Birth control medications can be a great option for people who are looking to:
- regulate their menstrual cycles
- regulate symptoms of premenstrual syndrome (PMS)
- lower their chance of becoming pregnant
Like most medications, birth control comes with its own set of side effects. Some people who use hormonal contraceptives might develop melasma.
Melasma is the darkening or discoloration of the skin. It typically occurs on the face, but it may be observed from the shoulders up. Women and people with darker skin types are
Forms of hormonal birth control that can trigger melasma include:
- oral contraceptives
- intrauterine devices (IUDs)
- vaginal rings
- birth control shot
- birth control patch
Although the exact cause of melasma is unknown, it’s attributed to the overproduction of the pigment melanin.
The outer layer of your skin, the epidermis, contains cells called melanocytes. These cells store and produce melanin. The more melanin your skin has, the darker your skin appears.
When the epidermis is exposed to ultraviolet (UV) or infrared radiation from the sun, as well as hormones found in certain birth control options, the melanocytes react by producing more melanin. This is what darkens the skin.
Hormonal stimulation can come in the form of:
A wide range of hormonal birth control options that contain progesterone and estrogen are associated with melasma. Examples include:
The birth control that’s least likely to be linked to melasma includes barrier methods and non-hormonal birth control options. Here are some examples of non-hormonal birth control:
While these methods of birth control might be effective in preventing pregnancy, they don’t offer some other benefits of hormonal birth control, such as regulated periods, improved acne symptoms, and fewer symptoms of PMS.
Talk with a medical professional to see which method or combination of birth control might be best for you.
If you still want to continue hormonal birth control for some of its other benefits, there might be some options for you. While any birth control brand that contains estrogen or progesterone can put you at risk for developing melasma, those with lower doses of hormones are found to be less likely to cause it.
Here are a couple options to consider.
The mini-pill can be a good option for people who would like to continue using the pill, but would like to avoid the symptoms of melasma.
The mini-pill is a progestin-only pill. Progestin is a derivative of progesterone. It’s less likely to stimulate the overproduction of melanin than a combination pill, which would include estrogen.
There are four hormonal IUDs available in the United States: Mirena, Kyleena, Liletta, and Skyla.
Each IUD has its own varying level of hormones. Skyla is considered to have the lowest possible dose of hormones, which might be a good fit for someone who’s looking to avoid melasma.
In general, IUDs don’t contain estrogen and aren’t as strongly associated with melasma as combination oral contraceptives.
In fact, a 2014 study found that the melasma in four patients cleared upon switching from oral contraceptives to IUDs. This suggests that simply lowering the hormonal dosage of your birth control could clear up melasma. Even so, this study’s sample size was small, and more research is needed.
If you want to avoid hormones altogether, there’s a non-hormonal IUD. ParaGard, which is also known as the copper IUD, is an incredibly effective method of birth control. The main side effect experienced by those who use the copper IUD is heavier, longer periods.
Consider speaking with a health professional to see which IUD might be the best fit for your body.
Melasma is considered to be a chronic disorder and behaves differently for everyone.
If your melasma is triggered by birth control, as the 2014 study above suggested, it could go away on its own after you stop taking a combination oral birth control medication.
If you’re unable to stop your birth control or notice that your melasma sticks around once you do stop, there are still ways to treat and manage your symptoms.
Since sun exposure worsens and triggers melasma, it’s a good idea to limit your exposure to infrared and UV radiation.
Here are some tips to keep your face protected from sunlight:
- Apply sunscreen to your face and neck daily.
- Wear brimmed hats and sunglasses when you go outside.
- Try to stay in the shade when you’re outside on sunny days.
- Opt for light and loose clothing that protect your shoulders and chest when you’re outside on sunny days.
There are treatments you can apply to your face to lighten your melasma. For best results, it’s worth discussing a treatment plan with your dermatologist.
Your dermatologist might also recommend the following creams:
- azelaic acid, which is an anti-inflammatory agent
- steroid creams, like hydrocortisone
- skin-lightening products, like hydroquinone and cysteamine
Sometimes prescription or over-the-counter topicals aren’t effective in fully treating hyperpigmentation. In these cases, your dermatologist might be able to offer an in-office treatment.
These treatments aren’t all covered by insurance, so they might come with a hefty cost. It’s important to check with your dermatologist to weigh which options are best for your overall health, cosmetic appeal, and finances.
- Microdermabrasion. Microdermabrasion uses a special applicator to gently exfoliate the epidermis. It rejuvenates the skin and can improve the appearance of melasma, among many other benefits.
- Chemical peels. Chemical peels utilize acids to exfoliate the skin, from its outermost layer to the middle layer. Depending on the severity of your melasma, your doctor may apply a light, medium, or deep peel.
- Laser skin resurfacing. Like microdermabrasion and chemical peels, lasers can remove the outermost layer of skin. Lasers also stimulate collagen and the growth of skin beneath the epidermal layer.
If you notice melasma symptoms on your face or body, it’s a good idea to check with a dermatologist to confirm your symptoms.
A dermatologist can help you rule out any other conditions that look similar to melasma, so that you receive the most effective treatment.
The treatment for melasma is generally cosmetic. Not all people who have melasma seek treatment. Whether you’d like to treat your condition with ointments and serums, procedures, or a change in birth control, it’s a good idea to talk with your primary care professional or OB-GYN.
It’s important to remember that every person’s tolerance for hormonal birth control is unique. What triggers melasma in one person might not cause any reaction in another.
If you think your melasma is triggered by hormonal birth control, talk with a medical professional to see what other birth control options fit your lifestyle.
If you don’t want to switch up your birth control, there are plenty of ways that your dermatologist can assist you in treating your symptoms.