Birth Control Pills and Melasma

iVillage Member
Registered: 05-07-2003
Birth Control Pills and Melasma
5
Tue, 07-18-2006 - 1:21pm

Hi all,

I have been on birth control pills, most recently OTC followed by OTC-lo, for the past 11 years. Recently I have noticed melasma (dark skin patches) on my upper lip. I understand that these are cause by lack of ovulation induced by estrogen in the combination pill.

Two questions:

1. Is there any hope of treating and getting rid of the melasma *without* going off the pill? Will continuing the pill make the melasma resistant to treatment? Other than the melasma, I've been doing fine on the pill. My dermatologist started me on hydroquinone, retin-a, vitamin c serum, and SPF 35 sunblock. We are considering the Obagi treatment.

2. Can the Mirena IUD have the same melasma effect? I understand the pill causes melasma because its estrogen supresses ovulation. Mirena has a progestin but no estrogen. Does Mirena suppress ovulation, or is melasma not an effect of Mirena? I tried the Mirena last month but panicked and had it removed :( I would be willing to try the IUD again, or the copper IUD, but I fear heavier periods on the copper.

In short, I wonder if the melasma alone is reason to go off the pill, or whether melasma is treatable while still on the pill. Any insights???

Thanks in advance!

fuchsia

iVillage Member
Registered: 12-30-2003
Tue, 07-18-2006 - 2:56pm

Hi fuchsia_g, welcome back!


      Jill

    

iVillage Member
Registered: 05-07-2003
Tue, 07-18-2006 - 3:20pm

Hi Jill,

Wow - thank you for the detailed response - and for reading the fine print on Mirena for me! According to those studies it sounds like ovulation was suppressed for 25 - 55% of women on Mirena, which are actually high proportions (a quarter). If the melasma is why i want to go off the pill, then Mirena may not be for me.

The copper T may be a better choice: it would be far better to have heavier periods than to walk around with a 'moustache'.

My other thought was to try the diaphragm for several months to see if going off the pill really helps. You use the diaphragm right Jill? Improvement in mood and libido and skin might offset the drawback in sponteneity.

I will do some more research, but welcome any other input from board members. Has anyone here actually successfully cleared melasma while staying on the pill? I will also ask on the Skin Conditions board.

cheers,
fuchsia




Edited 7/18/2006 3:21 pm ET by fuchsia_g
iVillage Member
Registered: 12-30-2003
Tue, 07-18-2006 - 4:13pm

>>My other thought was to try the diaphragm for several months to see if going off the pill really helps. You use the diaphragm right Jill? Improvement in mood and libido and skin might offset the drawback in sponteneity<<


      Jill

    

iVillage Member
Registered: 03-19-2003
Wed, 07-19-2006 - 7:35am

Just to clarify....it is the progestin in the pill (and Mirena) that causes the ovulation suppression.

Judie Cl for Birth Control 
iVillage Member
Registered: 05-07-2003
Wed, 07-19-2006 - 8:40am

Judie,

Wow - that is fantastic information to know - thank you! What an eye-opener! So if the progestin is the culprit suppressing ovulation, then anything with progestin (and the 20mcg per day in Mirena is a larger dose over time than OTC-Lo) could be implicated in the melasma. I am happy that i didn't continue on the Mirena - now i am actually happy that my options are narrowed, honestly.

fuchsia