Koulianos G T
Division of Reproductive Endocrinology and Infertility, Mobile Infirmary and Medical Center, Alabama, USA.
Cutis. 2000 Oct;66(4):281-6.
Combination oral contraceptives (OCs) (those that contain estrogen and progestin) are widely used in the treatment of acne because they modify an excessively androgenic hormonal environment and can decrease lesions. Dermatologists' knowledge of the most appropriate OC may be hampered by an incomplete understanding of these agents, misleading promotion, and confusion surrounding the new generation of OCs. Despite reports attributing significance to the degree of androgenicity of the progestin components of OCs, in vitro and animal bioassays of androgenicity have little clinical relevance. Because all of today's low-dose combination OCs are estrogen dominant, they are equally beneficial in women with androgenic conditions such as acne. Use of the OC containing the lowest dose of each hormone, consistent with the patient's needs, can enhance compliance by preventing or limiting common early-cycle side effects (e.g., nausea/vomiting, breast tenderness, weight gain, headache), while providing acne improvement.
复方口服避孕药（OCs，即含有雌激素和孕激素的避孕药）被广泛用于治疗痤疮，因为它们能改变雄激素水平过高的激素环境，并可减少皮损。皮肤科医生对最合适的OC的了解可能会受到对这些药物理解不全面、误导性宣传以及围绕新一代OC的困惑的阻碍。尽管有报告强调OC中孕激素成分的雄激素化程度的重要性，但雄激素化的体外和动物生物测定几乎没有临床相关性。由于当今所有低剂量复方OC都是以雌激素为主导，它们对患有痤疮等雄激素相关疾病的女性同样有益。使用含每种激素最低剂量且符合患者需求的OC，可以通过预防或限制常见的周期早期副作用（如恶心/呕吐、乳房压痛、体重增加、头痛）来提高依从性，同时改善痤疮。
