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  • Title: [Skin changes from taking hormonal contraceptives].
    Author: Zaun H.
    Journal: Med Monatsschr Pharm; 1981 Jun; 4(6):161-5. PubMed ID: 7242455.
    Abstract:
    Hormonal contraceptives can induce changes in the skin and its appendages. Many skin functions are regulated by sex hormones. Clinical use of synthetic sex hormones can effect these hormone-dependent functions. Some effects are due to individual overdose of hormonal contraceptives; others are due to allergic reactions to contraceptive components. Estrogenic potency rather than the kind of estrogen is the determining factor whereas the kind of gestagen used is more important than its potency. Nortestosterone derivatives can exhibit variable androgenic residual action whereas progesterone derivatives have a strongly anti-androgenic effect. The table lists various skin manifestations with their possible causative agent(s) and treatment prevention possibilities. Specially described are: 1) Chloasma where combined action of estrogens and gestagens seem to be responsible together with individual factors of hair color, pigmentation, and extent of light exposure. 2) Acne, seborrhea, and hirsutism resulting from androgenic effect of gestagens; 19-nortestosterone derivatives affect sebaceous glands, 17-hydroxyprogesterone derivatives act on hair follicles. The two have opposite effects. 3) Hair loss occurs during the initial months of contractive intake. It is caused by the gestagen action on the growth phase of the hair, is dose-dependent and self-limiting. Androgenic alopecia is induced by nortestosterone and depends on individual hair pattern. It starts, after several months of hormone intake. 4) Symptoms of individual hormone overdose, where metabolic factors can induce a variety of skin manifestations. Estrogens potentiate corticosteroid effects on the skin such as striae, telangiectasiae, and rosacea dermatitis. 5) "Allergies" or etiological unexplained reactions to contraceptives such as purpura, prurigo, urticaria, and eczema. Elimination testing is diagnostic for these. Real allergies to sex hormones are autoimmune reactions which can be diagnosed with skin tests or lymphocyte transformation tests.
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