Effect of Contraceptives on the Skin

Combined oral contraceptives (COCs) affected the skin by reducing androgenic hormones, limiting active testosterone, and decreasing sebaceous oil production. For women with acne, a COC low in progestogen and high in estrogen was recommended, with specific formulations suggested for those on systemic antibiotics. Despite concerns, there was little evidence linking COCs to hair loss, but a high estrogen to progestogen ratio was advised if hair loss occurred. COCs could cause cholasma, especially without sun protection, and were not recommended for women with a history of malignant melanoma or frequent skin candidiasis. Other skin disorders associated with COCs included erythema nodosum and lupus, while barrier methods and spermicides were linked to dermatitis, and copper IUDs to various skin issues.