Dark spots on the face, also known as hyperpigmentation, can occur for a variety of reasons. However, hormones often play a significant role in the development of these dark spots. Hormonal changes related to pregnancy, birth control pills, or conditions like polycystic ovary syndrome (PCOS) can trigger an overproduction of melanin which leads to hyperpigmentation on the face. Understanding which hormones are involved and how they cause dark spots can help find effective treatments.
Melanin and Hyperpigmentation
Melanin is a pigment that gives skin, hair, and eyes their color. It is produced by cells called melanocytes. When melanocytes become damaged or overactive, they can stimulate an overproduction of melanin. This excess melanin is deposited in clusters on the skin, causing darker patches or spots to appear.
Areas of increased melanin production are referred to clinically as hyperpigmentation or melasma. Melasma can show up as tan, brown, or grayish patches on the cheeks, nose, forehead and chin. It is especially common during pregnancy, but can also be triggered by hormonal birth control methods or conditions like PCOS that create hormonal imbalances.
Hormones That Contribute to Hyperpigmentation
Estrogen
Estrogen is the main female sex hormone. It plays an important role in the menstrual cycle and reproduction. Estrogen levels rise rapidly during pregnancy. This hormonal change causes the melanocytes in the skin to step up production of melanin. The high levels of estrogen during pregnancy often lead to melasma, referred to as the “mask of pregnancy”, on the face.
Estrogen levels also increase with use of birth control pills or hormone replacement therapies during menopause. The estrogen causes overstimulation of melanocytes and can worsen facial hyperpigmentation.
Progesterone
Progesterone is another female hormone that works with estrogen in the menstrual cycle and pregnancy. Progesterone levels also surge during pregnancy, remaining elevated throughout the 9 months.
Researchers believe that estrogen combined with high progesterone increases the risk of melasma in pregnant women. The hormonal impact makes pregnant women especially prone to facial hyperpigmentation and dark spots.
Melanocyte Stimulating Hormone
Melanocyte stimulating hormone (MSH) is made by the pituitary gland. It binds to melanocytes and directly triggers melanin production. When MSH levels are too high, it can overstimulate melanocytes and cause hyperpigmentation.
Hormonal conditions like PCOS lead to elevated MSH levels. The excess melanocyte stimulating hormone darkens facial skin by boosting melanin production.
Thyroid Stimulating Hormone
The thyroid uses thyroid stimulating hormone (TSH) to control metabolic functions. When thyroid activity is too high or low, TSH levels fluctuate abnormally. This can impact melanin synthesis and cause facial pigmentation.
Hyperthyroidism, hypothyroidism and Hashimoto’s thyroiditis influence TSH and thyroid hormones. Altered TSH levels from these thyroid disorders can stimulate melanocytes and cause melasma.
Other Factors That Promote Facial Hyperpigmentation
Inflammation
Inflammation is a key driver of increased melanin synthesis. Estrogen and progesterone elevate inflammation markers. Pregnancy is a prolonged inflammatory state. Chronic inflammation from autoimmune and hormonal disorders also sparks excess melanin production.
Genetics
Genetics make certain individuals more susceptible to facial hyperpigmentation when hormones fluctuate. Hispanics, Asians and those with darker complexions have greater risk of melasma during pregnancy or with oral contraceptives.
Sun Exposure
Ultraviolet rays from sunlight cause inflammation and skin damage. This melanocyte stimulation is heightened when combined with hormonal changes. Sun exposure makes the facial hyperpigmentation worse.
Skin Injuries
Injuries to facial skin from acne, rashes, burns, scratches or other trauma can trigger increased melanin production. The localized inflammation and skin healing ramps up melanocyte activity.
Hormonal Causes of Hyperpigmentation by Area
| Area of Face | Hormonal Cause |
|---|---|
| Cheeks | Melasma during pregnancy from elevated estrogen and progesterone |
| Forehead | Hyperpigmentation from high estrogen birth control pills |
| Upper Lip | Melasma related to hormonal conditions like PCOS influencing MSH and inflammation |
| Chin | Dark spots triggered by thyroid hormone fluctuations |
| Jawline | Hormonal acne leads to post-inflammatory hyperpigmentation as skin heals |
Treatments for Hormonal Hyperpigmentation
Avoid Triggers
Preventing dark spots from developing involves avoiding potential triggers:
- Use sunscreen daily and limit UV exposure
- Treat skin gently to prevent injury and inflammation
- Avoid oral contraceptives with high estrogen
- Control hormonal disorders like PCOS or thyroid imbalance
Prescription Creams
Prescription treatments like hydroquinone, tretinoin, azelaic acid, and kojic acid can lighten areas of hyperpigmentation. They work by blocking melanin production in the skin.
Chemical Peels and Lasers
In-office procedures like chemical peels and laser resurfacing remove the top layers of skin to eliminate dark spots. Results are longer lasting but require repeat treatments.
Natural Lighteners
Natural ingredients like vitamin C, niacinamide, licorice extract, mulberry extract and soy help interrupt melanin synthesis to gradually fade dark facial spots.
Conclusion
Hormonal fluctuations are a major cause of dark spots and melasma on the face. Estrogen, progesterone, MSH and thyroid hormones can all stimulate melanocyte activity and trigger hyperpigmentation, especially in sun-exposed facial areas. Avoiding triggers and using lightening creams, chemical peels or natural ingredients help treat hormonal hyperpigmentation. Controlling the underlying hormone imbalance is key to preventing recurrent dark spots on the face.