Is it common for acne to worsen after insertion of Nexplanon (etonogestrel), an intrauterine device (IUD)?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

Yes, it is common for acne to worsen after getting the Nexplanon implant, as progestin-only contraceptives like Nexplanon are associated with worsening of acne. Nexplanon is a hormonal contraceptive that releases progestin (etonogestrel) into your bloodstream, and this hormone can increase sebum production in your skin, leading to more acne breakouts 1. Studies suggest that progestin-only contraceptives, including Nexplanon, may worsen acne in some individuals, whereas combined oral contraceptives (COCs) containing estrogen and progestin can help improve acne symptoms 1. If you notice worsening acne after Nexplanon insertion, you can try over-the-counter treatments containing benzoyl peroxide or salicylic acid as first-line options. For more severe cases, consult your healthcare provider who might prescribe topical retinoids, antibiotics, or even recommend spironolactone to counteract the hormonal effects. Some key points to consider:

  • Progestin-only contraceptives like Nexplanon can increase sebum production, leading to acne breakouts 1
  • Combined oral contraceptives (COCs) containing estrogen and progestin can help improve acne symptoms 1
  • Alternative contraceptive methods may be better suited for individuals with acne-prone skin 1 Most acne flares tend to improve after 3-6 months as your body adjusts to the hormonal changes, but if acne becomes severe or significantly impacts your quality of life, discuss with your provider about alternative contraceptive methods that might be better suited for your skin type. According to the most recent guidelines, COCs are conditionally recommended for acne treatment based on moderate certainty evidence from 10 studies 1.

From the Research

Acne Treatment and Nexplanon

  • There is no direct evidence in the provided studies that discusses the relationship between Nexplanon and acne worsening.
  • However, some studies mention hormonal treatments, such as oral contraceptives, as a treatment option for acne in women 2, 3.
  • It is known that hormonal changes can affect acne, and some women may experience changes in their acne after starting or stopping hormonal contraceptives.
  • The provided studies discuss various treatment options for acne, including topical and oral medications, but do not specifically address the topic of acne worsening after Nexplanon use 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diagnosis and treatment of acne.

American family physician, 2004

Research

New and emerging treatments in dermatology: acne.

Dermatologic therapy, 2008

Research

Acne treatment review and future perspectives.

Dermatologic therapy, 2022

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.

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