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Second And Third Generation Oral Contraceptives Equally Effective For Acne Vulgaris: Presented at ACOG

By Peggy Peck
Special to DG News

LOS ANGELES, CA -- May 7, 2002 -- A double-blind study comparing ethinyl estradiol (EE)/desogestrel to EE/levonorgestrel found that both drugs were effective for reducing acne lesions.

These findings, reported here yesterday at the 50^th Annual Meeting of the American College of Obstetricians and Gynecologists, contradict marketing claims that promote some oral contraceptives as being less androgenic and thus more effective for the treatment of acne vulgaris.

Daniel M. Breitkopf, MD, assistant professor, University of Texas Medical Branch at Galveston, Texas, United States, and colleagues enrolled 34 women in the study. Nine women in the EE/levonorgestrel group and seven women in the EE/desogestrel group completed the nine-month treatment course.

There was no difference between mean age, body mass index, baseline SHBG, or baseline free and total testosterone, Dr. Breitkopf said. Women with congenital adrenal hyperplasia, androgen secreting tumors, or Cushing's syndrome were excluded from the study. Women taking hormones during the two months preceding enrollment were also excluded.

Acne was scored by lesion counting by a single examiner. Additionally, serum was analyzed for sex hormone binding globulin (SHBG), free testosterone and total testosterone at baseline and at three-month intervals.

After nine months of treatment, mean acne counts declined significantly in both treatment arms, with acne decreasing by 52.8 percent in the EE/levonorgestrel group and by 58.5 percent in the EE/desogestrel. The mean SHBG level increased in both groups and Dr. Breitkopf said that it is likely that the improvement in acne is mediated by this increase in SHBG.

Although the study demonstrated no difference in acne outcomes between the contraceptive, Dr. Breitkopf cautioned that because so many women failed to complete the study "it was simply not powered to detect small, but significant, differences".

The ACOG/Organon Research Award in Contraception funded the study.

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