Improving outcomes through collaboration

A roundtable was convened to examine the issues surrounding the use of hormonal therapy in the treatment of acne. Obstetrician-gynecologists (OB/GYNs) and dermatologists often have varying views with regard to the use of oral contraceptives (OCs) and other agents in patients with acne. If polycystic ovary syndrome (PCOS), the most common hormonal cause of acne, has been diagnosed, the use of OCs is not usually disputed. Hormonal evaluation is recommended for certain conditions such as virilization. Although PCOS is often the source of the problem, it is important to rule out a testosterone-producing tumor or an adrenal tumor. It was determined, however, that the perception that OCs cause cervical and breast cancer persists among some dermatologists. Even in women with a family history of breast cancer, OCs do not increase the risk. Nor is cervical cancer related to OC use; rather, it results from human papillomavirus. Thus, patients should be assured that OCs will not increase their risk for either of these cancers. Female patients should be advised to see their gynecologists annually for breast and pelvic examinations and to discuss their concerns surrounding the use of OCs.