical experience in Germany. Eur J Contracept Reprod Health Care. 2007; 13(1):31-8. DOI: 10.1080/13625180701577122. View

17.

Mohamed A, El-Sherbiny W, Mostafa W . Combined contraceptive ring versus combined oral contraceptive (30-μg ethinylestradiol and 3-mg drospirenone). Int J Gynaecol Obstet. 2011; 114(2):145-8. DOI: 10.1016/j.ijgo.2011.03.008. View

18.

Lullo J, Ethington E, Arshanapalli A, Reserva J, Jiang A, Adams W . Incidence of androgenic dermatologic side effects following placement of a levonorgestrel intrauterine device for menorrhagia: A survey-based study. J Am Acad Dermatol. 2017; 79(2):364-365. DOI: 10.1016/j.jaad.2017.12.051. View

19.

Teal S, Turok D, Chen B, Kimble T, Olariu A, Creinin M . Five-Year Contraceptive Efficacy and Safety of a Levonorgestrel 52-mg Intrauterine System. Obstet Gynecol. 2018; 133(1):63-70. PMC: 6319579. DOI: 10.1097/AOG.0000000000003034. View

20.

Kelekci S, Kelekci K, Yilmaz B . Effects of levonorgestrel-releasing intrauterine system and T380A intrauterine copper device on dysmenorrhea and days of bleeding in women with and without adenomyosis. Contraception. 2012; 86(5):458-63. DOI: 10.1016/j.contraception.2012.04.001. View