Contraceptives for acne

• Dianette
  • Co-cyprindiol
  • lisenced for use in Moderate to severe acne in females of child-bearing age refractory to topical therapy or oral antibacterials
• Yasmin
  • ethinylestradiol 30mcg plus drospirenone 3mg
  • not licenced for the treatment for acne but has been used by local consultants where other COCs have been used and found ineffective
• Lucette
  • ethinylestradiol 30mcg plus drospirenone 3mg
  • cost effective equivalent product
• Discontinue 3 months after acne has been controlled
• Gedarel - Trial swap to gedarel based COC is an option once control has been achieved

 Contraindications to COCP

• pregnancy
• breast feeding
• history of deep venous thrombosis and thromboembolic event
• active liver disease
• smoking after the age of 35 years
• migraine, breast cancer
• hypertension
• diabetes mellitus with vascular changes
• long-term immobilisation

 How do oral contraceptives work?

• Acne is triggered by an excess production of sebum. Sebum is an oil made by glands in your skin. Along with skin cells, sebum can clog pores and promote the growth of bacteria that contribute to acne. Androgens, a group of hormones that includes testosterone, stimulate your skin to produce sebum. A woman's ovaries and adrenal glands normally produce a low level of androgens. Higher levels of androgens can lead to excess sebum.
• Combined oral contraceptives lower the amount of androgens in your body. This results in less sebum and less severe acne.
• Progestogen-only pill or contraceptive implant, with androgenic activity, can make acne worse, as they can cause the levels of the ‘male hormones’ to fluctuate. This can then cause oily skin, resulting in acne.