Do you avoid progestin only contraceptives and IUDs in patients with acne due to their androgenic properties?   

I counsel similarly to Dr. @Shastry above. I also reference the following article, which shows the following odds ratios for certain conditions with hormonal IUDs vs copper: Acne vulgaris: 2.514 Hirsutism: 0.446 Rosacea: 0.376 Androgenetic alopecia: 0.109 Basically, I say they're less likely to...

I see a significant number of patients with hair loss, and progestin-only IUDs may have an adverse effect on alopecia in some cases. The mood changes are another notable side effects.

Progestin-only implants and IUDs have been shown in the literature to be associated with acne (Oliveira et al., PMID 39109858; Munjal et al., PMID 35219751). Combined estrogen-progesterone oral contraceptives, in contrast, are used in the treatment ladder for hormonal acne. In patients with pre-exis...