Association Between Hormonal IUDs and Increased Risk of Rosacea: A Multicenter Cohort Study [ID 900]

INTRODUCTION: Rosacea is a chronic skin condition characterized by facial erythema and inflammation, primarily affecting women aged 30–50. Hormonal factors may contribute to rosacea development. This study investigates the relationship between hormonal intrauterine devices (IUDs) and the incidence of rosacea compared to nonhormonal copper IUDs and oral contraceptive pills (OCPs). METHODS: A multicenter cohort study was conducted using the TriNetX network, collecting data from women aged 18–50 who had used Liletta, Mirena, Skyla, copper IUDs, or OCPs. Rosacea incidence was tracked at 1, 3, and 5 years post-IUD insertion or OCP initiation. Women with a prior diagnosis of rosacea were excluded. Incidence rates (IR), incidence rate ratios (IRR), and statistical significance ( P <.05) were calculated. RESULTS: At 1 year post-insertion, Liletta users had an IR of 634.28 per 100,000 person-years and an IRR of 1.665 compared to copper IUD users (IR 380.95) and OCP users (IR 351.29, IRR 1.45, P <.0001). Mirena showed an elevated IR of 529.30 (IRR 1.389 versus copper, P <.001). At 5 years, Liletta and Mirena continued to show significantly higher IRs (285.02 and 234.54, respectively), whereas Skyla and copper IUDs did not show significant increases. CONCLUSIONS/IMPLICATIONS: Hormonal IUDs, particularly Liletta and Mirena, are associated with a higher risk of rosacea compared to nonhormonal IUDs and OCPs. Clinicians should consider this risk during contraceptive counseling, and dermatologists should assess contraceptive use when managing rosacea. Further research is needed to explore the mechanisms behind this association.