Is a hormonal intrauterine device (IUD) or Nexplanon (etonogrel) more effective in improving acne?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 8, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Neither hormonal IUD nor Nexplanon is specifically designed to treat acne, and their effects on acne can vary significantly between individuals. Hormonal IUDs like Mirena, Kyleena, Liletta, and Skyla primarily release localized progestin and generally have minimal impact on acne, though some users report worsening of acne 1. Nexplanon, an implantable contraceptive that releases etonogestrel (a progestin), may actually worsen acne in some users due to its androgenic effects. If acne management is a priority alongside contraception, better options would include combined hormonal contraceptives like birth control pills containing ethinyl estradiol with anti-androgenic progestins (such as Yaz, Yasmin, or Ortho Tri-Cyclen), which are FDA-approved for acne treatment 1. These combined methods work by reducing androgen levels and decreasing sebum production, which helps improve acne. Some key points to consider when choosing a contraceptive method for acne management include:

  • The potential for hormonal IUDs to have minimal impact on acne, but also the possibility of worsening acne in some users
  • The potential for Nexplanon to worsen acne due to its androgenic effects
  • The effectiveness of combined hormonal contraceptives in reducing acne lesions and improving acne symptoms
  • The importance of discussing individual needs and concerns with a healthcare provider to determine the best contraceptive option for acne management. It is recommended to discuss with your healthcare provider about potentially using a hormonal IUD or Nexplanon while supplementing with other acne treatments like topical retinoids, benzoyl peroxide, or oral medications if needed.

From the Research

Comparison of Hormonal IUD and Nexplanon for Acne Treatment

  • The effectiveness of hormonal IUD (intrauterine device) and Nexplanon (a type of subcutaneous implant) in treating acne is a topic of interest, with some studies suggesting that these hormonal therapies may have varying effects on acne severity 2, 3.
  • A study published in 2003 reported three cases of women who developed severe acne vulgaris after using a levonorgestrel IUD or an etonogestrel implant, suggesting that progestagens in these hormonal therapies may contribute to acne development 2.
  • In contrast, a 2024 study found that users of a levonorgestrel 52-mg intrauterine device reported acne as a side effect, but the association was weaker after adjusting for age, race, ethnicity, obesity status, and parity 3.
  • Another study published in 2015 discussed the management of acne vulgaris with hormonal therapies in adult female patients, highlighting the potential benefits of hormonal treatments for acne, but did not specifically compare hormonal IUD and Nexplanon 4.
  • A 2017 review of hormonal therapies for acne noted that androgen receptor blockers, such as spironolactone, and ovarian androgen production blockers, such as oral contraceptives, may be effective in treating acne, but did not mention hormonal IUD or Nexplanon specifically 5.
  • A 2025 review of hormonal therapies for acne treatment discussed the use of combined oral contraceptives, spironolactone, and clascoterone, but did not provide a direct comparison between hormonal IUD and Nexplanon 6.

Key Findings

  • Hormonal IUD and Nexplanon may have different effects on acne severity, with some studies suggesting that progestagens in these therapies may contribute to acne development 2, 3.
  • The association between hormonal IUD use and acne is weaker after adjusting for age, race, ethnicity, obesity status, and parity 3.
  • Hormonal therapies, including androgen receptor blockers and ovarian androgen production blockers, may be effective in treating acne, but the specific effects of hormonal IUD and Nexplanon on acne are not well established 6, 4, 5.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

5
Research

Hormonal therapies for acne.

Clinics in dermatology, 2017

Related Questions

What is the differential diagnosis for a patient presenting with intermittent hypogastric pain, infrequent spotting, and hormonal acne, with a history of daily marijuana smoking and a hormonal intrauterine device (IUD)?
What is the treatment for hormonal cystic acne?
Can birth control be used with spironolactone (aldosterone antagonist) for acne treatment?
What are the treatment options for acne caused by Nexplanon (etonogestrel)?
What treatment is recommended for a female with an intrauterine device (IUD) and hyperestrogenism presenting with acne?
What topical antifungal cream should be prescribed for onychomycosis (Fungal infection of the nail)?
What is the next step in managing a patient with abdominal pain, who is hemodynamically stable, and has imaging findings of increased thickness of the sigmoid colon and thumbprint sign due to edema, suggestive of ischemic colitis?
What are the onset symptoms of Systemic Lupus Erythematosus (SLE)?
Are Novolin N (NPH insulin) and Humulin N (NPH insulin) interchangeable?
Is there suspected lumbarization of the first sacral vertebra (S1) with associated degenerative change at the S1/S2 interspace?
What are the benefits of loop diuretics (e.g. furosemide)?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question