Overview
What is it?
Ethinyl estradiol and levonorgestrel are synthetic hormones commonly found in combined oral contraceptive pills (COCPs). Ethinyl estradiol is a synthetic form of estrogen, while levonorgestrel is a synthetic progestin. These hormones are not naturally occurring but are designed to mimic the effects of natural hormones in the body. They are often prescribed not only for contraception but also for managing conditions like acne, particularly in cases where hormonal imbalances, such as hyperandrogenism, are involved .
How does it work?
Ethinyl estradiol and levonorgestrel work together to combat acne by regulating hormone levels in the body. Ethinyl estradiol increases the production of sex hormone-binding globulin (SHBG), which binds to free androgens (male hormones) and reduces their availability. This helps lower sebum production, a key factor in acne development. Levonorgestrel, on the other hand, has antiandrogenic properties, meaning it blocks androgen receptors and inhibits the activity of 5α-reductase, an enzyme that converts testosterone to its more active form, dihydrotestosterone (DHT). By reducing androgen levels and sebum production, these hormones help improve acne symptoms .
What are the benefits?
The combination of ethinyl estradiol and levonorgestrel offers several benefits for acne treatment. It helps reduce sebum production, which is a major contributor to acne. Additionally, it suppresses the growth of *Propionibacterium acnes* (a bacteria linked to acne) and reduces inflammation in the skin. This makes it particularly effective for treating moderate to severe acne, especially in individuals with hormonal imbalances like polycystic ovary syndrome (PCOS) .
Effectiveness
What does the research say?
Research shows that combined oral contraceptive pills containing ethinyl estradiol and levonorgestrel are effective in managing acne, particularly in women with PCOS. These pills have been shown to improve acne by reducing hyperandrogenism and regulating sebum production. While specific numerical data on efficacy rates are not always provided, studies consistently highlight their role as a reliable treatment option for hormonal acne .
Side Effects
Headache
Headache: Some individuals may experience headaches as a common side effect of hormonal contraceptives .
Mood changes
Mood changes: Hormonal fluctuations can lead to mood swings, irritability, or depression in some users .
Nausea
Nausea: Gastrointestinal disturbances, including nausea, are frequently reported, especially when starting the medication .
Breast tenderness
Breast tenderness: Hormonal changes can cause breast tenderness or swelling, which usually subsides over time .
Increased risk of blood clots
Increased risk of blood clots: Ethinyl estradiol, the estrogen component, is associated with a higher risk of venous thromboembolism (VTE), particularly in individuals with other risk factors .
Evidence
Clinical Studies & Trials
[1] Guidelines of care for the management of acne vulgaris.
This paper provides guidelines for managing acne vulgaris, a common skin condition affecting adolescents and adults.
View study[2] Contraception Selection, Effectiveness, and Adverse Effects: A Review.
This review discusses the effectiveness and side effects of various contraceptive methods, including combined oral contraceptives.
View study[3] Oral Contraceptives in Dermatology.
This paper explores the use of oral contraceptives in dermatology, particularly for treating acne and hirsutism.
View study[4] Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls.
This review discusses the role of combined oral contraceptives, including ethinyl estradiol and levonorgestrel, in managing PCOS symptoms like acne.
View study[5] North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management.
This paper provides guidelines for managing hidradenitis suppurativa, a chronic skin condition.
View study[6] North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management.
This paper focuses on the diagnosis and management of hidradenitis suppurativa.
View study[7] Choosing the Right Oral Contraceptive Pill for Teens.
This article reviews the types of oral contraceptive pills and their benefits for treating acne and other conditions in adolescents.
View study[8] From pathogenesis of acne vulgaris to anti-acne agents.
This paper discusses the pathogenesis of acne and the role of hormonal agents, including oral contraceptives, in its treatment.
View study[9] Cancer cervix: Epidemiology and disease burden.
This paper discusses the epidemiology of cervical cancer and the role of oral contraceptives as a risk factor.
View study[10] Androgens in women: Androgen-mediated skin disease and patient evaluation.
This paper explores the role of androgens in skin conditions like acne and the use of hormonal treatments.
View study[11] Pyogenic Granuloma
This paper discusses pyogenic granuloma, a benign vascular tumor, and its management.
View study[12] Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome.
This review compares the effectiveness of metformin and combined oral contraceptives in managing PCOS symptoms, including acne.
View study[13] Oral contraception.
This paper discusses the use of oral contraceptives for pregnancy prevention and off-label uses like acne treatment.
View study[14] Estetrol-Drospirenone combination oral contraceptive: a clinical study of contraceptive efficacy, bleeding pattern and safety in Europe and Russia
This clinical study evaluates the efficacy and safety of a new combined oral contraceptive.
View study