Birth control is good for a lot of things—clearing up acne and excess oil, lessening heavy periods and PMS symptoms, oh, and preventing pregnancy. For many women, it’s a little miracle pill known to take care of a wide range of life’s little annoyances. But it’s not all good. The very pill that keeps your skin clear and acne-free could be causing an entirely different but equally troublesome skin imperfection—dark spots.
Scroll through to find out if the pill is compromising your skin.
How Birth Control Affects Melasma
Have you ever heard of the “mask of pregnancy,” an area on the face (usually from the upper lip to forehead) that's covered in brown spots? It's common in pregnant women, but melasma (as it's more often referred to) affects plenty of women who are not with child. Many of those women are taking birth control pills. The reason is simple: hormones. Melasma occurs when melanocytes (the cells responsible for creating melanin, or pigment, in your skin) are stimulated into over-producing melanin-et voilà: dark spots. As you're probably aware, this happens from sun exposure (hence sunspots). But those melanocytes are also stimulated by the female sex hormones estrogen and progesterone. When you're taking the pill, those hormone levels change, and the result for many women is hyperpigmentation.
What You Can Do
Anyone can get hyperpigmentation, including men. People who naturally have more melanin in their skin have a higher likelihood of developing dark spots. It’s also hereditary, so some people are predisposed to the condition thanks to genetics. But melasma is most common among women who are pregnant, taking contraceptives, or who are on hormone replacement therapy.
For pregnant women, the condition usually clears up in the months after giving birth. Not surprisingly, women who are taking birth control can expect to see brown patches linger as long as they are using contraceptives. If you can’t part with the pill, talk to your doctor about switching to one with a lower dose of hormones. Better yet, ask about the mini pill. The mini pill (you’ll see it as Micronor, Nora-BE, Nor-QD, or Ovrette) is a progestin-only pill, so it doesn’t contain any estrogen, and it has less progestin than typical combination pills (like Estrostep Fe, Lo Loestrin, Ortho-Novum, Ortho Tri-Cyclen Lo, Yasmin, and Yaz).
What Is Hormone Replacement Therapy?
A form of hormone therapy used to treat symptoms associated with female menopause.
Even once your hormones have leveled off, your dark spots may need some extra attention to go away entirely. Keep scrolling for a few treatment options.
Murad's Rapid Age Spot and Pigment Lightening Serum is formulated with the highest level of hydroquinone available without a prescription. In other words, it works to fade dark spots and decrease hyperpigmentation.
Talk to your doctor about whether your skin can handle a prescription-strength retinol, like Tretinoin. If not, start slowly, with an over-the-counter product like First Aid Beauty's FAB Skin Lab Retinol Serum, which is gentle enough for even sensitive skin.
Azelaic acid is another ingredient often used to combat hyperpigmentation. The Ordinary's Azelaic Acid Suspension offers 10% of the powerhouse ingredient, fighting uneven texture, dark spots, and breakouts.
AHAs (alpha-hydroxy acids) have an exfoliative effect, meaning they help shed dead skin cells over time. Skinceuticals' C + AHA product comes infused with both glycolic and lactic acids, as well as vitamin C and hyaluronic acid.
The best line of defense against dark spots is, of course, sunscreen. Supergoop's version offers broad-spectrum protection and can be used on a range of skin types.
Cleveland Clinic. Birth control options. Updated April 12, 2019.
Handel AC, Miot LD, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063
Cleveland Clinic. Melasma. Updated July 27, 2020.
Hollinger JC, Angra K, Halder RM. Are natural ingredients effective in the management of hyperpigmentation? a systematic review. J Clin Aesthet Dermatol. 2018;11(2):28-37.