Background and Objective: Acne in women can often be successfully treated by the intake of oral contraceptives containing gestagens with anti-androgenic properties. This study aimed to evaluate the efficacy of the monophasic oral contraceptive ethinylestradiol/chlormadinone acetate (EE/CMA; Belara®) for the treatment of mild to moderate papulopustular acne of the face and acne-related disorders in comparison to EE/levonorgestrel (LNG; Microgynon®). Methods: 199 female acne patients were enrolled in a single-blind, randomized, multicentre phase III study and divided into two groups who received either EE/CMA or EE/LNG. The primary end point was fulfilled if the number of papules/pustules per half of the face present on admission had decreased by at least 50% in the 12th medication cycle. Results: 59.4% of the women under EE/CMA and 45.9% under EE/LNG were responders. The relative frequency of women with complete resolution was 16.5% under EE/CMA and 4.3% under EE/LNG at cycle 12.Conclusion: EE/CMAis an efficient treatment for women with mild and moderate papulopustular acne of the face and related disorders, reflecting the well-known anti-androgenic properties of the progestogen CMA.

Keywords:
Ethinylestradiol, Chlormadinone acetate, Levonorgestrel, Oral contraceptive, Acne, Androgenization
1.
Kaiser E: Action of a new hormonal contraceptive (Neo-Eunomin®) on androgenisation of the skin in women. Geburtsh Frauenheilkd 1984;44:651–655.
2.
Carlborg L: Cyproterone acetate versus levonorgestrel combined with ethinylestradiol in the treatment of acne. Acta Obstet Gynecol Scand 1986;134:29–32.
3.
McKenna TJ: The use of anti-androgens in the treatment of hirsutism. Clin Endocrinol 1991;35:1–3.
4.
Dieben T, Vromans L, Theeuwes C, Bennink HJT: The effects of CRT-24, a biphasic oral contraceptive combination, compared to Diane-35 in women with acne. Contraception 1994;50:373–382.
5.
Redmond GP, Olson WH, Lippman JS, Kafrissen ME, Jones TM, Jorizzo JL: Norgestimate and ethinylestradiol in the treatment of acne vulgaris: A randomized, placebo-controlled trial. Obstet Gynecol 1997;89:615–622.
6.
Ebling FJ: Hormonal control of sebaceous glands in experimental animals; in Montagna W, Ellis RA, Silver AF (eds): Advances in the Biology of Skin: The Sebaceous Gland. Oxford, Pergamon Press, 1963, vol 4, pp 200–219.
7.
Lucky AW, Henderson TA, Olson WH, Robisch DM, Lebwohl M, Swinyer LJ: Effectiveness of norgestimate and ethinylestradiol in treating moderate acne vulgaris. J Am Acad Dermatol 1997;37:746–754.
8.
Breckwoldt M, Wieacker P: Hirsutismus; in Bettendorf G, Breckwoldt M (eds): Reproduktionsmedizin. Stuttgart, Fischer, 1989, pp 483–487.
9.
Breckwoldt M, Zahradnik HP, Wieacker P: Hirsutism; in Orfanos CE, Happle R (eds): Hair and Hair Diseases. Berlin, Springer, 1990, pp 777–789.
10.
Cook H, Centner RL, Michael SE: An acne grading method using photographic standards. Arch Dermatol 1979;115:571–575.
11.
Plewig G: Klassifikation und Ätiopathogenese der Akne; in Braun-Falco O, Marghescu S (eds): Fortschr Prakt Dermatol Venerol 1976;8:1279–1288.
12.
Sansone G, Reisner RM: Differential rates of conversion of testosterone to dihydrotestosterone in acne and in normal human skin – Possible pathogenetic factors in acne. J Invest Dermatol 1971;56:366–372.
13.
Fugère P, Robin KL, Lussier-Cacan S, Davignon J, Farquhar D: Cyproterone acetate/ethinylestradiol in the treatment of acne: A comparative dose-response study of the estrogen component. Contraception 1990;42:225–234.
14.
Dubé JY, Ngo-Thi NH, Tremblay RR: In vivo effects on steroid hormones on the testosterone 5-α-reductase in rat skin. Endocrinology 1975;97:211–214.
15.
Frost P, Gomez EC: Inhibitors of sex hormones: Development of experimental models; in Montagna W, van Scott EJ, Stoughton RB (eds): Advantages in Biology of Skin. Pharmacology and Skin. New York, Meredith Corp, 1972, vol XII, pp 403–442.
16.
Dericks-Tan JSE, Gudacker V, Taubert HD: Influence of oral contraceptives on integrated secretion of gonadotropins. Contraception 1992;46:369–377.
© 2001 S. Karger AG, Basel
2001
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