Yes, acne is a common side effect of Kyleena, reported in 14.1% of women who were assigned to Kyleena in clinical trials. Women who are predisposed to hormonal acne (for example, they typically have a breakout of acne just before their period) are more likely than others to develop acne with Kyleena.

How does Kyleena cause acne?

Kyleena is a T-shaped plastic intrauterine device that is inserted into the uterus and which contains the hormone levonorgestrel which is believed to prevent pregnancy by thickening cervical mucus which prevents the passage of sperm into the uterus, inhibiting the motility of sperm and their survival, and changing the endometrium so it is unable to accommodate a fertilized egg.

Unfortunately, this creates an imbalance in progestin vs estrogen levels (levonorgestrel is a progestin hormone) and levonorgestrel has also been shown to cross-react with androgen receptors, increasing sebum and oil production in the hair follicles, exacerbating acne in some women. Some newer synthetic progestins, such as cyproterone acetate and drospirenone do not have this effect; however, these are not available in an intrauterine device.

How can you treat Kyleena-associated acne?

Anyone with acne-prone skin needs to maintain a good skincare routine.

Cleaning your skin twice daily with a gentle acne cleansing treatment and then following up with a treatment cream containing ingredients such as salicylic acid or azelaic acid. Products containing retinol can also encourage the turnover of skin cells. Avoid picking or squeezing pimples, this will only make scarring worse, and try following a low-sugar, low-dairy, diet involving plenty of fresh vegetables and beans.

If your acne persists, see your doctor to talk about prescription anti-acne treatments.

What are the most common side effects with Kyleena?

The most common side effects reported in clinical trials with Kyleena include:

• Vulvovaginitis (irritation and inflammation of the vulva and vaginal area): 24.3%
• Ovarian cysts: 22.2%
• Acne: 14.1%
• Abdominal pain: 13.3%
• Headache: 12.9%
• Pelvic pain: 8.2%
• Dysmenorrhea (pain during menstruation): 8%
• Increased bleeding: 7.9%
• Breast pain: 7.1%
• Nausea: 4.7%
• Genital discharge: 4.5%
• Depression: 4.4%
• Breast discomfort: 3.5%
• Device expulsion: 3.5%
• Migraine: 3.3%
• Uterine spasm: 2.4%
• Seborrhea (excessive discharge of sebum): 1.8%
• Upper genital tract infections: 1.5%
• Alopecia: 1%

Serious adverse events that occur in less than 1% of people include ectopic pregnancy, pelvic inflammatory disease, spontaneous abortion, and uterine perforation.