The role of combined oral contraceptives containing norgestimate for acne vulgaris treatment: a review

Eur J Contracept Reprod Health Care. 2023 Jun;28(3):184-191. doi: 10.1080/13625187.2023.2197539. Epub 2023 Apr 12.

Abstract

Introduction: Both Food and Drugs Administration and European Medicine Agency (EMA) approve the use of a triphasic combined oral contraceptive (COC) containing ethinyl-oestradiol (EE) and norgestimate (NGM) for acne vulgaris treatment in women requiring an effective contraception. COCs can target sebum production and may also play a role in decreasing follicular hyperkeratinisation.

Results: Specific advantages of the use of an anti-androgenic progestin such as NGM in this condition are presented in this review, including the lowest venous thrombosis risk in the COCs scenario, as established by the EMA, associated with a very satisfactory cycle control. The results of aggregate analysis of published data (n = 163 vs. n = 161 treated subjects) demonstrate a significant effect in comparison with the placebo of a greater than 50% reduction, in terms of inflammatory lesions (from 19.0 to 8.2), comedones (from 35.2 to 17.7) and total lesions (from 54.3 to 25.9) count.

Conclusions: The choice of a triphasic combination of EE/NGM seems a referenced, highly effective, easy-to-use and safe therapeutic approach for acne vulgaris, alone or in combination with different targeted drugs.

Keywords: Combined hormonal contraceptives; acne vulgaris; ethinylestradiol; hyperandrogenism; norgestimate; pill.

Plain language summary

Triphasic ethinyl-oestradiol and norgestimate is on label for mild to moderate acne vulgaris treatment worldwide, in women requiring an effective contraception. This combination demonstrated a significant effect in comparison with the placebo of a greater than 50% reduction, in terms of inflammatory lesions, comedones and total lesions count.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris* / drug therapy
  • Contraceptives, Oral, Combined* / therapeutic use
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Humans
  • Norgestrel / therapeutic use

Substances

  • Contraceptives, Oral, Combined
  • norgestimate
  • Norgestrel
  • Ethinyl Estradiol