Acne and Oral Contraception

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Hans van der Slikke, MD: "It's October of 2001, and we're at the ASRM Conference in Orlando. Next to me is Professor Warren - welcome, Professor Warren."

Michelle P. Warren, MD: "Thank you."

Hans van der Slikke, MD: "You're from Columbia University in New York and you presented a poster about oral contraceptives, weight gain, and especially acne. What was your starting point?"

Michelle P. Warren, MD: "We were specifically interested in seeing whether the tricyclic oral contraceptive Estrostep improved acne in a variety of young women who had a moderate acne condition in the face. The primary aim was to reduce the acne lesions but in addition we were interested in seeing if these young people experienced any weight gain on the pill. This is a low dose tricyclic and we were hoping that these women would have a good effect with very few side effects, and that's what turned out to be the case. In the placebo group there was a significant increase in weight and in the treated group there was a non-significant increase in weight."

Hans van der Slikke, MD: "How many patients did you include in your trial?"

Michelle P. Warren, MD: "We had 495, and half of them were on placebo. We had a few in the placebo group, I believe 12, that became pregnant and they were excluded from the analysis. But in the patients who continued on therapy over the six months there was absolutely no weight gain on treatment, and this is very important for people who go on oral contraceptives because there's a reluctance to start oral contraceptives if people feel there are going to be side effects, and one of the side effects that young women dread most is weight gain. So even though it may improve the skin, they worry about weight gain so to my knowledge this is the only study which has looked specifically in a randomized trial and compared the treated to the placebo group and showed no effect of treatment on weight."

Hans van der Slikke, MD: "Were there many women who continued this drug after the trial?"

Michelle P. Warren, MD: "Yes, as a matter of fact, we had almost 20% of the women request continuation of the oral contraceptive which is large for a clinical trial. So there was a very good compliance and excellent continuation of treatment for those who wished to continue an oral contraceptive."

Hans van der Slikke, MD: "Thank you very much for this interview."