The stimulation of epidermal melanogenesis by means of hormones has long been known. During pregnancy, for example, hormonal influences can cause an increased pigmentation in the face (chloasma), the areolae, the linea alba, and the perineal skin. After administration of estrogen-containing oral contraceptives, facial hyperpigmentation was observed in 8% to 29% of women. The application of estrogen-containing ointments to children can also lead to hyperpigmentations in the genital area and in the area of the nipples and the linea alba (3). One study found that of 62% of the women tested, hormonal influences in the premenstrual phase led to increased pigmentation, particularly in the periorbital region (8).
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