Hi everyone.

My GF wants to start taking BC pills but she has a small melasma spot on her face which she is really worrying about being a girl. As far as I know, melasma is a skin condition that can get worse with sun exposure and with hormonal changes.

She just returnet to Thailand last night after being in Canada for 6 months and her melasma improved a lot so I guess it might me mostly sun exposure in her case, so she wants to try start taking BC pills.

I read that some women have their melasma getting out of hands when they get pregnant but in many cases it goes away after they give birth and their hormones go back to normal levels.

So the question is: which hormones have bigger influence on melasma - estrogen or progesterone, (or both equally) and which BC pill has more or less one or the other hormone? Which brand would you recomment and what dosage?

P.S. She would go see a doctor but I like doing my research first personally before I see one so I know what to ask for.

It is important to have the skin looked at by a qualified dermatologist; here in Thailand with the unfortunate attitude to darker skin and the obsession with lighter skin, dermatologists are very aware of the issue but there are also quite a number of characters out there who practice some unscientific and sometimes unethical methods of treatment.

Melasma will not go away; merely fades with less sun exposure. All birth control tabs will make it worse and pregnancy most often results in the areas remaining darker than before even if it gets a bit less after a normal hormone balance returns.

So key is to avoid sun exposure and use a high SPF factor sunblock or hat when exposed.

It's an exclusively female thing and the exact cause is still not known...

It is not known for certain but it is thought that the estrogen is the culprit, hence either a pill with the lowest possible dose of estrogen (0.02 mg i.e. 20 mcg) or a progestin-only pill would likely cause less of a flare up than the more common brands which usually contain 30 - 35 mcgs of an estrogen.

20 mcg brands in Thailand include:

Meliane

Annylynn

Ciclomex

Lindynette

Yaz

(altho these are all similiar in estrogen content they contain different types of progestin so a woman who tolerates one will not necessarily tolerate all and vice versa)

Progestin-only brands include;

Cerazette

Exluton

Hyan

Be warned that with both the low dose estrogen and the progestin-only pills, the risk of pregnancy is greater if a single pill is missed than would otherwise be the case.

She should be sure to use sun screen.

if the melasma does flare up anyway, it will usually subside after stopping the pills.

Thanks Sheryl, this is the answer I was looking for.

Here is one more question about progesterone only pills. I heard somewhere that it causes weight gain. Is it correct or am I wrong?

So netimes they do. For that matter so sometimes do the combined (estrogen + progetsin) pills. Won't know until she starts as every woman repsonds a little differently.