A patch-released norelgestromin and ethinyl estradiol association in the treatment of papulo-pustular inflammatory acne

Aim. A relationship between acne and excessive androgenic stimulation of the pilo-sebaceous unit is by now widely established. So far, the hormonal treatment of acne with estro-progestins had been carried out per os. Recently, however, an estroprogestin contraceptive preparation containing norelgestromin and ethinyl estradiol has been marketed as transdermal patch. The purpose of this open pilot study is to evaluate the efficacy and tolerance of this new tool in the treatment of papulopustular inflammatory acne. Methods. The study included twelve 18 to 37-year old (mean 23 years) patients with papulo-pustular inflammatory acne and no clinical signs of hyperandrogenism. No topical treatments with antibiotics, antiseptic agents or retinoids were permitted during treatment. The patients were evaluated at the beginning of the study and then every 3 months to check the effects of therapy, and were photographed according to standardized methods. Results. Clinical improvement was observed from the 4th month after patch application. In some patients, after 11 months of treatment the papulo-pustular inflammatory acneic lesions had almost disappeared. A good agreement was found between the experimenter's and the patients' evaluations on treatment efficacy. Conclusion. Our results suggest that the norelgestromin-ethinyl estradiol combination and the technology used for its administration are able to decrease inflammatory acne manifestations in patients wishing to get a contraceptive agent. The patch has the advantage of making the active substance directly available with no liver loading, while avoiding irregularities linked to intestinal absorption and causing no significant changes of body weight.