NuvaRing® has a beneficial effect on acne-results from a clinical experience program in Spain

NuvaRing® has a beneficial effect on acne-results from a

clinical experience program in Spain

I Lete Lasa

Santiago Apóstol Hospital, Gynecology Department, Vitoria,


Background Acne is a common skin disorder in women that

is influenced by hormonal fluctuations during the menstrual cycle. Although

there is no standard approach for acne treatment, women are often prescribed

combined oral contraceptives (COCs), with higher estrogen-dosed COCs typically

having the best effect.

Objective To evaluate the effect of NuvaRing® (which

releases 15 µg ethinylestradiol and 120 µg etonogestrel daily) on acne as one

of the potential non-contraceptive benefits of the monthly contraceptive ring.

Methods A total of 896 Spanish women requesting

contraceptive advice from their family planning centre, hospital or private

centre were invited to participate in this observational, multi-centre,

prospective, open study. Physicians performed an evaluation for the incidence of

acne at baseline and after three and six cycles of NuvaRing® use. Women were

classified as either new users of hormonal contraception (HC)-those starting

NuvaRing® treatment who were not previously using HC-or switchers-those

switching from another HC method (mainly COCs-used by 47% of the total study

group) to the monthly contraceptive ring.

Results Of the 805 women (mean age = 29 ± 6 years) who

started using NuvaRing®, 722 (90%) completed cycle 3 and 595 (74%) completed

cycle 6. There was a significant reduction in the incidence of acne, both in

NuvaRing® users new to HC and in the group of women switching to the ring from

other HC methods: in new users the incidence of acne decreased from 18.7% at

baseline to 9.6% after cycle 3 (p<0.001) and 7.2% after cycle 6 (p<0.001) and in switchers, acne decreased from 13.5% of women at baseline to 7.7% after cycle 3 (p<0.01) and 5.0% after cycle 6 (p<0.001).

Conclusions NuvaRing® had a beneficial effect on acne,

despite a low daily dose of 15 mcg ethinylestradiol. This beneficial effect is

likely to be the result of desogestrel’s (the precursor of etonogestrel) low

androgenicity and high selectivity index, plus the stimulation of sex hormone

binding globulin synthesis as a result of the continuous release of


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