Hormonal Contraceptives and Acne: A Comparative Analysis Between Hormonal IUD and Other Methods

• DOI: https://doi.org/10.22533/at.ed.159512503016

• Palavras-chave: Hormonal IUDs; Acne vulgaris; Combined oral contraceptives; Progestin androgenicity; Dermatological outcomes.

• Keywords: Hormonal IUDs; Acne vulgaris; Combined oral contraceptives; Progestin androgenicity; Dermatological outcomes.

• Abstract: INTRODUCTION Hormonal contraceptives play a dual role in reproductive health and dermatological outcomes, particularly in relation to acne. Hormonal IUDs, which release progestins, are associated with an increased risk of acne due to their androgenic activity. Conversely, combined oral contraceptives (COCs) demonstrate efficacy in reducing acne severity through estrogen’s counteraction of androgenic effects. Specific formulations with antiandrogenic progestins, such as drospirenone, show the most significant dermatological benefits, highlighting the role of hormonal composition in treatment outcomes. OBJETIVE To evaluate the impact of hormonal contraceptives, particularly hormonal IUDs and combined oral contraceptives, on acne severity and management. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Hormonal IUDs” OR “Acne vulgaris” OR “Combined oral contraceptives” OR “Progestin androgenicity” OR “Dermatological outcomes”the last 5 years. RESULTS AND DISCUSSION Clinical evidence reveals that hormonal IUDs may exacerbate acne in predisposed individuals, including those with polycystic ovary syndrome. Randomized controlled trials emphasize the superiority of COCs in managing inflammatory and non-inflammatory acne lesions by regulating hormonal imbalances. Patients using progestin-only contraceptives experience variable dermatological outcomes, with some reporting worsening acne, underscoring the need for personalized contraceptive counseling and integrated care. CONCLUSION Contraceptive choice should consider individual dermatological profiles to optimize outcomes. Hormonal IUD discontinuation can lead to transient acne flare-ups, further complicating management. Future research should aim to refine contraceptive formulations, minimizing dermatological side effects while maintaining efficacy, ultimately improving both reproductive and dermatological health in affected populations.