Increased use of oral retinoids for acne requires stronger contraception advice


A new study has revealed rates of prescription oral retinoid use have doubled among reproductive-aged women over the past decade.

Dr Laura Gerhardy

Dr Laura Gerhardy, Nepean Hospital Maternal Fetal Medicine specialist

While used as a popular treatment for severe acne, the medication can pose a risk to unborn babies if contraception is not used. When taken near or during pregnancy, oral retinoids are known to cause miscarriage, congenital abnormalities and potentially impact a child’s neurodevelopment.

The findings were recently published in the Australasian Journal of Dermatology as part of a joint study between researchers from Nepean Blue Mountains Local Health District and University of Sydney.

Using data from Australian Pharmaceutical Benefits dispensing claims, researchers examined whether women using oral retinoids were also using contraception concurrently.

Results found that between 2013 to 2021 there were 1,545,800 retinoid dispensings to women aged 15 to 44 years old. Of this figure, 57 per cent were oral retinoids.

The rate of oral retinoid dispensings doubled over the study period. One oral retinoid prescription was dispensed for every 36 women in 2021.

Lead author of the study, and Nepean Hospital Maternal Fetal Medicine specialist Dr Laura Gerhardy says while prescription oral retinoids may be increasing in popularity, what’s most concerning is the lack of highly effective contraception.

“In the study, only 1 in 4 retinoids dispensed had a contraception prescription dispensed around the same time. Contraception with a low failure rate is recommended, like an intrauterine device or a contraceptive implant,” says Laura.

Some of the women appearing to have no contraception in the study will be using pills that are not subsidised on the PBS, or using condoms, but these are less effective.

“Women need to be aware of associated risks when taking oral retinoids, and an effective contraception plan should be in place before the retinoid prescription,” says Laura.

Full findings of the research are available to view online.

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