A randomized, controlled trial of a low-dose contraceptive containing 20 μg of ethinyl estradiol and 100 μg of levonorgestrel for acne treatment

Abstract Objective: To evaluate the efficacy of a low-dose oral contraceptive (OC) containing 100 μg of levonorgestrel (LNG) and 20 μg of ethinyl estradiol (EE) compared with placebo for the treatment of moderate acne. Design: Multicenter, randomized, double-blind, placebo-controlled clinical trial. Setting: Outpatient dermatology clinics. Patient(s): Women (≥14 years old; n=350) with normal menstrual cycles and moderate acne were randomized to receive LNG/EE or placebo for six cycles. Intervention(s): Twenty μg of EE and 100 μg of LNG. Main Outcome Measure(s): Acne lesion counts and clinician global assessment were performed at baseline and at each cycle. Patient self-assessment was carried out at baseline and at cycles 4 and 6; blood pressure and weight were measured at baseline and at cycles 1, 3, and 6. Result(s): Inflammatory, noninflammatory, and total lesion counts at cycle 6 with LNG/EE were significantly lower compared to placebo. Patients in the LNG/EE group also had significantly better clinician global and patient self-assessment scores than those in the placebo group at cycle. Changes in weight from baseline were similar between patients in the LNG/EE and placebo groups at all measured time points. Conclusion(s): This double-blind, placebo-controlled study demonstrates that a low-dose OC containing 20 μg of EE and 100 μg of LNG is an effective and safe treatment for moderate acne.