Contraceptive pills are a great option for people who:
- regulate the menstrual cycle
- Regulating symptoms of premenstrual syndrome (PMS)
- lower the chance of getting pregnant
Like most medications, birth control pills come with their own side effects. Some people who use hormonal contraceptives develop melasma.
Melasma is a darkening or discoloration of the skin. It usually occurs on the face, but can also occur above the shoulders. Women and people with dark skin,
Hormonal birth control that can cause melasma include:
- oral contraceptives
- Intrauterine device (IUD)
- vaginal ring
- birth control shot
- contraceptive patch
The exact cause of melasma is unknown, but it is thought to be caused by overproduction of the pigment melanin.
The outer layer of the skin, the epidermis, contains cells called melanocytes. These cells store and produce melanin. The more melanin in your skin, the darker your skin will appear.
When the epidermis is exposed to ultraviolet (UV) or infrared radiation from the sun and the hormones found in certain birth control options, melanocytes respond by producing more melanin. This is what causes the skin to darken.
Hormone stimulation occurs in the following ways:
Various hormonal contraceptives, including progesterone and estrogen, have been associated with melasma. Examples include:
Contraceptives least associated with melasma include barrier methods and non-hormonal contraceptive options. Here are some examples of non-hormonal contraception.
Although these contraceptive methods may be effective in preventing pregnancy, they do not provide the other benefits of hormonal contraception, such as regulating menstrual cycles, improving acne symptoms, and reducing PMS symptoms.
Talk to your health care professional about which contraceptive method or combination is best for you.
If you want to continue using hormonal birth control for other benefits, you may have several options. Brands of birth control pills that contain estrogen or progesterone run the risk of developing melasma, but those with lower amounts of the hormone have been found to be less likely to cause melasma.
There are several options to consider.
minipill
The mini-pill is a good option for people who want to continue using the pill but want to avoid the symptoms of melasma.
The minipill is a progestin-only pill. Progestin is a derivative of progesterone. Less likely to stimulate overproduction of melanin than combinations containing estrogen.
IUD
There are four hormonal IUDs available in the United States: Mirena, Kylina, Liletta, and Skyla.
Each IUD has its own varying levels of hormones. Skyla is considered to have the lowest possible dose of hormones and may be suitable for people who want to avoid melasma.
IUDs generally do not contain estrogen and are not as strongly associated with melasma as combined oral contraceptives.
actual, 2014 survey They found that four patients’ melasma healed when they switched from oral contraceptives to IUDs. This suggests that simply reducing the hormonal dose of birth control may eliminate melasma. Still, the sample size of this study was small and further research is needed.
If you want to avoid hormones completely, there are non-hormonal IUDs. ParaGard, also known as the copper IUD, is an incredibly effective method of birth control. The main side effects experienced by people using copper IUDs are that they are more severe and last longer.
Consider talking to your health care professional about which IUD is best for your body.
Melasma is considered a chronic disease, and symptoms vary from person to person.
As the 2014 study mentioned above suggests, if melasma is caused by birth control, it may resolve on its own when you stop taking the combination oral contraceptive pill.
If you can’t stop taking birth control or find that your melasma remains after you stop, there are still ways to treat and manage your symptoms.
Sunscreen
It is recommended to limit exposure to infrared and ultraviolet light, as exposure to sunlight can worsen and cause melasma.
Here are some tips to protect your face from the sun.
- Apply sunscreen to your face and neck every day.
- Wear a brimmed hat and sunglasses when going out.
- When you are outside on a sunny day, try to stay in the shade.
- When you’re outdoors on a sunny day, choose light, loose-fitting clothing that protects your shoulders and chest.
local treatment
There are treatments that can be applied to the face to reduce melasma. For best results, it’s worth discussing your treatment plan with your dermatologist.
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Your dermatologist may also recommend the following creams:
in-office treatment
Prescription drugs and over-the-counter topical medications may not completely treat hyperpigmentation. In these cases, your dermatologist may be able to offer home treatment.
All of these treatments are not covered by insurance and can be expensive. It’s important to consult a dermatologist to discuss which options are best for your overall health, aesthetic appeal, and finances.
- Microdermabrasion. Microdermabrasion uses a special applicator to gently exfoliate the epidermis. It has many benefits, including rejuvenating the skin and improving the appearance of melasma.
- Chemical peel. Chemical peels use acids to exfoliate the skin from the outermost layer to the middle layer. Depending on the severity of melasma, your doctor will apply a light, medium, or deep peel.
- Laser skin resurfacing. Similar to microdermabrasion and chemical peels, lasers can remove the outermost layer of skin. The laser also stimulates the growth of collagen and skin beneath the epidermal layer.
If you notice symptoms of melasma on your face or body, it is recommended that you consult a dermatologist to confirm the symptoms.
Your dermatologist can help you rule out other conditions similar to melasma so you can receive the most effective treatment.
Treatment of melasma is generally performed for cosmetic purposes. Not everyone who has melasma requires treatment. If you want to treat your symptoms with ointments, serums, treatments, or changes in birth control, we recommend talking to your doctor or gynecologist.
It’s important to remember that everyone’s tolerance to hormonal birth control varies. What causes melasma in one person may cause no reaction in another.
If you think your melasma is caused by hormonal birth control, talk to your health care professional about other birth control options that fit your lifestyle.
If you don’t want to change your birth control, there are many ways your dermatologist can help treat your symptoms.
