What should you know about Mirena and melasma?

Melasma presents as flat brown or grey-brown patches, often on the cheeks, forehead, upper lip or jaw. Hormonal shifts can make pigment-producing cells more reactive, while sunlight and visible light can deepen the colour. The timing of patches after Mirena placement is useful information, but it cannot by itself establish causation.

Melasma is different from every other dark patch. A clinician may examine the distribution and surface of the skin to distinguish it from sun-damaged skin, post-inflammatory pigmentation or another lesion.

Use broad-spectrum sunscreen and physical shade consistently, and consider a hat when outdoors. Choose gentle, fragrance-free skincare and avoid picking or irritating the patches. Photograph the areas in similar lighting so changes can be tracked during review.

A dermatologist may discuss skin-brightening treatment, prescription creams or procedures such as chemical peel, microneedling or laser toning. Procedures can irritate some skin and worsen pigmentation, so treatment should be tailored to your skin tone and the diagnosis.

Arrange an assessment for a new, changing, one-sided or irregularly coloured patch, bleeding, crusting, pain or a spot that does not resemble the rest of your pigmentation. Seek advice before stopping Mirena if contraception is important; a clinician can weigh skin concerns against reproductive needs.

Does this pattern fit melasma or another cause of dark patches? Could Mirena, pregnancy, medicines or light exposure be contributing? Which sunscreen and treatment suit my skin tone? What are the risks of a peel, microneedling or laser treatment for my pigmentation?