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Oral contraceptive use
A total of 7,000 women in Denmark used oral contraceptives. An increased risk was found for acne (RR: 3.45; 95% confidence interval 2.06-5.36; I 2 =88%) and seborrhoea (RR: 3.27; 95% confidence interval 1.77-5.09; I 2 =86%-97%). [18]
A total of 46,100 women in France, Germany, Sweden and Norway used oral contraceptives. There was an increased risk for seborrhoeic and acne lesions (RR: 3.31; 95% confidence interval 1.93-5.22; I 2 =87%) [19,20]
Biological mechanisms
The main mechanism seems to be an increased production of sebum in the skin, which probably triggers an inflammation reaction and this may lead to the formation of pore-forming pustules in the keratinocytes [21].
The risk of acne is increased in individuals with a family tretinoin gel uk history of seborrhoeic disorders (RR 2.41, P value of 0.004).
Oral contraceptives have been attributed to the development of hyperandrogenism [22].
A prospective case-control study undertaken in Denmark (N=2940) showed that the use of oral contraceptives was associated with an increased risk of seborrhoeic lesions (odds ratio 3.2, 95% confidence interval 1.5 to 6.7). However, a recent case-control study in Sweden (N=5381) found that women who had used a combined oral contraceptive within 1 year of onset seborrhoeic lesions were not at an increased risk of developing seborrhoeic lesion as compared to women who used less effective oral contraception. [23]
Evaluation of these mechanisms may lead to a reconsideration of the appropriate use oral contraceptive for women with mild to moderate acne.
Treatment
Treatment of acne can be achieved by a combination of dietary supplement (dietary phytochemicals and prebiotics) systemic treatment.
Non-expert recommendations are aimed at reducing the risk factors (excessive sun exposure and using sunscreens) the inflammatory changes in skin (incl. the production of keratinocytes and increased sebum production) [24]
In a large study of over 2000 women, oral estrogen therapy had a consistent and beneficial effect on the skin, decreasing incidence of new acne by 20% [25]. A
Can you buy zoloft over the counter systematic evaluation of the effects long-term use oral progestogen therapy in the management of moderate to severe acne showed a significant decrease of new acne lesions as compared to the control group,
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