A patient-reported study of hormonal contraceptives has found a significantly varied effect on acne among commonly prescribed agents.

The study included a total of 2,147 patients who presented for a consultation concerning their acne and who were using hormonal contraception. Each patient evaluated and discussed how their contraceptive had affected their acne. Using the Kruskal-Wallis test and logistic regression analysis, researchers examined outcomes by contraceptive type. 

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The results showed that, on average, depot injections, subdermal implants, and hormonal intrauterine devices worsened acne. Conversely, vaginal ring and combined oral contraceptive (COC) use were associated with an on average improvement. For COCs, the researchers noted a positive effect linked to the presence of triphasic progestin dosage (P=0.005), while no significant effect was associated with variation of estrogen dose (P=0.880).

For the COCs, based on the progestin component, drospirenone was shown to be most helpful followed by norgestimate and desogestrel and lastly levonorgestrel and norethindrone (P≥0.035 for all comparisons).

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