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Hormonal Contraceptives and Dermatology

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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.

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References

  1. Louw-du Toit R, Perkins MS, Hapgood JP, et al. Comparing the androgenic and estrogenic properties of progestins used in contraception and hormone therapy. Biochem Biophys Res Commun. 2017;491(1):140–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Raudrant D, Rabe T. Progestogens with antiandrogenic properties. Drugs. 2003;63(5):463–92.

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  4. Toyoda M, Morohashi M. Pathogenesis of acne. Med Electron Microsc. 2001;34(1):29–40.

    CAS  PubMed  Google Scholar 

  5. Lynn DD, Umari T, Dunnick C, et al. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016;7:13–25.

    PubMed  PubMed Central  Google Scholar 

  6. Collier CN, Harper JC, Cafardi JA, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58(1):56–9.

    PubMed  Google Scholar 

  7. Thiboutot D. Acne: hormonal concepts and therapy. Clin Dermatol. 2004;22(5):419–28.

    PubMed  Google Scholar 

  8. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945 e33–73 e33.

    Google Scholar 

  9. Powell A. Choosing the right oral contraceptive pill for teens. Pediatr Clin N Am. 2017;64(2):343–58.

    Google Scholar 

  10. Katsambas AD, Dessinioti C. Hormonal therapy for acne: why not as first line therapy? Facts and controversies. Clin Dermatol. 2010;28(1):17–23.

    PubMed  Google Scholar 

  11. Rabe T, Kowald A, Ortmann J, et al. Inhibition of skin 5 alpha-reductase by oral contraceptive progestins in vitro. Gynecol Endocrinol. 2000;14(4):223–30.

    CAS  PubMed  Google Scholar 

  12. Arowojolu AO, Gallo MF, Lopez LM, et al. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev. 2012;7:CD004425.

    Google Scholar 

  13. Lortscher D, Admani S, Satur N, et al. Hormonal contraceptives and acne: a retrospective analysis of 2147 patients. J Drugs Dermatol. 2016;15(6):670–4.

    PubMed  Google Scholar 

  14. Schramm G, Heckes B. Switching hormonal contraceptives to a chlormadinone acetate-containing oral contraceptive. The Contraceptive Switch Study. Contraception. 2007;76(2):84–90.

    CAS  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  16. Suwanmalee O, Taneepanichskul S. A clinical study of transdermal contraceptive patch in Thai women. J Med Assoc Thai. 2006;89(Suppl 4):S1–4.

    PubMed  Google Scholar 

  17. Harel Z, Riggs S, Vaz R, et al. Adolescents’ experience with the combined estrogen and progestin transdermal contraceptive method Ortho Evra. J Pediatr Adolesc Gynecol. 2005;18(2):85–90.

    PubMed  Google Scholar 

  18. Lopez LM, Grimes DA, Gallo MF, et al. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013;4:CD003552.

    Google Scholar 

  19. Wieder DR, Pattimakiel L. Examining the efficacy, safety, and patient acceptability of the combined contraceptive vaginal ring (NuvaRing). Int J Womens Health. 2010;2:401–9.

    PubMed  PubMed Central  Google Scholar 

  20. 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. 2008;13(1):31–8.

    CAS  PubMed  Google Scholar 

  21. Mohamed AM, El-Sherbiny WS, Mostafa WA. Combined contraceptive ring versus combined oral contraceptive (30-mug ethinylestradiol and 3-mg drospirenone). Int J Gynaecol Obstet. 2011;114(2):145–8.

    CAS  PubMed  Google Scholar 

  22. Lullo JJ, Ethington E, Arshanapalli A, et al. Incidence of androgenic dermatologic side effects following placement of a levonorgestrel intrauterine device for menorrhagia: a survey-based study. J Am Acad Dermatol. 2018;79(2):364–5.

    PubMed  Google Scholar 

  23. Teal SB, Turok DK, Chen BA, et al. Five-year contraceptive efficacy and safety of a levonorgestrel 52-mg intrauterine system. Obstet Gynecol. 2019;133(1):63–70.

    CAS  PubMed  Google Scholar 

  24. Kelekci S, Kelekci KH, 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.

    CAS  PubMed  Google Scholar 

  25. Fedele L, Bianchi S, Raffaelli R, et al. Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device. Fertil Steril. 1997;68(3):426–9.

    CAS  PubMed  Google Scholar 

  26. Lockhat FB, Emembolu JO, Konje JC. The evaluation of the effectiveness of an intrauterine-administered progestogen (levonorgestrel) in the symptomatic treatment of endometriosis and in the staging of the disease. Hum Reprod. 2004;19(1):179–84.

    CAS  PubMed  Google Scholar 

  27. Rybo G, Andersson K, Odlind V. Hormonal intrauterine devices. Ann Med. 1993;25(2):143–7.

    CAS  PubMed  Google Scholar 

  28. Dubuisson JB, Mugnier E. Acceptability of the levonorgestrel-releasing intrauterine system after discontinuation of previous contraception: results of a French clinical study in women aged 35 to 45 years. Contraception. 2002;66(2):121–8.

    CAS  PubMed  Google Scholar 

  29. Darney P, Patel A, Rosen K, et al. Safety and efficacy of a single-rod etonogestrel implant (Implanon): results from 11 international clinical trials. Fertil Steril. 2009;91(5):1646–53.

    PubMed  Google Scholar 

  30. Brache V, Faundes A, Alvarez F, et al. Nonmenstrual adverse events during use of implantable contraceptives for women: data from clinical trials. Contraception. 2002;65(1):63–74. https://doi.org/10.1016/s0010-7824(01)00289-x.

    Article  CAS  PubMed  Google Scholar 

  31. Urbancsek J. An integrated analysis of nonmenstrual adverse events with Implanon. Contraception. 1998;58(6 Suppl):109S–S115115.

    CAS  PubMed  Google Scholar 

  32. Funk S, Miller MM, Mishell DR, et al. Safety and efficacy of Implanon, a single-rod implantable contraceptive containing etonogestrel. Contraception. 2005;71(5):319–26.

    CAS  PubMed  Google Scholar 

  33. Bahamondes L, Brache V, Meirik O, et al. A 3-year multicentre randomized controlled trial of etonogestrel- and levonorgestrel-releasing contraceptive implants, with non-randomized matched copper-intrauterine device controls. Hum Reprod. 2015;30(11):2527–38.

    PubMed  Google Scholar 

  34. Berenson AB, Odom SD, Breitkopf CR, et al. Physiologic and psychologic symptoms associated with use of injectable contraception and 20 microg oral contraceptive pills. Am J Obstet Gynecol. 2008;199(4):351.e1–12.

    Google Scholar 

  35. Wanyonyi SZ, Stones WR, Sequeira E. Health-related quality of life changes among users of depot medroxyprogesterone acetate for contraception. Contraception. 2011;84(5):e17–22.

    CAS  PubMed  Google Scholar 

  36. Harel Z, Biro FM, Kollar LM. Depo-Provera in adolescents: effects of early second injection or prior oral contraception. J Adolesc Health. 1995;16(5):379–84.

    CAS  PubMed  Google Scholar 

  37. Kaunitz AM. Long-acting injectable contraception with depot medroxyprogesterone acetate. Am J Obstet Gynecol. 1994;170(5 Pt 2):1543–9.

    CAS  PubMed  Google Scholar 

  38. Sangi-Haghpeykar H, Poindexter AN 3rd, Moseley DC, et al. Characteristics of injectable contraceptive users in a low-income population in Texas. Fam Plann Perspect. 1995;27(5):208–11 (225).

    CAS  PubMed  Google Scholar 

  39. London RS. A comparison of levonorgestrel implants with depo-medroxyprogesterone acetate injections for contraception. J SOGC. 1993;15(8):925–8 (32).

    CAS  PubMed  Google Scholar 

  40. Brown J, Kives S, Akhtar M. Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database Syst Rev. 2012;3:CD002122.

    Google Scholar 

  41. Phemister DA, Laurent S, Harrison FN Jr. Use of Norplant contraceptive implants in the immediate postpartum period: safety and tolerance. Am J Obstet Gynecol. 1995;172(1 Pt 1):175–9.

    CAS  PubMed  Google Scholar 

  42. Saeed R, Akram J, Changezi H, et al. Treatment of hirsutism in polycystic ovarian syndrome with Diane, 50 mcg ethinyl estradiol and 2 mg cyproterone acetate. Specialist. 1993;9:109–12.

    Google Scholar 

  43. Porcile A, Gallardo E. Oral contraceptive containing desogestrel in the maintenance of the remission of hirsutism: monthly versus bimonthly treatment. Contraception. 1991;44(5):533–40.

    CAS  PubMed  Google Scholar 

  44. Beigi A, Sobhi A, Zarrinkoub F. Finasteride versus cyproterone acetate-estrogen regimens in the treatment of hirsutism. Int J Gynaecol Obstet. 2004;87(1):29–33.

    CAS  PubMed  Google Scholar 

  45. Venturoli S, Marescalchi O, Colombo FM, et al. A prospective randomized trial comparing low dose flutamide, finasteride, ketoconazole, and cyproterone acetate-estrogen regimens in the treatment of hirsutism. J Clin Endocrinol Metab. 1999;84(4):1304–10.

    CAS  PubMed  Google Scholar 

  46. Sahin Y, Bayram F, Kelestimur F, et al. Comparison of cyproterone acetate plus ethinyl estradiol and finasteride in the treatment of hirsutism. J Endocrinol Investig. 1998;21(6):348–52.

    CAS  Google Scholar 

  47. Fruzzetti F, Bersi C, Parrini D, et al. Treatment of hirsutism: comparisons between different antiandrogens with central and peripheral effects. Fertil Steril. 1999;71(3):445–51.

    CAS  PubMed  Google Scholar 

  48. Harborne L, Fleming R, Lyall H, et al. Metformin or antiandrogen in the treatment of hirsutism in polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88(9):4116–233.

    CAS  PubMed  Google Scholar 

  49. Morin-Papunen L, Vauhkonen I, Koivunen R, et al. Metformin versus ethinyl estradiol–cyproterone acetate in the treatment of nonobese women with polycystic ovary syndrome: a randomized study. J Clin Endocrinol Metab. 2003;88(1):148–56.

    CAS  PubMed  Google Scholar 

  50. Morin-Papunen LC, Vauhkonen I, Koivunen RM, et al. Endocrine and metabolic effects of metformin versus ethinyl estradiol-cyproterone acetate in obese women with polycystic ovary syndrome: a randomized study. J Clin Endocrinol Metab. 2000;85(9):3161–8.

    CAS  PubMed  Google Scholar 

  51. Lemay A, Dodin S, Turcot L, et al. Rosiglitazone and ethinyl estradiol/cyproterone acetate as single and combined treatment of overweight women with polycystic ovary syndrome and insulin resistance. Hum Reprod. 2006;21(1):121–8.

    CAS  PubMed  Google Scholar 

  52. Carr BR, Breslau NA, Givens C, et al. Oral contraceptive pills, gonadotropin-releasing hormone agonists, or use in combination for treatment of hirsutism: a clinical research center study. J Clin Endocrinol Metab. 1995;80(4):1169–78.

    CAS  PubMed  Google Scholar 

  53. Heiner JS, Greendale GA, Kawakami AK, et al. Comparison of a gonadotropin-releasing hormone agonist and a low dose oral contraceptive given alone or together in the treatment of hirsutism. J Clin Endocrinol Metab. 1995;80(12):3412–8.

    CAS  PubMed  Google Scholar 

  54. Barrionuevo P, Nabhan M, Altayar O, et al. Treatment options for hirsutism: a systematic review and network meta-analysis. J Clin Endocrinol Metab. 2018;103(4):1258–64.

    PubMed  Google Scholar 

  55. Martin KA, Anderson RR, Chang RJ, et al. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(4):1233–57.

    PubMed  Google Scholar 

  56. Al Khalifah RA, Florez ID, Dennis B, et al. Metformin or oral contraceptives for adolescents with polycystic ovarian syndrome: a meta-analysis. Pediatrics. 2016;137(5):e20154089.

    PubMed  Google Scholar 

  57. Barth JH, Cherry CA, Wojnarowska F, et al. Cyproterone acetate for severe hirsutism: results of a double-blind dose-ranging study. Clin Endocrinol (Oxf). 1991;35(1):5–10.

    CAS  Google Scholar 

  58. Amiri M, Kabir A, Nahidi F, et al. Effects of combined oral contraceptives on the clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Contracept Reprod Health Care. 2018;23(1):64–77.

    CAS  PubMed  Google Scholar 

  59. Battaglia C, Mancini F, Fabbri R, et al. Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study. Fertil Steril. 2010;94(4):1417–25.

    CAS  PubMed  Google Scholar 

  60. Ahrendt HJ, Makalova D, Parke S, et al. Bleeding pattern and cycle control with an estradiol-based oral contraceptive: a seven-cycle, randomized comparative trial of estradiol valerate/dienogest and ethinyl estradiol/levonorgestrel. Contraception. 2009;80(5):436–44.

    CAS  PubMed  Google Scholar 

  61. Yazdabadi A, Magee J, Harrison S, et al. The Ludwig pattern of androgenetic alopecia is due to a hierarchy of androgen sensitivity within follicular units that leads to selective miniaturization and a reduction in the number of terminal hairs per follicular unit. Br J Dermatol. 2008;159(6):1300–2.

    CAS  PubMed  Google Scholar 

  62. Yip L, Zaloumis S, Irwin D, et al. Gene-wide association study between the aromatase gene (CYP19A1) and female pattern hair loss. Br J Dermatol. 2009;161(2):289–94.

    CAS  PubMed  Google Scholar 

  63. Yip L, Zaloumis S, Irwin D, et al. Association analysis of oestrogen receptor beta gene (ESR2) polymorphisms with female pattern hair loss. Br J Dermatol. 2012;166(5):1131–4.

    CAS  PubMed  Google Scholar 

  64. Greenwald AE. Oral contraceptives and alopecia [in Spanish]. Dermatol Iber Lat Am. 1970;12:29–36.

    CAS  PubMed  Google Scholar 

  65. Yokoyama Y, Sato S, Saito Y. Alopecia related to low dose oral contraceptive. Arch Gynecol Obstet. 2002;266(1):46–7.

    CAS  PubMed  Google Scholar 

  66. Su LH, Chen LS, Chen HH. Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol. 2013;69(2):e69–77.

    PubMed  Google Scholar 

  67. Cormia FE. Alopecia from oral contraceptives. JAMA. 1967;201(8):635–7.

    CAS  PubMed  Google Scholar 

  68. Zaun H, Gerber T. The influence of monophasic ovulation-inhibitors on hair growth [in German]. Arch Klin Exp Dermatol. 1969;234(4):353–61.

    CAS  PubMed  Google Scholar 

  69. Zaun H, Ruffing H. The influence of biphasic hormonal contraceptives on hair growth [in German]. Arch Klin Exp Dermatol. 1970;238(2):197–206.

    CAS  PubMed  Google Scholar 

  70. Booranabunyat S, Taneepanichskul S. Implanon use in Thai women above the age of 35 years. Contraception. 2004;69(6):489–91.

    CAS  PubMed  Google Scholar 

  71. Qin LH, Goldberg JM, Hao G. A 4-year follow-up study of women with Norplant-2 contraceptive implants. Contraception. 2001;64(5):301–3.

    CAS  PubMed  Google Scholar 

  72. van Amerongen D. Removal rates of subdermal levonorgestrel implants. J Reprod Med. 1994;39(11):873–6.

    PubMed  Google Scholar 

  73. Kato K, Joachim A, Nielsen P, et al. Norplant and its side effects [in German]. Zentralbl Gynakol. 1995;117(5):260–2.

    CAS  PubMed  Google Scholar 

  74. Sivin I, Mishell DR Jr, Darney P, et al. Levonorgestrel capsule implants in the United States: a 5-year study. Obstet Gynecol. 1998;92(3):337–44.

    CAS  PubMed  Google Scholar 

  75. Paterson H, Clifton J, Miller D, et al. Hair loss with use of the levonorgestrel intrauterine device. Contraception. 2007;76(4):306–9.

    CAS  PubMed  Google Scholar 

  76. Griffiths WA. Diffuse hair loss and oral contraceptives. Br J Dermatol. 1973;88(1):31–6.

    CAS  PubMed  Google Scholar 

  77. Williams WV. Hormonal contraception and the development of autoimmunity: a review of the literature. Linacre Q. 2017;84(3):275–95.

    PubMed  PubMed Central  Google Scholar 

  78. Vallings R. Oral contraceptives and alopecia areata. Br Med J. 1965;2(5468):1005.

    CAS  PubMed  PubMed Central  Google Scholar 

  79. Lee DJ, Ewer K. Implanon and alopecia. J Fam Plann Reprod Health Care. 2006;32(4):255.

    PubMed  Google Scholar 

  80. Peterkin GAG. Oral contraceptives and alopecia areata. Br Med J. 1965;2(5470):1124.

    Google Scholar 

  81. Orentreich N, Berger RA. Oral contraceptives and alopecia areata. Br Med J. 1966;1(5485):483.

    CAS  PubMed  PubMed Central  Google Scholar 

  82. Orfanos CE, Wustner H. Penetration and side effects of local estrogen application in alopecia androgenetica [in German]. Hautarzt. 1975;26(7):367–9.

    CAS  PubMed  Google Scholar 

  83. Rodrigues M, Antunes I, Magalhaes S, et al. Androgenic alopecia: an entity to consider in adolescence. BMJ Case Rep. 2017;2017:bcr2017220679.

    PubMed Central  Google Scholar 

  84. Pindado-Ortega C, Saceda-Corralo D, Buendía-Castaño D, et al. Prescribing habits for androgenic alopecia among dermatologists in spain in 2017: a cross-sectional study. Actas Dermo-Sifiliográficas (English Edition). 2018;109(6):536–42.

    CAS  Google Scholar 

  85. Brzezinska-Wcislo L. Assessment of efficacy of Diane-35 in androgenetic feminine alopecia [in Polish]. Wiad Lek. 2003;56(3–4):202–5.

    PubMed  Google Scholar 

  86. Peereboom-Wynia JD, van der Willigen AH, van Joost T, et al. The effect of cyproterone acetate on hair roots and hair shaft diameter in androgenetic alopecia in females. Acta Derm Venereol. 1989;69(5):395–8.

    CAS  PubMed  Google Scholar 

  87. Grund E, Schmidt-Elmendorff H. The treatment of virilizing syndromes. Comparative clinical studies of 2 antiandrogen-active gestagens (cyproterone acetate, megestrol acetate [in German]. Med Welt. 1975;26(48):2180–7.

    CAS  PubMed  Google Scholar 

  88. Iorizzo M, Vincenzi C, Voudouris S, et al. Finasteride treatment of female pattern hair loss. Arch Dermatol. 2006;142(3):298–302.

    CAS  PubMed  Google Scholar 

  89. Rushton DH, Ramsay ID. The importance of adequate serum ferritin levels during oral cyproterone acetate and ethinyl oestradiol treatment of diffuse androgen-dependent alopecia in women. Clin Endocrinol (Oxf). 1992;36(4):421–7.

    CAS  Google Scholar 

  90. Ekoe JM, Burckhardt P, Ruedi B. Treatment of hirsutism, acne and alopecia with cyproterone acetate. Dermatologica. 1980;160(6):398–404.

    CAS  PubMed  Google Scholar 

  91. Carmina E, Lobo RA. Treatment of hyperandrogenic alopecia in women. Fertil Steril. 2003;79(1):91–5.

    PubMed  Google Scholar 

  92. Soltz-Szots J. Treatment of the chronic post partum hair loss with ovulation inhibitors [in German]. Z Haut Geschlechtskr. 1969;44(12):433–6.

    CAS  PubMed  Google Scholar 

  93. Aldoori N, Dobson K, Holden CR, et al. Frontal fibrosing alopecia: possible association with leave-on facial skin care products and sunscreens; a questionnaire study. Br J Dermatol. 2016;175(4):762–7.

    CAS  PubMed  Google Scholar 

  94. Buendia-Castano D, Saceda-Corralo D, Moreno-Arrones OM, et al. Hormonal and gynecological risk factors in frontal fibrosing alopecia: a case-control study. Skin Appendage Disord. 2018;4(4):274–6.

    PubMed  Google Scholar 

  95. Tziotzios C, Petridis C, Dand N, et al. Genome-wide association study in frontal fibrosing alopecia identifies four susceptibility loci including HLA-B*07:02. Nat Commun. 2019;10(1):1150.

    PubMed  PubMed Central  Google Scholar 

  96. Tan J, Berg M, Gallo RL, et al. Applying the phenotype approach for rosacea to practice and research. Br J Dermatol. 2018;179(3):741–6.

    CAS  PubMed  Google Scholar 

  97. Rainer BM, Kang S, Chien AL. Rosacea: epidemiology, pathogenesis, and treatment. Dermatoendocrinol. 2017;9(1):e1361574.

    PubMed  PubMed Central  Google Scholar 

  98. Li W, Zhang M, Danby F, et al. Personal history of rosacea and risk of incident cancer among women in the US. Br J Cancer. 2015;113(3):520–3.

    PubMed  PubMed Central  Google Scholar 

  99. Prenen M, Ledoux-Corbusier M. Hormonal contraception and dermatology [in French]. Arch Belg Dermatol Syphiligr. 1971;27(3):253–8.

    CAS  PubMed  Google Scholar 

  100. Sibenge S, Gawkrodger DJ. Rosacea: a study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol. 1992;26(4):590–3.

    CAS  PubMed  Google Scholar 

  101. Zaun H. Skin changes from taking hormonal contraceptives [in German]. Med Monatsschr Pharm. 1981;4(6):161–5.

    CAS  PubMed  Google Scholar 

  102. Plewig G, Jansen T, Kligman AM. Pyoderma faciale. A review and report of 20 additional cases: is it rosacea? Arch Dermatol. 1992;128(12):1611–7.

    CAS  PubMed  Google Scholar 

  103. Massa MC, Su WP. Pyoderma faciale: a clinical study of twenty-nine patients. J Am Acad Dermatol. 1982;6(1):84–91.

    CAS  PubMed  Google Scholar 

  104. Jansen T, Plewig G, Kligman A. Diagnosis and treatment of rosacea fulminans. Dermatology. 1994;188(4):251–4.

    CAS  PubMed  Google Scholar 

  105. Spirov G, Berova N, Vassilev D. Effect of oral inhibitors of ovulation in treatment of rosacea and dermatitis perioralis in women. Australas J Dermatol. 1971;12:145–54.

    CAS  PubMed  Google Scholar 

  106. Mauss J. Cyproterone therapy of papulopustular rosacea in women [in German]. Hautarzt. 1981;32(2):94–5.

    CAS  PubMed  Google Scholar 

  107. Choudry K, Humphreys F, Menage J. Rosacea in association with the progesterone-releasing intrauterine contraceptive device. Clin Exp Dermatol. 2001;26(1):102.

    CAS  PubMed  Google Scholar 

  108. Bruni V, Pontello V, Luisi S, et al. An open-label, multicentre trial to evaluate the vaginal bleeding pattern of the combined contraceptive vaginal ring NuvaRing. Eur J Obstet Gynecol Reprod Biol. 2008;139(1):65–71.

    CAS  PubMed  Google Scholar 

  109. Hsiao JL, McMichael AJ, Curtis AR, et al. Folliculitis and other follicular disorders. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Philadelphia: Elsevier; 2018. p. 628–632.

    Google Scholar 

  110. Nazary M, van der Zee HH, Prens EP, et al. Pathogenesis and pharmacotherapy of Hidradenitis suppurativa. Eur J Pharmacol. 2011;672(1–3):1–8.

    CAS  PubMed  Google Scholar 

  111. Lee A, Fischer G. A case series of 20 women with hidradenitis suppurativa treated with spironolactone. Australas J Dermatol. 2015;56(3):192–6.

    PubMed  Google Scholar 

  112. Joseph MA, Jayaseelan E, Ganapathi B, et al. Hidradenitis suppurativa treated with finasteride. J Dermatol Treat. 2005;16(2):75–8.

    CAS  Google Scholar 

  113. Stellon AJ, Wakeling M. Hidradenitis suppurativa associated with use of oral contraceptives. BMJ. 1989;298(6665):28–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  114. Jemec GB, Heidenheim M, Nielsen NH. Hidradenitis suppurativa: characteristics and consequences. Clin Exp Dermatol. 1996;21(6):419–23.

    CAS  PubMed  Google Scholar 

  115. Schmitt JV, Bombonatto G, Martin M, et al. Risk factors for hidradenitis suppurativa: a pilot study. An Bras Dermatol. 2012;87(6):936–8.

    PubMed  PubMed Central  Google Scholar 

  116. Mortimer PS, Dawber RP, Gales MA, et al. A double-blind controlled cross-over trial of cyproterone acetate in females with hidradenitis suppurativa. Br J Dermatol. 1986;115(3):263–8.

    CAS  PubMed  Google Scholar 

  117. Sawers RS, Randall VA, Ebling FJ. Control of hidradenitis suppurativa in women using combined antiandrogen (cyproterone acetate) and oestrogen therapy. Br J Dermatol. 1986;115(3):269–74.

    CAS  PubMed  Google Scholar 

  118. Kraft JN, Searles GE. Hidradenitis suppurativa in 64 female patients: retrospective study comparing oral antibiotics and antiandrogen therapy. J Cutan Med Surg. 2007;11(4):125–31.

    CAS  PubMed  Google Scholar 

  119. Scheinfeld N. Hidradenitis suppurativa: a practical review of possible medical treatments based on over 350 hidradenitis patients. Dermatol Online J. 2013;19(4):1.

    PubMed  Google Scholar 

  120. Wu CQ, Grandi SM, Filion KB, et al. Drospirenone-containing oral contraceptive pills and the risk of venous and arterial thrombosis: a systematic review. BJOG. 2013;120(7):801–10.

    CAS  PubMed  Google Scholar 

  121. El Amki M, Binder N, Steffen R, et al. Contraceptive drugs mitigate experimental stroke-induced brain injury. Cardiovasc Res. 2019;115(3):637–46.

    PubMed  Google Scholar 

  122. Lidegaard O, Lokkegaard E, Jensen A, et al. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012;366(24):2257–66.

    CAS  PubMed  Google Scholar 

  123. Palacios S, Colli E, Regidor PA. Multicenter, phase III trials on the contraceptive efficacy, tolerability and safety of a new drospirenone-only pill. Acta Obstet Gynecol Scand. 2019;98(12):1549–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  124. Yazdanyar S, Jemec G. KITTEN following CAT on the long-term use of rifampicin in hidradenitis suppurativa and effectiveness of oral contraceptives. Br J Dermatol. 2019;181(1):225–6.

    CAS  PubMed  Google Scholar 

  125. Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations: part I: diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol. 2019;81(1):76–90.

    PubMed  Google Scholar 

  126. Gunthert AR, Faber M, Knappe G, et al. Early onset vulvar Lichen Sclerosus in premenopausal women and oral contraceptives. Eur J Obstet Gynecol Reprod Biol. 2008;137(1):56–60.

    PubMed  Google Scholar 

  127. Kohlberger PD, Joura EA, Bancher D, et al. Evidence of androgen receptor expression in lichen sclerosus: an immunohistochemical study. J Soc Gynecol Investig. 1998;5(6):331–3.

    CAS  PubMed  Google Scholar 

  128. Clark JA, Muller SA. Lichen sclerosus et atrophicus in children. A report of 24 cases. Arch Dermatol. 1967;95(5):476–82.

    CAS  PubMed  Google Scholar 

  129. Higgins CA, Cruickshank ME. A population-based case–control study of aetiological factors associated with vulval lichen sclerosus. J Obstet Gynaecol. 2012;32(3):271–5.

    CAS  PubMed  Google Scholar 

  130. Redmond GP, Olson WH, Lippman JS, et al. Norgestimate and ethinyl estradiol in the treatment of acne vulgaris: a randomized, placebo-controlled trial. Obstet Gynecol. 1997;89(4):615–22.

    CAS  PubMed  Google Scholar 

  131. Koltun W, Lucky AW, Thiboutot D, et al. Efficacy and safety of 3 mg drospirenone/20 mcg ethinylestradiol oral contraceptive administered in 24/4 regimen in the treatment of acne vulgaris: a randomized, double-blind, placebo-controlled trial. Contraception. 2008;77(4):249–56.

    CAS  PubMed  Google Scholar 

  132. Maloney JM, Dietze P Jr, Watson D, et al. Treatment of acne using a 3-milligram drospirenone/20-microgram ethinyl estradiol oral contraceptive administered in a 24/4 regimen: a randomized controlled trial. Obstet Gynecol. 2008;112(4):773–81.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1150 NW 14th Street, Miami, FL, 33136, USA

    Natalie M. Williams, Michael Randolph, Ali Rajabi-Estarabadi, Jonette Keri & Antonella Tosti

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  1. Natalie M. Williams
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  2. Michael Randolph
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  3. Ali Rajabi-Estarabadi
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  4. Jonette Keri
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  5. Antonella Tosti
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Contributions

NW was responsible for the literature review and writing of the following manuscript sections: Alopecia, Hirsutism, Hidradenitis Suppurativa, Rosacea, and Lichen Sclerosis. MR was responsible for the literature review and writing of the following manuscript sections: Acne. AR made substantial contributions to the conception/design of the project, created the outline, and edited the manuscript. JK made substantial contributions to the conception or design of the project and technical editing of the manuscript. AT made substantial contributions to the conception/design of the project, created the outline, and edited the manuscript.

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Correspondence to Natalie M. Williams.

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No sources of financial assistance were used to conduct the study described in this manuscript and/or to assist with the preparation of the manuscript.

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Natalie M. Williams, Michael Randolph, Ali Rajabi-Estarabadi, Jonette Keri, and Antonella Tosti have no conflicts of interest to declare.

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Williams, N.M., Randolph, M., Rajabi-Estarabadi, A. et al. Hormonal Contraceptives and Dermatology. Am J Clin Dermatol 22, 69–80 (2021). https://doi.org/10.1007/s40257-020-00557-5

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