I think I did develop melasma from the Mirena. I talked to my doctor about it, and she said that you are more likely to develop this condition from pregnancy or oral contraceptives, but she couldn't rule out the IUD as the cause. Of course, she also said that as women age, their hormone levels change and my melasma could simply be the result of aging (super, since I'm 34). I am about 3 months post removal (due to problems far greater than melasma), and the dark spots on my forehead and cheeks appear to be slowly fading, but I am diligent with the sunscreen and exposed to the sun less due to the change in seasons.