Use of Oral Contraceptives in the Management of Acne

The document from 2011 discusses the use of oral contraceptives in managing acne, which is primarily caused by increased sebum production stimulated by androgens. Estrogens, on the other hand, reduce sebum production by increasing the production of sex hormone-binding globulin (SHBG), which binds androgens. Oral contraceptives, particularly those containing ethinyl estradiol, can reduce androgen production by inhibiting the hypothalamus-pituitary axis and increasing SHBG levels. The antiandrogenic effect of oral contraceptives is also influenced by the type of progestin they contain. Progestins derived from 19-nortestosterone have androgenic properties, while others have antiandrogenic properties, which can help in the management of acne. The paper suggests that for treating acne, oral contraceptives with low doses of ethinyl estradiol (20 or 30 µg) combined with antiandrogenic progestins like cyproterone acetate, drospirenone, or chlormadinone acetate are effective, as supported by studies in animals and humans.