SOME UNWANTED EFFECS OF HRT: SKIN REACTIONS
Occasionally menopausal women who use oestrogen develop a skin disorder called chloasma when exposed to the sun. The development of patches of darker skin on the face, legs and hands is similar to the skin reaction that sometimes occurs during pregnancy. The cause of the problem is uncertain, but deposits of melanin in the skin are involved. The discoloration usually becomes less noticeable when oestrogen therapy ceases, but it may become more noticeable on exposure to the sun, even after stopping HRT. Wearing a hat and applying a maximum-protection sunscreen should become part of your outdoor routine. Your doctor may have some suggestions about the most appropriate sunscreen in your particular case, and forms of treatment that may remove the discoloration.
Skin irritation or rash can occur when hormone patches are used and, less commonly, women report a more generalised allergic response. As we saw in the case of Margaret in chapter I, this can be severe enough to cause the abandonment of patch therapy. The problem appears to be worse in hot climates, and the reported incidence varies from 5 to 40 per cent in user groups worldwide. Occasionally there is also a severe local allergic response to the patch adhesive.
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