J Am Acad Dermatol

Hormonal IUDs associated with increased rosacea incidence

April 28, 2025

Study details: This multicenter cohort study examined the incidence of rosacea among women aged 18-50 using hormonal IUDs (Liletta, Mirena, Skyla) vs. nonhormonal (copper) IUDs. Participants were monitored for rosacea diagnosis at 1, 3, and 5 years post-IUD insertion, excluding those with prior rosacea or IUD removal.

Results: At 1-year postinsertion, Liletta had the highest incidence rate (IR) of rosacea at 634.28 per 100,000 person-years (incidence rate ratio [IRR], 1.665; 95% confidence interval [CI], 1.346-2.059, P < .001). Mirena had an IR of rosacea at 529.30 and an IRR of 1.389 (95% CI, 1.160-1.658, P < .001). Skyla had an IR of 409.00, but its IRR of 1.074 (95% CI, 0.752-1.533, P = .696) wasn’t statistically significant. Similar trends were observed at 3 and 5 years, with Liletta consistently showing the highest rates, followed by Mirena.

Clinical impact: Hormonal IUDs, particularly Liletta and Mirena, are associated with a higher incidence of rosacea compared with nonhormonal IUDs. Consider these dermatologic side effects when prescribing hormonal IUDs and discuss potential skin-related outcomes with patients to ensure informed decision-making.

Source:

Arza A, et al. (2025, February). J Am Acad Dermatol. Incidence of rosacea associated with hormonal intrauterine devices: A comparative study with nonhormonal intrauterine devices. https://pubmed.ncbi.nlm.nih.gov/39447756/