Hormonal IUDs and acne
There are two major types of IUDs (Intrauterine birth control devices). Copper IUDs and hormone-based IUDs. The “ParaGard” is currently the single FDA-approved copper device available to women. The other four IUDs are hormone-based IUDs which all contain levonorgestrel(a typepe of hormone) in varying amounts. These hormone-based IUDs are Mirena, Liletta, Kyleena, and Skyla.
Levonorgestrel is a type of progesterone, which is a hormone that the body secretes in high amounts during pregnancy. This type of progesterone makes it difficult for a fertilized egg to implant into the uterine wall and start a pregnancy.
Progesterone and the Skin
It is well known that birth control pills which contain estrogen and progesterone can improve acne. It is believed today that the estrogen in these pills suppresses male sex hormones and sebum (skin oil) production, leading to improvement in acne.
Current theories suggest that progesterone may contribute to acne by increasing sebum (oil) production in the skin, causing skin cell proliferation and/or stimulating inflammation.
Hormonal IUDs and Acne
In a large study on >2,000 patients, hormone-based IUDs were seen to worsen acne when compared to other methods of contraception including the vaginal ring and combined oral contraceptive pills.
Progesterone-based IUDs were found to be associated with worsened rates of acne compared to oral contraceptive pills and copper-based IUDs. There have been several cases reported in the literature of severe acne after progestin-based Copper-based IUDs were not found to cause acne.