Melasma And Other Skin Manifestations Of Oral Contraceptives

Pigmentary anomalies, particularly melasma, were common skin changes from oral contraceptive use, appearing in 24-29% of users in two studies. Melasma, a blotchy hyperpigmentation of the face, often emerged 1-4 months after starting the pill and showed minimal improvement in most cases even after stopping the drug. Histological exams revealed normal epidermis with pigment in the basal cell layer. A history of pregnancy-related melasma was a significant predictor. Other skin issues included acne, alopecia, aphthous stomatitis, erythema nodosum, and urticarial reactions. Reducing sunlight exposure and progesterone, and using hydroquinone cream, provided slight improvements.