Relationship between long-acting reversible contraception and acne in a cohort of adolescents and young adults

Markus D Boos; Morgan E Ryan; Carly Milliren; Sarah Golub; Sofya Maslyanskaya; Michelle Escovedo; Amy DiVasta; Sarah Pitts

doi:10.1111/pde.15578

Relationship between long-acting reversible contraception and acne in a cohort of adolescents and young adults

Pediatr Dermatol. 2024 Mar 5. doi: 10.1111/pde.15578. Online ahead of print.

Authors

Markus D Boos¹, Morgan E Ryan², Carly Milliren², Sarah Golub³, Sofya Maslyanskaya⁴, Michelle Escovedo⁵, Amy DiVasta⁶, Sarah Pitts⁶

Affiliations

¹ Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA.
² Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA.
³ Division of Adolescent Medicine, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA.
⁴ Division of Adolescent Medicine, Children's Hospital of Montefiore, New York, New York, USA.
⁵ Division of Adolescent/Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.
⁶ Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

PMID: 38444121
DOI: 10.1111/pde.15578

Abstract

Background: The use of progestin-only long-acting reversible contraception (LARC) may be a risk factor for acne. Few studies have focused primarily on the effects of hormonal LARC on the development or exacerbation of acne in adolescents and young adults. We sought to understand the incidence and management of acne following hormonal LARC insertion in this adolescent/young adult population.

Methods: A secondary data analysis was conducted of prospectively collected quality improvement (QI) data from the Adolescent Medicine LARC Collaborative. Subjects were evaluated by clinicians in adolescent medicine clinics at participating study sites, and acne severity was documented using a standardized recording instrument and scale. Descriptive statistics were reported as frequencies and percentages for categorical variables or mean and standard deviation (SD) for continuous variables. We compared demographic and clinical characteristics by those who had worsening acne, accounting for site inter-correlation using Cochran-Mantel-Haenszel chi-square tests for categorical variables and linear generalized estimating equation (GEE) regression for continuous variables.

Results: Of 1319 subjects who completed LARC insertion, 28.5% (376/1319) experienced worsening acne following use of progestin-only LARC. Acne was a contributing factor to LARC removal in only 3% (40/1319), and the sole reason for removal in 0.4% (5/1319) of all subjects. As this was a secondary analysis of prospectively collected QI data, limitations of this study include incomplete or inaccurate documentation of acne severity. Moreover, LARC insertions without follow-up/removal visits or with only follow-up/removal within 8 weeks of insertion were excluded from our study, which may also bias results.

Conclusions: Adolescents and young adults seeking progestin-only LARC should be counseled about the potential for developing acne or experiencing a worsening of existing acne during LARC use. However, acne was not a common reason for LARC discontinuation.

Keywords: acne; adolescence; long-acting reversible contraception; progestin.

Abstract

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