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.