Effectiveness of oral contraceptives in the treatment of acne

Antiandrogen Therapy for Skin and Hair Disease

Androgen hormones play an important role in common skin and hair conditions including acne vulgaris, hirsutism, and androgenetic alopecia. Blocking this androgen effect may lead to significant improvements in these conditions. Several medications that work through a variety of different mechanisms may be prescribed safely and effectively as antiandrogen therapies in the dermatology arena.

Healthy skin for women: a review of common conditions and therapies

OBJECTIVE

To review common dermatologic conditions that may be of particular concern to women throughout their lives, including acne, contact dermatitis, skin conditions of pregnancy, dry skin, and sun-related skin damage.

DATA SOURCES

Articles identified through a search of MEDLINE and pharmacology and dermatology textbooks using the terms women, dermatology, skin, acne, skin cancer, sunscreens, pregnancy, melanoma, basal cell carcinoma, dermatitis, cosmetic dermatitis, dry skin (xerosis), actinic keratosis, oral contraceptives, and striae. Additional references were identified from the bibliographies of retrieved articles and book chapters.

DATA SYNTHESIS

A number of skin conditions may be of particular concern to women throughout their lives. Acne, which may be particularly troublesome during the teenage years and young adulthood, and skin conditions that are common during pregnancy may be influenced by hormonal changes that occur at different life stages. Skin conditions that are influenced by the environment include contact dermatitis, dry skin, and sun-related skin damage, including actinic keratosis, carcinoma, and melanoma. Many of these conditions are amenable to nonpharmacologic therapy and over-the-counter treatments, whereas others require prescription pharmacotherapy. Pharmacists are in an ideal position to advise women about the appropriate management of these conditions and to identify lesions that require additional assessment.

CONCLUSION

Pharmacists can make valuable contributions to patients' self-care of the skin by recommending products, educating patients about skin health, and counseling patients about prescription medications. Gaining a greater understanding of skin conditions that are of particular concern to women can prepare pharmacists to make these contributions.

Oral contraceptives: an update on health benefits and risks

OBJECTIVE

To review the health benefits and risks of oral contraceptives, with an emphasis on emerging noncontraceptive benefits and the pharmacist's role in promoting safe and effective use of these widely prescribed medications.

DATA SOURCES

Published articles identified through MEDLINE (1995-2001) using the search terms oral contraception, neoplasms, cardiovascular disease, menstrual cycle, and other pertinent subject headings. Additional articles and books were identified from the bibliographies of the retrieved articles.

DATA SYNTHESIS

Combined oral contraceptives (COCs), which contain synthetic estrogen and progestin, are the second most common form of birth control for women after sterilization. When taken properly, COCs are highly effective, with a pregnancy rate of 0.1% among perfect users. Also, a growing body of evidence points to multiple noncontraceptive benefits of COCs, including protection from several types of cancer and a variety of gynecologic benefits, such as reduced menstrual bleeding irregularities and fewer ectopic pregnancies. COCs are one of the most studied classes of medications, and they have been found to have an excellent safety profile in nonsmoking healthy women. They may be used continuously until menopause. For women with coexisting medical conditions or other special circumstances, the risks and benefits of COCs must be carefully evaluated before use.

CONCLUSION

More than 40 years after their introduction, COCs remain the leading form of hormonal contraception. By assessing patients' contraceptive needs, evaluating their risk factors, and providing sensitive and thorough counseling, pharmacists can help ensure the safe and effective use of these medications.