Contraception and Acne Treatment in Adolescents

Introduction to Yaz

The American Academy of Dermatology recommends Yaz (drospirenone and ethinyl estradiol) for females ≥14 years of age for both contraception and acne treatment, as it is FDA-approved for this age group 1
Yaz is specifically approved for contraception in women who choose an oral contraceptive and for the treatment of moderate acne vulgaris in females at least 14 years of age who have achieved menarche and desire contraception 1, 2

Clinical trials have shown that Yaz demonstrates significant efficacy in improving moderate acne, with improvement typically becoming noticeable after 3 months of treatment 1
Before prescribing Yaz to a 14-year-old, consider important safety factors, including thorough medical history, blood pressure measurement, and assessment of pregnancy status 1
Contraindications to Yaz use include history of thromboembolism or thrombophilia, uncontrolled hypertension, complicated valvular heart disease, migraines with aura or focal neurologic symptoms, current breast cancer, and liver disease with abnormal liver function 2

The recommended dosage of Yaz is one tablet daily at the same time every day, and for acne treatment, improvement may not be noticeable until after 3 months of use 1
Yaz can be used in combination with topical acne treatments for enhanced efficacy 1
Yaz offers several additional benefits for adolescents, including regulation of menstrual cycle, reduction in menstrual pain and heavy bleeding, and improvement in premenstrual symptoms 1

The effectiveness of Yaz for contraception is 91% with typical use, and condoms should be used in addition to hormonal contraception to protect against STIs 3, 4
Backup contraception, such as condoms or abstinence, should be used for the first 7 days after starting Yaz, and missing pills increases pregnancy risk 3, 4

Most antibiotics, except rifampin and griseofulvin, do not reduce the effectiveness of combined oral contraceptives 1
Patients should be counseled that acne improvement typically takes at least 3 months, and Pap smears and pelvic examinations are not mandatory before starting Yaz 1
Schedule follow-up visits 1-3 months after initiation to assess for side effects and adherence 4