Synonym
Chloasma, MelasmaThe occurrence of pigmentation disorders caused by the pill occurs in almost 10-20 percent of patients who take the pill regularly or permanently. These are mainly pigment disorders in the area of the face and pigment disorders of the neck. The pigment disorder is usually manifested in flat, brownish skin areas in the area of the cheeks, forehead, chin, upper lip, bridge of nose and temples.
This is an excessive coloration (pigmentation) of the skin, also known as hyperpigmentation. The pigmentation disorder is usually distributed symmetrically. The pigmentation disorder can also frequently occur in the area of the forearms.
The skin change is purely cosmetic in nature. There is no pain, itching or other symptoms. Excessive pigmentation when taking the pill is also called melasma or chloasma. To be more precise, the term melasma is used for pregnant women and chloasma for other hormone-related pigmentation disorders of various causes.
Cause
The cause of the pigment disorder caused by the pill is hormonal. The pill contains so-called estrogens, i.e. female hormones, which can have an influence on the production of pigments in the skin. There are various speculations as to what effect exactly the female hormones have on the pigment-producing cells.
Some assume that the estrogens stimulate the pigment-producing cells (melanocytes) to multiply or divide. Other sources assume that the melanocytes are stimulated by the female hormones to produce the pigments when exposed to sunlight. There are 2 types of pigments, the red pheomelanin and the black eumelanin.
The melanocytes are located in the lower layers of the skin, so that they pass on the pigment to the upper cells, which are called horny cells. These horny cells are rejected and regenerated from time to time, so the pigment disorder is reversible once the cause of the increased pigment production is eliminated. As a result, some areas of the skin produce more pigment, which is deposited in the skin and discolors the area darker than the surrounding skin.
In addition to the female hormones, the influence of UV radiation can also intensify the pigment disorder, so that it is recommended to avoid excessive sun exposure or visits to solariums, to apply cream with a high sun protection factor or to take the pill in the evening so that the estrogen level during the day is lower. Another risk factor that can contribute to pigment disorders is thyroid disease. Stress is also suspected of stimulating the production of a hormone called melanocyte-stimulating hormone (MSH), which can also stimulate hyperpigmentation.
Further risk factors are increased moles, intake of various cosmetics, drugs, perfumes. It has also been observed that people from warm climatic zones are more likely to have an increased risk of pigmentation disorders. As this is a hormone-related effect, a similar form of pigment disorder also occurs during pregnancy, as increased levels of female hormones are also produced there. This form of pigment disorder can also be triggered by taking other estrogen-containing preparations, for example during menopause. Finally, there is a genetic risk of suffering from a pigment disorder when taking the pill.
