I'm 37 and started developing melasma a few years back. My mom and sister have it as well. I had not been on hormonal birth control for 10 years. I had always tanned and believe this plus age/heredity were the reasons for my melasma. In the short 3 months that I had the merina....it wrecked havoc on my body. My melasma darkened and became more prominent. I am 3 months post removal and still suffering from side-effects (major hair loss and muscle aches the worst) but the melasma has faded. So, yes.......I do believe that it made it worse. I know that birth control (hormonal) always made my mom's worse as well as exposure to the sun of course.