Oral Contraceptives in Dermatology

Patients with hyperandrogenic syndromes and diseases exacerbated by pregnancy and those taking common dermatologic drugs associated with risk to the fetus require prescription of contraceptives by the dermatologist. In healthy, nonsmoking women, oral contraception does not increase the risk of cerebral or cardiac vascular disease and is associated with major benefits besides avoiding pregnancy. These include prevention of ovarian and endometrial carcinoma, ectopic pregnancy, pelvic inflammatory disease, ovulation pain, and menstrual cycle disorders. This article will review the mechanism of action, side effects, health risks, contraindications, initiation of the oral contraceptive regimen, and patient follow-up, as well as interactions between contraceptives and other drugs.