Expert Recommendations for Use of Combined Oral Contraceptives in Preadolescent and Young Adolescent Patients With Acne Vulgaris
Andrea L. Zaenglein, Natalie Allen, Sasigarn Bowden, Hannah R. Chang, Kristina Derrick, Alison Edelman, Dawn Eichenfield, Lawrence Eichenfield, Sarah Gold, Emmy Graber, Julie Harper, Sarah Horvath, Patricia Huguelet, Karin J. Kartawira, Leah Lalor, Irene Lara‐Corrales, Megha M. Tollefson, Tierney E. Wallace, Jonette KeriABSTRACT
Acne vulgaris commonly presents in early adolescence with the onset of adrenarche. Treatments for acne in this age group typically mirror those in older adolescents. However, while combined oral contraceptives are an effective hormonal treatment for acne vulgaris in young women, the safety of using a systemic hormonal therapy in younger patients for the management of acne has not been established. Concerns include effects on pubertal development and weight, bone health, cancer risks, and psychiatric effects. This Pediatric Dermatology Research Alliance (PeDRA) consensus project convened a multidisciplinary work group to address these issues and, utilizing a modified Delphi process, to establish best practices regarding the use of combined oral contraceptives in patients under 16 years of age based on available evidence and expert opinion.