I am a woman who has been taking the Pill. Lately I have noticed dark spots on my cheeks and around my mouth. Could this be a side effect from the Pill? If it is, what should I do about it?

-- Freckled Femme

Yes, this is a side effect of the Pill, an effect known as chloasma or melasma. The condition is not dangerous, but it can be displeasing, and it occurs in a fair number of women taking oral contraceptives.

Birth control pills contain synthetic estrogens, which can cause your body to become more sensitive to ultraviolet light. Sun exposure can stimulate melanin pigment cells more than normal, and often in an uneven pattern.

You should try and limit your exposure to the sun, either by wearing more protective clothing or using more sunscreen. You should also talk to the doctor who prescribed the Pill and tell him or her about these side effects. Changing brands or switching to a lower dose can often help.

These spots will usually fade after you change pills and/or get out of the sun. However, sometimes some discoloration will remain. In that case, a dermatologist can recommend various skin bleaching agents if they are still very visible. Although the spots are probably making you self-conscious, rest assured that the condition is not dangerous and will fade over time, so try not to worry about it too much.

-DocXXX

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