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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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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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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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