Melasma & Birth Control: Is There A Connection?


Medically Reviewed by Dr. Lee Hwee Chyen

MBBS MRCP (UK) FAMS (Dermatology)

Melasma & Birth Control: Is There A Connection?

Melasma is not just a cosmetic concern but also a dermatological issue that is interlinked with various factors, including hormonal changes, which brings us to the question of its connection with birth control. This raises important considerations for those on hormonal contraceptives, as understanding this link could help with better management of melasma.

What is Melasma?

Melasma is a skin condition characterised by dark, discoloured patches on both sides of the face. The most common areas affected are the cheeks, bridge of the nose, forehead, chin, and upper lip.

Melasma is more prevalent in women than men, particularly during reproductive years. It is believed to be influenced by sun exposure, genetic predisposition, and hormonal changes, making it a multifactorial issue.

Birth Control and Hormonal Changes

Birth control pills are one of the most widely used methods of contraception, chosen for their efficacy and reversibility. These pills work by altering the body’s natural hormonal balance to prevent pregnancy.

The primary hormones involved in this process are oestrogen and progesterone, which are also implicated in the development of melasma. It’s this hormonal manipulation that raises the question of birth control’s role in melasma formation or exacerbation.

Birth Control and Melasma

The relationship between birth control and melasma hinges on several key factors that highlight how hormonal contraceptives can influence the development or exacerbation of this skin condition:

Hormonal Fluctuations

Birth control pills often contain oestrogen and progestin, which can trigger melasma by stimulating melanocytes, the cells responsible for producing melanin in the skin. This is particularly noticeable in individuals with a genetic predisposition to melasma.

Increased Sensitivity to Sunlight

Hormonal contraceptives may increase the skin’s sensitivity to UV radiation, making it more susceptible to the development of melasma. UV exposure can activate melanocytes, leading to increased melanin production and the appearance of dark patches.

Oestrogen Levels

High levels of oestrogen in certain birth control pills can exacerbate melasma, especially in those with a history or risk of the condition. Lower oestrogen or progestin-only options may have a reduced impact.

Duration of Use

The length of time on hormonal birth control can influence melasma’s severity. Longer durations of hormone exposure may increase the likelihood of developing or intensifying melasma.

Individual Susceptibility

Genetic factors, skin type, and individual hormonal responses can affect how significantly birth control influences melasma. Those with a family history of melasma or darker skin types are often more susceptible.

Managing Melasma for Birth Control Users

  • Sun Protection: UV exposure can exacerbate melasma, making sun protection essential. This includes using a broad-spectrum sunscreen daily, wearing protective clothing, and seeking shade whenever possible.
  • Topical Treatments: Prescription topicals containing ingredients such as hydroquinone, tretinoin and other agents can lighten dark patches. These should be used under the guidance of a dermatologist.
  • Lifestyle Modifications: Incorporating antioxidant-rich foods into your diet and avoiding direct sun exposure can also help manage melasma.
  • Switching Birth Control Methods: Exploring birth control options that are less likely to cause melasma, such as low-oestrogen pills or progestin-only methods, can be beneficial.


Melasma and birth control are linked through the common thread of hormonal changes. For individuals experiencing melasma, understanding this connection could help better manage the condition. By combining professional medical advice, protective measures, and lifestyle adjustments, it’s possible to mitigate the effects of melasma for those using birth control.

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