In reply to Dr. John Kirks letter published in the Medical Journal of Australia August 14 1971 concerning the implied association of norgestrel (dl) to acne vulgaris I wish to point out to Dr. Kirk and your readers that in the development of a successful progestogen such a side effect was indeed looked for and I am happy to report the following results: 1) In trials with 567 women treated with .5 mg norgestrel (dl) plus 50 mcg of ethinyl estradiol over a total of 3553 cycles acne did not appear in any patients (Frank R. Lock Professor of Obstetrics and Gynecology et. al. Bowman Grey School of Medicine North Carolina). 2) In a total recorded clinical experience up to 1969 with this compound in combination with ethinyl estradiol 52505 cycles with 5695 women were studied and acne was reported in .04% of cases. 3) While other trials have reported an incidence of 2.7% in treated women it was found that in the controlled group the incidence was 5.9% (Ruben Apelo et al); and finally Dr. W. McBrides study at the Womens Hospital Crown Street Sydney with .25% mg of d-norgestrel combined with 50 mcg of ethinyl estradiol in 400 Australian women showed that "minor side effects were almost nonexistent" and acne was not recorded. It is our experience that the use of dl norgestrel and now the further refined d-isomer when taken in combination with 50 mcg of ethinyl estradiol does not alter the natural incidence of acne vulgaris nor does it appear to aid in its treatment. (FULL TEXT)
