Acne vulgaris affects more than 40 % of adolescent women. An enhanced sebaceous gland activity with hyperceratinisation, follicular occlusion, Propiobacterium acnes overgrowth and inflammatory reaction belongs to the major pathogenetic factors of acne.
Hormonal antiandrogen treatment targets the androgen-metabolizing cells of the pilosebaceous unit. OCs reduce acne lesions by complex effect: increasing sex hormone-binding globulins levels, decreasing free testosterone and androgen levels , by blocking of androgen receptors and inhibiting of peripheral androgen conversion.
The combinations of ethinyl estradiol with cyproterone acetate, dienogest, drospirenone and chlormadinone acetate have shown the strongest antiacne activity. Successful treatment of acne with hormonal contraception requires missing of any generally known contraindications