HRT and hyperpigmentation

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Just had some cosmetic surgery round my eyes that should have healed in 2 weeks but I have brown hyperpigmentation which is impossible to cover. My Dr thinks it’s triggered by the bio identical estrogen I’m taking and that it will take weeks to resolve. I wasn’t asked about any hormones before the treatment and hadn’t considered this to be a complication so wasn’t prepared. This post is partly to warn others and partly to ask for suggestions to resolve quickly.  

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  • Posted

    Yes Brown hyper-pigmentation can be an issue with estrogen, and also suggests sun damage. Another issue with estrogen can be small round red colored dots. I got one on my breast and also one on the top of my leg. 

    As far a resolution,  are you also taking progesterone to offset the estrogen?  

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    • Posted

      I have the mirena coil fitted so hadn’t considered anything extra. I haven’t had any pigmentation issues until a non surgical cosmetic treatment which required wound healing. Worrying.
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  • Posted

    Isn't the Mirani coil progestin only, i.e. no oestrogen?  What bio-identical oestrogen are you using?

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    • Posted

      I take topical estrogen- estrogel, 2 pumps a day. Mirena is progesterone only and I clearly can’t reduce or increase the dosage but I can come off the estrogen for a while to let the levels decrease which will hopefully help my skin recover. I have had melasma in the past but hadn’t had any whilst on the HRT. It looks really bad but I’m hoping in a few weeks it will look better. I’ve been told to use Azelaic acid on the patches and am having an infrared light treatment today just make sure any inflammation has gone.
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    • Posted

      If you google this condition, there are a lot of reasons for hyper-pigmentation to occur, and some relate to post-inflammatory hyper-pigmentation from skin injury and going out in the sun.  Hemosiderin could be the cause too.  If this is the case, then it is likely to heal and fade as your  skin absorbs it.

      Hemosiderin would relate to injections which could pierce the artrioles and let blood flow into the skin, and skin peeling for the post-inflammatory hyper-pigmentation.  (Just trying to think of cosmetic treatments that are not surgical but require wound healing examples.)

      Vitamin C gels/creams and retinoids are said to help but usually it is instructed to not put around the eyes!  They do say to stay away from laser therapy.

      My mum had hyperpigmentation around her eyes and she never used oestrogen - just not in her time.  And it is funny that some of what I read blamed it on progestin as oestrogen helped prevent the build up of melanin.  Then it was also adrenal hormones, etc.

      Perhaps just give it more time.  I for one, would not interfere with my oestrogen supplementation when it was working for me.  Messing with oestrogen supplementation creates a hell worse than hyper-pigmentation. smile  Or perhaps if you don't experience any problems with reducing your oestrogen, then you probably don't need it for now.

       

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