Ask Charlotte: Can An IUD Help My Melasma?

Every woman knows the terrors of birth control: emotional roller-coasters, skincare nightmares, unexpectedly heavy periods, cramps—the list goes on and on. One reader wonders specifically if the IUD (intrauterine device) can help with melasma (darkening birthmark-like patterns on the skin), which has been worsening with her hormonal pill birth control. If the IUD can help, which brand is best? We reached out to Dr. David Shobin, an obstetrician and gynecologist with over 35 years of experience.

QUESTION — MELASMA + IUDs:

I've been on birth control since I was 14, and lately it's been making my melasma even worse. I'm thinking about getting an IUD. Do you have any thoughts on how that might affect my melasma? Do you recommend a particular IUD?

ANSWER — DR. DAVID SHOBIN:

For a long time it was thought that the excessive melanin production of melasma was due to an overproduction of progesterone, especially in pregnancy, when the placenta's progesterone is copiously produced. This probably also applies to BCPs and the LNG-52 IUD's like Skyla, Mirena, and Liletta. An IUD is a marvelous—and underused—form of contraception. That leaves the progestin-free IUD, ParaGard, which has also been around the longest. Side effects (10%) are slightly increased menstrual flow and possibly slightly increased menstrual cramps. Highly recommended.

IN OTHER WORDS:

Some IUDs that use hormones—Skyla, Mirena, and Liletta—can cause an overproduction of progesterone, which has been linked to melasma. Dr. Shobin recommends the hormone-free IUD ParaGard for someone with melasma issues.

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Dr. Shobin also writes about how hormones affect skin. While we're on the subject: are your ladyparts pH balanced? Does it matter?

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