Contribution of the combined oral contraceptive ethinylestradiol 20 µg/dienogest 2mg, in the treatment of mild to moderate acne vulgaris and its perceived psychological effects in young university women

Abstract

Background: In adult females, acne is usually a chronic condition, and its management remains challenging due to therapeutic failures or limited healthcare seeking, with repercussions on mental health. Oral contraceptives may provide an alternative to reduce acne and enhance psychological well-being. Objective: To identify the change in the severity of acne in young university women who used the combined oral contraceptive pills of ethinylestradiol 20 µg/dienogest 2 mg, and its perceived psychological effects on self-esteem, social relations, and noncontraceptive benefits. Methods: A prospective cohort was conducted between 2015 and 2016. Photographic monitoring of acne lesions was performed at 3, 6, 9, and 12 months after the start of the study. The photographs were evaluated by 2 specialists in dermatology, who established the degree of acne. Information was gathered regarding the perception of acne progression, the improvement of self-esteem, and noncontraceptive benefits. A descriptive analysis was performed. Results: In total, 86 women were included. At 6-month follow-up, the percentage of mild comedonal acne changed from 5.8 to 37.8%. At 12 months, at least 35% of the women had no acne lesions, and 43% were classified with mild comedonal acne. Results above 68% indicated that there was a favorable perception in the improvement of self-esteem, and the participants recognized that these changes improved their social relations (first month: 58.6% to sixth month: 90.5%). Limitations: A locally applied acne severity scale was employed, as it provides detailed lesion characterization but restricts comparability with other studies, and a lack of standardized scales for measuring perceived psychological and non-contraceptive benefits. Conclusion: Young women with acne who use oral contraceptives with dienogest and ethinyl estradiol obtain the additional benefit of reducing acne severity.