Skin Discolouration and Low Dose Birth Control

One of the more distressing side effects associated with oral contraceptives, even low dose birth control pills, in some women, can be a darkening of the skin on the face called ‘melasma.’ Apart from skin
discolouration, there are no other symptoms so the side effect is mainly cosmetic.

Symptoms

Melasma appears as uniform, brown, symetrical brown patches (same on both sides of your face)  on the forehead,cheeks, nose and upper lip.  If you are a young woman with brownish skin tones you are at a higher risk of being affected by melasma, although 10% of men do get melasma.  It is especially common
in pregnant women (the mask of pregnancy) and women taking birth control pills, or hormone replacement therapy (HRT) during menopause. Melasma does not seem to occur with HRT AFTER menopause.

 Hormone and Genetic Connection to Melasma

The sun seems to be a significant risk factor for melasma so if you live in the tropics, your risk is higher.When you expose your skin to the sun, it is thought that the female sex hormones, estrogen and progesterone, stimulate your melanocytes (pigment-producing cells)  to produce more melanin pigments. Hence, women taking synthetic estrogen and progestin, even in low dose birth control pills, are ’supporting’ this reaction in the body.  If you have light brown skin and live in a country were you get intense sun exposure, you are particularly susceptible to developing this condition. Unfortunately, if members of your family are predisposed to this condition, this will be a  major factor in determining whether you will also develop melasma.

 Can I get rid of melasma?

 Melasma often fades over a period of time if you stop taking HRT and low dose birth control pills and limit your sun exposure- but in some cases,  it can last a lifetime. Using a good quality sunscreen is highly recommended, SPF 30 or higher (which also helps to prevent wrinkles and skin cancer) or anything that blocks ultraviolet light and sources of light indoors.  There is a likelihood of melasma returning if you resume taking birth control pills or return to HRT during menopause. Melasma often disappears after
having a baby although it can return with subsequent pregnancies.

 A dermatologist or physician can prescribe creams which do not bleach the skin but decrease the activity of the pigment producing cells.

DO NOT use DIY chemical peels or be tempted to use microdermabrasion at home to get rid of melasma as you could make the skin condition worse.

 Disclaimer: As I have been asked about ‘dark skin patches and the pill’, I have included this post on low dose birth control pills and  melasma  for educational purpose only. The information should be used as encouragement for you to talk to your doctor about your particular case and not as a substitute for treatment. 

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