Melasma During Pregnancy: Causes, Prevention and Treatment

Melasma is a skin condition in which some skin cells become darker. Commonly occurring during pregnancy, melasma is sometimes referred to as chloasma, or the ‘mask of pregnancy’ because dark patches on the face can resemble a mask. While not being harmful to the health of either mother or child, pregnancy melasma can be a source of embarrassment for some expecting mothers.

If you are currently expecting, or thinking about becoming pregnant, this post will cover everything you need to know about pregnancy-induced melasma, including ways to prevent occurrence and treatment options.

What is Pregnancy-Related Melasma?

Melasma during pregnancy is a skin condition in which melanocytes, the skin cells that produce melanin, produce more pigment than usual. Melasma is only a pigmentary concern, and does not affect the health of the mother or baby.

Primary symptoms include darkening patches of skin on the face, especially around the forehead, cheekbones, nose and upper lip. Exposure to the sun can make melasma worse. In addition, melasma can make skin that is already darker even more so. Freckles or scars, and dark skin around nipples and genitals may become even darker than usual during pregnancy.

If your hyperpigmentation is accompanied by consistent itching, irritation or discomfort, it’s important to note that these are not symptoms of melasma. See your dermatologist in that instance.

How Common is Melasma During Pregnancy?

During pregnancy, the body goes through significant hormonal changes. This can be a trigger for melasma. This common condition occurs in 50-70% of pregnant women.

You’re also more likely to develop melasma during pregnancy if someone in your family has had it, if you have naturally dark skin, or if you spend a lot of time in the sun.

What Causes Melasma During Pregnancy?

Melasma can occur at any point in a pregnancy, although it typically develops during the second or third trimester. It’s caused by hormonal changes that take place during pregnancy, which affect the skin’s pigment-producing melanocytes. Melasma sometimes resolves itself one hormonal balance is restored. Sometimes, however, it persists.

Does Pregnancy-Related Melasma Differ from Traditional Melasma?

Pregnancy is not the only cause of melasma. Non-pregnancy related hormonal changes like oral contraceptives may also cause skin hyperpigmentation. Melasma can even occur in men, although it’s far more common in women. The following are common melasma triggers:

• Pregnancy
• Non-pregnancy related hormonal imbalances
• Hormonal birth control
• Hormone replacement therapy
• Sun exposure
• Heat exposure

In addition to the above, genetics play a crucial role. If someone in your family has had melasma, you’re more vulnerable to the condition.

Can Melasma During Pregnancy Be Prevented?

It’s impossible to prevent melasma with certainty, but there are ways to reduce your risk or minimize the appearance of your melasma.

• Avoid Excess Sun Exposure

UV light exposure only makes hyperpigmentation worse by further darkening skin. During your pregnancy, avoid spending too much time in the sun. Wear protective clothing and sunscreen as needed.

• Avoid Excess Heat

Heat can trigger melasma by causing the blood vessels in the skin to dilate and send signals to create pigmentation.

• Use Gentle Skin Care Products

Products that irritate the skin can make melasma worse. Swap out face washes, lotions or creams that contain fragrances or coloring. Look for products that say ‘fragrance-free,’ ‘for sensitive skin,’ or ‘non-comedogenic’ on the label.

• Use Make-Up Formulated for Sensitive Skin

If you’re using concealer or foundation to cover your melasma, choose products developed for sensitive skin. Make-up labeled as ‘non-comedogenic’ or ‘hypoallergenic’ is less likely to irritate skin and worsen melasma.

• Eat Well, Sleep Well and Hydrate

While pregnancy is a primary cause of melasma, eating a well-balanced diet and getting plenty of sleep can prevent hormonal imbalances or vitamin deficiencies that aren’t pregnancy-related. Eat a variety of healthy, whole foods, drink plenty of water and get sufficient rest.

Can Melasma Be Treated During Pregnancy?

Some melasma treatments are safe to begin during pregnancy. See a board-certified dermatologist to figure out the best and safest option for your skin.

Will My Melasma Clear Away After Delivery?

Melasma that arises during pregnancy may go away on its own, but it won’t happen overnight. It may take several months for your hormones to balance and skin pigmentation to fade. You may need to use different topicals or chemical peels to help get rid of stubborn pigment.

If Melasma Continues After Birth, What Treatments Are Available? 

Treatments for melasma include topical creams, chemical peels, as well as gentle skin resurfacing procedures. Your dermatologist may recommend one or more of the following:

• Topical Creams

Hydroquinone, corticosteroids, and tretinoin (Retin-A) are just a few of the many options used to treat melasma.

• Chemical Peels

Chemical peels address discoloration by exfoliating the top layers of skin, allowing newer and more evenly toned skin cells to rise to the surface.

• Laser Treatments

Not all laser therapies are ideal for treating discoloration. Fractional lasers are commonly used for treating melasma. If you have dark skin, seek a provider who is experienced in laser treatment for people of color.

Elizabeth Geddes-Bruce, MD is a board certified dermatologist and dermatologic surgeon specializing in the practice of both cosmetic and medical dermatology. Dr. Geddes-Bruce is fellowship-trained in cosmetic dermatology and laser surgery. She served as Chief Resident at one of the nation’s top dermatology programs – The University of Texas at Houston and M.D. Anderson Cancer Center.