From the Guidelines
Oral contraceptives can cause areas of hyperpigmentation, although the provided evidence specifically mentions this side effect in relation to the transdermal contraceptive patch, not oral contraceptives. However, considering the hormonal components and their effects on the body, it is reasonable to infer that oral contraceptives, which also contain estrogen and progesterone, could potentially lead to hyperpigmentation 1.
Key Points to Consider
- The transdermal contraceptive patch, which contains a combination of estrogen and progestin, has been associated with skin effects such as hyperpigmentation, contact dermatitis, and other irritation 1.
- The risk of hyperpigmentation may be related to the hormonal influence of estrogen and progesterone on melanocytes, leading to increased melanin production, especially when the skin is exposed to sunlight.
- While the provided evidence does not directly address oral contraceptives, the principle of hormonal influence on skin pigmentation can be applied, suggesting a potential risk of hyperpigmentation with oral contraceptive use as well.
Management and Prevention
- Strict sun protection is crucial to minimize the risk of hyperpigmentation, including the use of broad-spectrum sunscreen with SPF 30 or higher, wearing protective clothing, and avoiding peak sun hours.
- If hyperpigmentation develops, discontinuing the contraceptive method may lead to fading of the patches over time, though dermatological treatments like topical lightening agents may be necessary for persistent cases.
From the FDA Drug Label
Chloasma may occasionally occur, especially in women with a history of chloasma gravidarum. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet radiation while taking COCs
- Yes, oral contraceptives can cause areas of hyperpigmentation, specifically chloasma.
- This condition may occur especially in women with a history of chloasma gravidarum.
- Women with a tendency to chloasma are advised to avoid exposure to the sun or ultraviolet radiation while taking COCs 2
From the Research
Oral Contraceptives and Hyperpigmentation
- Oral contraceptives can cause areas of hyperpigmentation, as oestrogens can increase melanocyte count and melanin content, leading to hyperpigmentation of the skin 3.
- Hormonal therapies, including oral contraceptive pills, have been associated with melasma, a condition characterized by areas of hyperpigmentation 4.
- Melasma is an acquired, chronic pigmentary disorder that can be caused by hormonal changes, including those induced by oral contraceptives 5.
- Hyperpigmentation disorders, including melasma, can be treated with topical agents, chemical peels, cryotherapy, light or laser therapy, or a combination of these methods 6.
Mechanism of Hyperpigmentation
- Oestrogens in oral contraceptives can stimulate melanocytes, leading to an increase in melanin production and hyperpigmentation 3.
- The relationship between hormone secretion and melasma development is complex and not fully understood, but hormonal therapies, including oral contraceptives, have been implicated in the development of melasma 4.
- Oral contraceptives can also cause other skin changes, including acne and hirsutism, particularly if they contain androgenic progestogens 7.
Treatment of Hyperpigmentation
- Treatment of melasma and other hyperpigmentation disorders often involves topical agents, such as hydroquinone, and other therapies, including chemical peels and laser therapy 5, 6.
- Oral tranexamic acid has been shown to be a promising new treatment for moderate and severe recurrent melasma 5.
- Treatment of hyperpigmentation disorders should be individualized and may involve a combination of therapies to achieve optimal results 6.