Progestins are synthetic steroid hormones widely used in hormonal contraceptives, but their pharmacological effects vary according to molecular structure, receptor affinity, and androgenic or antiandrogenic activity. These differences may be clinically relevant in androgen-dependent dermatological conditions, particularly adult female acne and androgenetic alopecia. This literature review aimed to examine the relationship between the androgenic activity of progestins and their potential dermatological effects, with emphasis on the hormonal mechanisms underlying adult acne and androgenetic alopecia and on differences among individual progestin profiles. A qualitative literature review was conducted using PubMed/ MEDLINE, Web of Science, SciELO, Google Scholar, and the Virtual Health Library. Publications addressing progestin pharmacology, androgenic activity, hormonal mechanisms, acne, androgenetic alopecia, and related dermatological effects were considered. The reviewed literature indicates that progestins differ substantially in their interactions with steroid receptors and consequently exhibit distinct androgenic, antiandrogenic, and tissue-specific effects. Progestins with greater androgenic activity may enhance androgen-dependent processes in susceptible individuals, including sebaceous gland activity and follicular responses, whereas compounds with antiandrogenic properties may exert different effects on androgen-sensitive tissues. In adult female acne, these mechanisms may interact with sebaceous activity, follicular keratinization, inflammation, and peripheral androgen sensitivity. In androgenetic alopecia, the potential influence of progestins appears to depend largely on genetic susceptibility, local androgen metabolism, androgen receptor activity, and follicular sensitivity. Therefore, the dermatological effects of progestins should be considered within the broader context of individual pharmacological profiles and patient characteristics. Further clinical studies are warranted to better define the magnitude and clinical relevance of these associations.