Which Contraceptives Improve Acne the Most?

The vaginal ring and combined oral contraceptives (COCs), especially those with drospirenone, improve acne the most, according to a new study.

It is well known that hormonal contraceptives can either improve or worsen acne. However, the effect of hormone type, hormone dose, and route of delivery on acne is less understood.

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For their study, the researchers included 2147 women who were using a hormonal contraceptive at the time of their first consultation for acne.

Participants completed an assessment at baseline to report how the contraceptive affected their acne. Then the researchers used the Kruskal-Wallis test and logistic regression analysis to compare the outcomes by contraceptive type.

On average, the vaginal ring and COCs improved acne, whereas depot injections, subdermal implants, and hormonal intrauterine devices worsened acne.

In the COC categories, drospirenone was the most helpful in improving acne, followed by norgestimate and desogestrel, and then levonorgestrel and norethindrone.

Additionally, although triphasic progestin dosage had a positive effect on acne, estrogen dosage did not.

“Different hormonal contraceptives have significantly varied effects on acne, including among types of COC,” the researchers concluded.

—Amanda Balbi


Lortscher D, Admani S, Satur N, Eichenfield LF. Hormonal contraceptives and acne: a retrospective analysis of 2147 patients.  J Drugs Dermatol. 2016;15(6):670-674. http://jddonline.com/articles/dermatology/S1545961616P0670X