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brown patches on skin = melasma

jd2
hi everyone!
a long time ago (maybe a year or so), i was talking to someone about some brown patches on my skin (and theirs) that look like collections of freckles, and that my endo said they were caused by my thyroid problem.
i said i'd post if i found any more info, so hopefully whoever i was talking to will see this!

i stumbled across a skin condition called melasma while i was googling contraceptive pills, and realised this sounds exactly like the patches on my skin that i have, but i have it on my back and arm not my face (although my back and arms probably get more sun than my face because i wear hats).

with a google search for melasma and thyroid, i found an article that found that in their study "there was a true association between thyroid autoimmunity and melasma, mostly in women whose melasma develops during pregnancy or after ingestion of oral contraceptive drugs." (http://jcem.endojournals.org/cgi/content/abstract/61/1/28).

there are also some suggested treatments on the internet, but mine's not anywhere im really worried about, so i probably won't be trying those (although i do find mine gets fainter during winter when im out of the sun).

hope this info gets to the right person, or helps other people out!
24 Responses
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Avatar universal
Try to avoid exposing your face to sun, wear hats or use strong sunblock (neutrogena 90 with helioplex) every day under makeup when exposed to sun. Continue to gently exfoliate. Will take a while, but should lighten. After I went off birth control and started using block more often, mine went away, but took years. When I get in the sun, I can see traces of it...
Helpful - 0
Avatar universal
hi guys,
I have dark patches on my face, mainly cheek, forehead, and eyebrows. I have tried a whole load of lotions and potions. | am currently trying the face peel and laser. with Very little progress, have not been to my gp as yet. I was diagnosed with Hypothyroidism some years ago, and since then my face is in a mess. Im new to all this, so any advice would greatfully accepted.
Helpful - 0
Avatar universal
It's not just birth control. I haven't been on birth control in my life and I have horrible melasma on my upper lip and right cheek bone area. It developed about a year ago. I can't cover it with make up. I wear SPF 40 sun screen, avoid the sun and guess what...I have Hashimoto's/Hypothyroiditis! I have had it for almost 14 years now. I asked my endo about it and he said it could be from the Hashi's/Hypo since it is related to a hormonal issue most likely. And it would explain it since my melasma started to get REALLY dark a few months ago when my thyroid levels went all wacky due to my Hashimoto's.  While it is true that some birth control can cause it, it is because of the high levels of estrogen from the birth control...estrogen can cause a build up of copper in the body...copper can lead to melasma/hyper pigmentation and other issues.  
I was tested for Addison's Disease and was negative for it. I have been checked for adrenal fatigue and was negative for it. So for me...it only leaves my thyroid issues. I hope that my thyroid is level again soon to help these spots lighten up. Especially since the nice weather is here and I'd like to get outside. They are so dark right now it's not worth going out if I don't have to and I have started to use sunscreen inside as well and keep the blinds down and the curtains closed. Yes, it's that bad. I hope someone finds something that works for us soon! GL to you all!
Helpful - 0
Avatar universal
I have just noticed this dark "mustache" looking appearance above my lip and I don't like it at all... I have been having pretty severe muscle cramps and my dr. just ran a TSH test but it came back .84 which shows normal is .34 and above, so I am wondering what else can be causing this... I am getting very self conscience of it!
Helpful - 0
Avatar universal
It is birth control ladies... I began taking birth control before I got married, went on my honeymoon and as soon as the sun hit my skin, I got really bad malasma.  Worst honeymoon ever! I've been in the sun my whole life and never had issues until bc. And it doesn't go away even when you stop taking the bc.  Mine didn't for a long time, worse if you're in the sun a lot.  Mine finally faded years later and only because I'm not in the sun a lot anymore and fanatical about sunscreen and keeping my face out of the sun.  Came back when I got pregnant tho'.  I won't take anything that can have that much effect on my skin, body or mood.  Not worth it, there are other ways... I don't know why the health professionals seem to know so little or be totally unconcerned with all of the side effects....
Helpful - 0
Avatar universal
From the reading I've done 3.2 TSH is on the hypo side for women. Normally between 1 and 2 is ideal for women to be in balance. As such some endos consider 3.2 to be outside of normal. There are revised recommendations out there to cap the normal range at 3 for the upper limit. Be careful about what doctors say is normal because some people are more sensitive than others to even mild thyroid disfunction. If you're above 3 I think they should check you for antibodies.

From a personal point of view I have melasma and have also been diagnosed as hypothyroid. I'm very sensitive in that I get symptoms if my TSH is elevated even if apparently my T4 and T3 are "normal". The doctor is still trying to find the right thyroxine dose for me to correct the thyroid imbalance but my TSH was between 1 and 2 for a short time and during that time I noticed some normal colored skin starting to appear in amongst the melasma. Not a lightening of the brown but little normal patches forming in the middle as though individual pigment cells were starting to go back to normal. This was even though I still took birth control. Now I am hypo again (my TSH is elevated) and the fading has stopped and other symptoms have somewhat returned. I definitely think the melasma and the hypothyroidism are related and I'm hoping when I get the right dose of medication and my TSH is between 1 and 2 in a stable way the melasma will fade altogether.

Definitely I think people with melasma should get a thyroid function test in case there is a link in their situation.
Helpful - 0
550611 tn?1214952010
I have just had my Physicians Assistant tell me that my thyroid was fine at 3.2 TSH. I have melasma and I use try luma to fade it. My boyfriend asked me if I was using that fake tan stuff on my face because it was wearing off funny. I didn't use fake tan though. I had darker skin all around my hair line, my upper lip and my eyes. Now I am wondering if my PA is wrong.
Helpful - 0
Avatar universal
I have melasma that started with my last pregnancy two years ago.  It is getting diffiuclt to hide the spots on my cheeks and above my lip.  I am getting ready to see a dermatologist, but now I see this might be related to thyroid disease.  
As far as I know, I do not have hypo, but my father has hyper, his sister has hypo, his mother, my paternal grandmother, has hyper...  I am so scared I am next.  I have gained a lot of weight resently and I am ratehr fatigued, which  attributed to the weight gain.  I am the heaviest I have ever been at 191 lbs; I am usually about 165.
Are there more absolute symptoms to look for?  Advice please.
Helpful - 0
Avatar universal
hi i have just read your posted comment i have been so depressed about the dark line above my lip that seemed to appear about a year after my first child.  After my second child my hair receeded really badly especially on one side, but this has sorted itself on its own, and is ok now.  Does this sound similar to you?  What test do i need to ask the doc for?  So hope this helps want to enjoy going out with kids instead of locking myself away...

your help will be much appreciated von
Helpful - 0
Avatar universal
jd2
wow! i didnt realise it was so common. thanks to everyone for your comments. im lucky at the moment and only have a small spot on my face (and the ones on my back and arms dont really bother me), but if it gets worse i'll definately be trying the triluma!
Helpful - 0
209405 tn?1189755821
Thanks!

The spots on my hand went away. And it was just one hand...weird. I wonder if thyroid made me more sensitive to the sun because I've never tanned, have always worn sunscreen, and avoid direct sun like plague when I'm outside. Sometimes my eyes can't take the bright light.
Helpful - 0
185634 tn?1257071139
I'm so glad that you're feeling better!!  It's amazing how much that little gland can affect the way you feel.  I had NO idea until I had to start dealing with this almost a year ago.  

As far as your spots, they could be from the sun.  I have them all over my shoulders now too - especially in the summer.  I'd definitely keep an eye on them, and if they start changing, see a dermatologist.

Good luck to you, and congrats again on feeling good!!

Lori
Helpful - 0
185634 tn?1257071139
I'll have to try that Neutrogena moisturizer this summer.  I too, loved being in the sun and getting tan.  I was well into my 30's before I quit.  I'm sure that didn't help matters any.  I still love being outside in the summer, I'm just way more careful.  A tan face isn't all what it's cracked up to be.  These last couple of years have been awful, trying to cover up my skin mustache.  I just hope it's gone for good.

My hair was falling out too, which was not so good since it's fine and thin to begin with.  I've been on my meds for about 3 months now, and it's starting to slow a bit.  I even have some new growth in there!  Don't think I'll ever have nice thick hair like I used to have, but at least I don't have to clean the shower drain twice while I'm in there!
Helpful - 0
209405 tn?1189755821
I have Graves, still have my thyroid and currently taking antithyroid med, PTU. It's working for me and I feel a whole world from where I began. I am not on birth control and haven't been for a few years.
Helpful - 0
277535 tn?1218136198
I hope so too!!

it's funny that once I realized my hair was falling out, I quit worrying so much about my skin mustache!!  

Neutrogena makes a tinted daily moisturizer with an spf of 30 that I use in the summer and love.   I now realize that sunscreen is my skin's best friend...I have come a long way since my tan teen years!!
Helpful - 0
185634 tn?1257071139
Oh my gosh!!  Same with me!!  When I first noticed it, I thought it was hair.  So I got the 'ol wax out (which I use for my eyebrows), and OH BOY, did that smart!  But after I was done, I realized it was the skin as well.  Very nice.....NOT!  I started using concealer and that worked for a while until they got really dark.  Then nothing would cover them.  I was so self conscious about them.  

Well, I have the Triluma that I can go to if they come back next summer, but by the looks of things, they may be gone for good.  Let's hope so!  Hopefully it's the same for you.

Lori
Helpful - 0
277535 tn?1218136198
Oh yeah, I have read that too much ACTH in the system can cause dark spots.

This is from Wikipedia- Melasma
"The condition most commonly causing the darkening of skin is known as Addison's disease. The darkening may be brown or reddish, typically appearing in the creases of the palms, pressure areas of the body and the mouth. In Addison's disease it is caused by excess production of adrenocorticotropic hormone (ACTH), which simultaneously releases a compound called melanocyte stimulating hormone (MSH)."
Helpful - 0
277535 tn?1218136198
It made my upper lip look all red and dried out.  I would have to put lotion on continuously throughout the day because my skin was peeling big time.  It kind of looked like i had a cold when your nose gets all red from using tissues but it was on my upper lip.  It was quite attractive!!  

I only use it every now and again when I think I can see it.  For awhile there I thought I just needed to bleach my upper lip hairs but then I realized it was my skin!  It is not like it was back in April so I guess I will just wait and see what happens!
Helpful - 0
185634 tn?1257071139
By the way.......I haven't been on birth control pills for over 15 years, so that had nothing to do with mine.

skymax ~ What is your thyroid story?  Do you still have yours?  Are you on meds?  Makes one wonder, doesn't it?

barleypop ~ Did the Triluma make you itchy too?  It really dried my skin out and made it a little red, but it also itched like crazy!  I haven't used it very many times, because like I said....it's pretty much gone.
Helpful - 0
209405 tn?1189755821
I had got these dark brown spots/freck-like on my hand recently. I thought they were caused by bug-bite and went to Urgent Care. They said it was sun or age but I always wear sunscreen and I'm only 31. I'm also getting them on my chest and stomach.  
Helpful - 0
185634 tn?1257071139
I was the one in question that was complaining about the brown spots on my upper lip.  I actually made an appointment with the dermatologist before I had my thyroid removed (due to cancer).  Lo and behold, once the thyroid was gone, the brown spots started to fade.  By the time I saw the dermatologist, they were almost gone - but so was the summer sun.  I decided to go ahead and get the Triluma as well - in case it comes back next year.  BUT, it started out of the blue and was there year round for two years.  I asked my doc, my endo, the surgeon, and the dermatologist - and all of them said the same thing.......they didn't think that my thyroid condition had a thing to do with it.  

I'm not a doctor, but I do know my body.  I beg to differ on that one, but I'm not complaining because they're GONE!!  We'll see what happens when summer comes again, but given the fact that they were pretty dark last winter, I'm thinking it won't be a problem......thank goodness.  Nothing worse than a middle aged woman looking like she has a mustache!!  Yuck!!  

Lori
Helpful - 0
277535 tn?1218136198
I have melasma on my upper lip!  Yes, the mask of pregnancy....I almost flipped out when I heard that one!!  

I thought it was caused by my birth control pills (Allese 28) back in March 2007 (prior to diagnosis with hypo) so I switched to a progesterone only birth control pill because I was convinced it was the estrogen in my bc pills.  I had been on the Allese 28 for 6 years before I noticed the melasma so I am not sure if it was birth control related.  I took the progesterone only bc pill until August when I noticed my hair falling out and went to the gynecologist to change birth control pills again.  I told her about my hair falling out and my skin breaking out (i had clear skin all my life so this was weird!).  The doctor didn't think it was bc pill related so she checked my thyroid and low and behold I was hypo!  

I guess I am trying to say is that I don't know if it is birth control related or if it is my thyroid.  I have been off birth control since Sept but I still have faint spots above my upper lip.  nobody else can see it but I do.  I use Triluma cream which was prescribed by my gynecologist but my dermatologist said it is what she prescribes as well.  It does work but it makes you skin reddish and dry...but usually only the day after you apply it.  I don't use it every night any more (i think you only use it for 6 to 8 wks).  

All I know is that I am never messing with my hormones again!!  I still am not sure if my hair falling out is/was caused my my thyroid, stopping birth control with estrogen in it back in Sept., or the thyroid meds!!  

Just use lots and lots of sunscreen because the sun makes the spots worse!!  I work outside in the summer so I lather it on!!  
Helpful - 0
212753 tn?1275073111
stay o a at least a 30 block sunscreen and to fade them you need to use a good beta hydroxy exfloiator. alot of our meds make us hyper sensitive to the sun. Paulas Choice has a great exfolitaor on her website but sunscreen is a must or it will come back.
loveVenora
Helpful - 0
168348 tn?1379357075
I *think* I recall some people have/had this with their thyroid over their lip and around their lip .. somebody on the board I think ????

Thanks for the info and link ........ like mask of pregnancy was it called?

Cheryl
Helpful - 0
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