From the Guidelines
Norethisterone and ethinylestradiol can be used alongside Implanon to manage acne, as per the guidelines of care for the management of acne vulgaris, which conditionally recommends combined oral contraceptive pills for acne treatment 1. When considering the use of norethisterone and ethinylestradiol with Implanon for acne, it's essential to weigh the benefits of this combination against potential side effects. The guidelines suggest that combined oral contraceptive pills can be effective for acne treatment, with a conditional recommendation based on moderate certainty of evidence 1.
- Key points to consider:
- The combination of norethisterone and ethinylestradiol can help reduce sebum production and decrease free testosterone levels, which can contribute to acne improvement.
- Patients should be monitored for potential side effects of combined hormonal methods, including headaches, nausea, and increased risk of blood clots.
- If acne persists despite this approach, dermatological treatments or considering alternative contraceptive methods may be necessary.
- The recommended approach involves taking a combined oral contraceptive pill containing norethisterone and ethinylestradiol while the Implanon remains in place, typically with 35mcg ethinylestradiol and 0.5-1mg norethisterone for 21 days followed by a 7-day break, or continuously without breaks. The use of norethisterone and ethinylestradiol with Implanon for acne management should be individualized, taking into account the patient's medical history, potential side effects, and the severity of acne, as suggested by the guidelines of care for the management of acne vulgaris 1.
From the Research
Norethisterone and Ethinylestradiol with Implanon for Acne
- The use of norethisterone and ethinylestradiol with Implanon for acne treatment is not directly mentioned in the provided studies.
- However, the studies discuss the use of hormonal therapies, including combined oral contraceptives (COC), for acne treatment 2, 3, 4.
- COC, which typically contain ethinylestradiol and a progestin such as norethisterone, have been shown to be effective in reducing acne lesions 3, 4.
- Implanon, a progestin-only contraceptive implant, may also have an effect on acne, although its use in combination with norethisterone and ethinylestradiol is not specifically mentioned in the studies.
- The studies suggest that hormonal therapies, including COC and spironolactone, can be effective for treating acne in women, especially when used in combination with other treatments 2, 3, 4.
Acne Treatment Options
- The studies discuss various treatment options for acne, including topical retinoids, benzoyl peroxide, azelaic acid, and oral antibiotics 3, 5, 4.
- Hormonal therapies, including COC and spironolactone, are also discussed as treatment options for acne in women 2, 3, 4.
- The most effective treatment for acne is oral isotretinoin, followed by triple therapies containing a topical retinoid, benzoyl peroxide, and an antibiotic 6.
Considerations for Acne Treatment
- The studies emphasize the importance of individualized treatment approaches for acne, taking into account patient preferences, contraceptive needs, comorbidity profile, access, and cost 2, 3, 4.
- Clinicians should discuss contraceptive options and provide individualized shared decision-making with patients based on their specific needs and circumstances 2.