Plenty of us were put on birth control in our teen years, whether it was to control our menstrual cycle, regulate our skin, or, quite literally, control the possibility of birth (novel concept!). I didn't go on birth control until I was 22, and while some of my girlfriends hated the side effects, I only experienced the benefits. My skin was gorgeous, my cycles were shorter, and I gained weight — but in all the right places. What was there to complain about?
Four years later, at 26, I had noticed my skin tone was uneven but didn't think much about it. During a visit to Renée Rouleau  — Demi Lovato's esthetician — she informed me that there were dark spots on my cheeks and above my lip, which she diagnosed as melasma. Renée asked me a few questions during my facial to pinpoint what the culprit could be.
"Do you take birth control?"
"Yes . . . "
"That's more than likely it. Melasma can be caused by hormones."
Um, excusez-moi? No, Renée, birth control solves all of my beauty woes — it does not create new issues! Admittedly, I thought those symmetrical spots on my cheeks were the remnants of the self tanner I had applied to my face. So naive, Kirbie, so naive . . .
What is melasma?
With any skin issue I think I have (or, apparently, actually have), I do my research. Melasma  is referred to as "the mask of pregnancy," because expecting women tend to get it due to the surge of hormones they experience. It's dark pigment that can appear on the forehead, cheeks, and upper lip. All cases vary in intensity. It may disappear on its own, but more than likely, it will take some effort to remove. And it's clearly not reserved for moms-to-be — you can get it during any hormonal stage in your life, like puberty or, in my case, taking birth control.
Not so shockingly, melasma is also triggered by the sun. (Something my Texas-turned-SoCal skin knows all too much about.) In combination with the hormones, not even SPF 30 could protect me from melasma.
This launched my foray against these unwanted spots. First up? Visiting my dermatologist, who highly suggested I get off the pill. Pick your jaw up off the floor — she had good reason for this recommendation: since oral contraception was the issue, anything I would do to get rid of the pigment would likely be ineffective while still taking it. She also shed light on another beauty gripe I had. "Is your hair not growing? Could be an issue with the pill, too." That's when the lightbulb went off. My hair is fine, but it used to feel fuller back in college. Since then, it's been weak, and I can't get it to grow past my shoulders.
And that was that. Off the pill I went! It sounds simple, but this wasn't a rash decision. I took a lot of time to consider my options, the pros and cons; I dwelled on it for awhile. (I shouldn't have to say this, but I will: make sure this is the right decision for your body and your lifestyle.) I was able to get off the pill because it wasn't necessary that I stay on . . . if you know what I mean. But trust me, it wasn't easy.
What happened after I quit the pill
A week later, my skin broke out more than I've ever experienced in my life, which my dermatologist had warned me about. "Your body is so used to getting a certain amount of hormones every day, now it needs to adjust to not getting them."
The timeframe this hormone hell would take? "A few months, possibly a year."
As someone who works on camera for a living, I had to consciously remind myself about my goals for my skin — get it clear without oral medication — and not hop on an antibiotic to fix the breakouts quickly. In a few weeks time, I saw small improvements. I loved that my hair started to grow again and felt fuller than it had in years. And I appreciated that the melasma wasn't taking up more real estate on my face or getting darker.
What are the treatment options?
But it was still there. Nobody would notice if I wore tinted moisturizer, but it was still an insecurity of mine. I talked to Renée about my treatment options, and she suggested the following when it comes to treating melasma:
- Exfoliate regularly. "Exfoliation is beneficial for breaking up the pigmented cells to allow them to fade. Combined with a skin-lightening agent, such as vitamin C, exfoliation will help accelerate the fading process."
- Try retinol. "Retinol is an ingredient derived from vitamin A that is proven to lift brown spots and reduce the appearance of large pores, lines, and wrinkles. It's essential to use as part of an antiaging strategy to ensure even-toned skin."
- Get professional treatments. "Many of my clients are seeking the new Bio Brasion Treatment, which is the next generation of microdermabrasion," Renee said. "It's performed on wet skin and uses a crystal-free, low-suction abrasion system to exfoliate. Speak to your esthetician who can advise on treatments to treat hyperpigmentations." IPL photo facials are also helpful at breaking up the pigment.
- Always wear SPF 30 or higher. If you're spending time and money to get rid of your dark spots, make sure they don't return by wearing proper UVA/UVB coverage each day. Look for sunscreens with zinc oxide and titanium dioxide.
Overall, it took 12 months to get to the point I'm at now: clear skin with minimal dark spots. If you look close, you can still see the outline of the melasma on my cheeks, but it's significantly less noticeable than before. So, what did I do? I received four photo facials over the course of five months, which helped to break up the dark pigment on my cheeks, improve the texture of my skin, and enhance the overall tone. I went to SkinLaundry , which is essentially like a 10-minute dry cleaning service for your skin here in California, and it only cost $75 a session. (A deal in comparison to some IPL treatments.) Along the way, I used topical treatments at night from Bakel, Murad, and Caudalie — not all at once, mind you — and slathered on an SPF 30 moisturizer each morning.
As for my breakouts, I can't say they went away within a few weeks, or even a few months. It took about a year for my hormones to balance themselves out.
How I feel about oral contraceptives
Do I think that just because you have some dark spots that you should get off birth control? Definitely not. I know at some point I will have the need to get back on birth control! If you need oral contraceptives but are concerned about your skin, there are options! Talk to your gynecologist. Mine suggested getting on a minipill , which is similar to regular birth control pills, except it's progestin only. It's recommended for women who are breastfeeding, have certain health issues, or for women who have experienced melasma. There are side effects to every birth control option, so be sure to chat with your doctor on what's best for you, and if it isn't working out, switch to another pill.
Right after a shower. Here, the melasma doesn't look bad. In fact, the great thing about photos is that it masks my melasma some! This is after several laser treatments and using topicals. You can still see some remnants on my cheeks and above my lip.
Most melasma shows up symmetrically on the cheeks, on the forehead, and above the lip. You can see some pigment still hanging out above my cupid's bow.
The patch on the apple of my cheek is about an inch in length. At first I thought it was leftover makeup or self tanner.