The Connection Between Your Birth Control And Melasma

The Connection Between Your Birth Control And Melasma

We’ve talked about what causes melasma, but now we are going to take a deep dive into how melasma and birth control (aka ‘oral contraceptive pills’) are related.

How Does Birth Control Contribute To Melasma?

Hormones are among the primary cause of melasma – especially estrogen. Elevated levels of estrogen in the body increase pigment production, and hormonal birth control works by increasing the levels of estrogen in the body. That’s why melasma is commonly seen with oral contraceptive use. One study found that 25% of women reported their melasma began after beginning hormonal birth control (Ortonne).

Several studies have been done to figure out the exact role estrogen plays in the development of this condition (Handel).

Hormonal birth control contributes to melasma in the following ways:

  • Estrogen acts directly on melanocytes (the cells that make your pigment), which in turn causes more pigment production.
  • Estrogen increases the number of melanocortin receptors in melanocytes. This makes the melanocyte cells more sensitive to sun or inflammation.
  • Estrogen also increases the expression of PDZK1, a gene that increases the levels of the pigment-forming enzyme tyrosinase. Tyrosinase is a pigment-making mini-factory that increases your skin’s capacity to create pigment.

Estrogen isn’t the only ingredient in many hormonal birth control methods. Progesterone is another common ingredient in oral contraceptives. A study looking at both affected and unaffected skin in melasma found that the affected skin had significantly increased numbers of progesterone receptors (Tamega). This means that the affected skin could also be especially sensitive to progesterone levels.

If I Stop Taking Birth Control, Will My Melasma Go Away?

Your melasma may lighten significantly if you stop taking birth control. However, if you have a family history of melasma, it’s less likely that your melasma was triggered by oral contraceptives (Ortonne).

How long does it take for melasma to go away after stopping birth control?

This varies from person to person, as some people see improvement within months and others do not. In either case, UV protective measures such as daily sunscreen, sun avoidance during peak hours (10 am – 2 pm), and wearing broad-brimmed hats are an essential part of helping melasma fade faster.

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Should I Keep Taking My Birth Control If I Have Melasma?

It depends on your preferences when it comes to contraception. There are many options available, including both non-hormonal and hormonal methods. Some women find a progesterone-only hormonal birth control is better for managing melasma compared with those containing estrogen.

Learn more about your birth control options:

Can I Treat My Melasma If I Am Taking Birth Control?

Definitely! In fact, you should start treatment as soon as possible. The earlier you start a prescription-based daily regimen that includes the three most effective ingredients for treating melasma, the sooner your skin will be clear. That means you don’t have to change your entire contraceptive plan while treating melasma.



Brandon Kirsch

Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the Naples Community Hospital. Kirsch Dermatology Website Dr. Kirsch started his career as a lawyer and holds law degrees from the University of Western Ontario (LL.B.) and Georgetown (LL.M. Securities and Financial Regulation). Dr. Kirsch completed his pre-medical studies at the University of Pennsylvania, medical school at Brown University, internship at the Mayo Clinic (Florida) and dermatology residency at the University of North Carolina. In partnership with the Mayo Clinic, he filed to patent a novel topical composition for the treatment of skin hyperpigmentation that he co-developed and also oversaw a successful pilot study of the formulation. Dr. Kirsch has experience with therapeutic drug development programs from pre-clinical to Phase 3 studies. He is licensed to practice medicine in California, Colorado, Florida, and North Carolina and law in New York and Ontario.

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