NuvaRing® has a beneficial effect on acne-results from a
clinical experience program in Spain
I Lete Lasa
Santiago Apóstol Hospital, Gynecology Department, Vitoria,
Spain
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
ethinylestradiol.