Treatment Risks
There are some contraindications to the use of oral contraceptives for the treatment of acne, Dr. Schlosser noted. Hypercoagulability, a history of venous thromboembolism (VTE), stroke or coronary artery disease, any gynecologic cancer, uncontrolled hypertension, abnormal liver function tests, pregnancy, or abnormal vaginal bleeding should be considered before prescribing.
Oral contraceptives do increase the risk of venous thromboembolism, although that risk is highly dependent on other factors as well, including advancing age and tobacco use. Dr. Schlosser said a concrete, direct link between oral contraceptives and VTE risk has yet to be found, but he hopes an ongoing case-control study of more than 50,000 oral contraceptive users (including up to 5 years of follow-up data) will provide answers.
Finally, Dr. Schlosser added, the single greatest risk of VTE among women is pregnancy and the postpartum period. "So I would say if you’re treating acne in a woman of childbearing age with an oral contraceptive, you are also protecting her from the biggest risk factor she has for thromboembolic events."
Disclosures: Dr. Schlosser said she had no relevant financial disclosures.