The influence of ethinylestradiol/dienogest combination on the reduction
of acne vulgaris in young females
K. Sedlecki (1), D. Zdravkovic (2), Z. Stankovic (1), S. Perovic (1), I.
Mazibrada (1)
Department of Pediatric and Adolescent Gynecology, Family Planning Center,
Mother and Child Health Care Institute of Serbia, Belgrade (1); Department of
Pediatric Endocrinology, Pediatric University Clinic, Mother and Child Health
Care Institute of Serbia, Belgrade (2)
Introduction: The influence of combined oral contraceptives (COC) in
suppressing sebaceous gland activity is well known. The preparation consisted of
30 µg ethinylestradiol and 2 mg dienogest was found to have more prominent
effect on sebaceous gland production than the other COCs.
Objective: To assess a hypothesis that COC containing 30 µg
ethinylestradiol and 2 mg dienogest could efficiently reduce acne vulgaris (AV)
in young females.
Design & Methods: This investigation included 107 young female
patients of the Department of pediatric and adolescent gynecology, Mother and
Child Health Care Institute of Serbia, Belgrade. The study enrolled all patients
with AV problem, who had attended this Department during the first two months of
the study period. The severity of AV was evaluated according to type, intensity
and lesions spreading, ranked afterwards as mild, moderate or severe. Menstrual
irregularities were used as the indicator for possible engagement of ovarian
hyperandrogenism in the presence of AV. The study group passed 6 cycles of COC,
containing 30 µg ethinylestradiol and 2 mg dienogest each. The assessment of
the therapeutic outcome on this preparation was made after 3 and 6 cycles.
Changes in the severity of acne were ranked on a five-degree scale (from
excellent to deleterious effect). The significance of the observed differences
was statistically analyzed by means of descriptive statistics. The study was
conducted from February 27th 2003 to October 21st 2003.
Results: The participants of the study were aged 15–19 (60 or 56.1%)
and 20–24 (47 or 43.9%). All of them had papulopustular and nodular skin
lesions on the face, chest and back ranked as moderate in 62 (57.9%) and severe
in 45 (42.1%) females. Menstrual disturbances, oligomenorrhoea (89 or 83.2%) and
dysfunctional uterine bleeding (9 or 8.4%), were present in all but 9 (8.4%)
subjects. After 3 cycles of treatment, excellent effect was observed in 11
(10.3%) females with moderate acne, very good effect in 72 (67.3%), mildly good
effect in 9 (8.4%), no effect in 14 (13.1%), and deterioration in 1 (0.9%). The
improvement of AV was more evident after 6 cycles, when excellent effect was
registered in 60 (56.1%) cases, very good effect in 35 (32.7%), mildly good in 7
(6.5%), no effect in 4 (3.7%). Precipitated withdrawal of one participant after
3 cycles was caused by deterioration of her acne.
Conclusion: COC containing 30 µg ethinylestradiol and 2 mg dienogest
showed very good results in AV reduction. As a lowdose preparation, it could be,
therefore, used in young females exclusively for the AV treatment.
