| Abstract [eng] |
SUMMARY The Relationship Between Changes in Skin Pigmentation and the Use of Combined Contraceptives Author: Jonė Grabauskaitė Supervisor: Indrė Trečiokienė Objective: To analyze the association between hormonal contraceptive use and skin pigmentation changes and to identify factors influencing the development of hyperpigmentation. Aims: 1. To determine the prevalence of pigmentation changes among reproductive-age women using hormonal contraceptives. 2. To identify factors that may influence the development of pigmentation changes during hormonal contraceptive use. 3. To evaluate women’s attitudes toward pigmentation changes associated with hormonal contraceptive use. 4. To assess the experiences and practices of healthcare and pharmacy specialists in counseling patients about possible pigmentation changes related to hormonal contraceptive use. Methods: A mixed-methods study comprising quantitative and qualitative components was conducted. In the quantitative part, data were collected through an anonymous questionnaire survey of women currently using or previously having used hormonal contraceptives. The collected data included demographic characteristics, contraceptive use patterns, occurrence of pigmentation changes, the influence of risk factors (UV exposure, stress, nutrition, genetic predisposition), localization and intensity of pigmentation, and other related factors. Chi-square (χ²) tests were applied, and p < 0.05 was considered statistically significant. In the qualitative component, four semi-structured interviews were conducted with a dermatologist, a gynecologist, a family physician, and a pharmacist. Thematic analysis was applied to the qualitative data. Results: In the study group (n = 352), 15% of women reported experiencing pigmentation changes while using hormonal contraceptives. Most pigmentation changes were assessed as mild (42%) or moderate (44%) in intensity and were most commonly localized in the facial area (85%). The occurrence of pigmentation changes was statistically significantly associated with the duration of 6 contraceptive use (>3 years) (p = 0.040) and stress level (p = 0.023). No statistically significant association was found between pigmentation changes and dietary habits (p > 0.05). In the qualitative part of the study, specialists indicated that pigmentation changes are a possible, though not the most common, adverse effect of hormonal contraceptives and that their development is influenced by multifactorial mechanisms, including UV exposure, hormonal effects on melanocytes, and characteristics of the dermal microenvironment. All specialists emphasized the importance of photoprotection; however, they acknowledged that patients often do not receive sufficient information about pigmentation prevention. Conclusions: 1. Skin pigmentation changes are a possible side effect of hormonal contraceptives. 2. The development of pigmentation is influenced not only by hormonal contraceptives but also by individual and environmental factors. 3. Women’s awareness of pigmentation changes remains insufficient. 4. Healthcare professionals still lack knowledge about pigmentation as a possible side effect of hormonal contraceptives. |
