Counseling adolescents on links between progestin-only LARC and acne may be appropriate, authors suggested.

The use of progestin-only long-acting reversible contraception (LARC) may have an increased risk of developing acne or experiencing worsening of acne symptoms, a new analysis indicates. 

"Few studies have focused primarily on the effects of hormonal LARC on the development or exacerbation of acne in adolescents and young adults," the authors wrote in their study, published in Pediatric Dermatology.  We sought to understand the incidence and management of acne following hormonal LARC insertion in this adolescent/young adult population."

To accomplish this, the authors analyzed data from the Adolescent Medicine LARC Collaborative. The study focused on 1,319 subjects who underwent LARC insertion. Acne severity was assessed using a standardized instrument and scale, and the researchers documented the findings during evaluations at adolescent medicine clinics. 

According to the results, 28.5% of participants experienced worsening acne after using progestin-only LARC. Despite the significant incidence of worsening acne, it was a contributing factor to LARC removal in only 3% of cases and the sole reason for removal in just 0.4% of cases.

The authors acknowledged study limitations, which included potential inaccuracies or incomplete documentation of acne severity. The analysis also excluded LARC insertions without follow-up or removal visits within 8 weeks of insertion, potentially introducing bias to the results.

"Adolescents and young adults seeking progestin-only LARC should be counseled about the potential for developing acne or experiencing a worsening of existing acne during LARC use," the researchers concluded. "However, acne was not a common reason for LARC discontinuation."

Source: Boos M, Ryan M, Milliren C, et al. Relationship between long-acting reversible contraception and acne in a cohort of adolescents and young adults. Ped Dermatol. 2024;doi.org:10.1111/pde.15578