Melasma And Pregnancy: All Your Questions Answered

Melasma And Pregnancy: All Your Questions Answered

Pregnancy is an exciting time. You have so much going on as you wait to usher your little one into the world. But as you enter your second and third trimester, you may start to notice some darker spots or patches appear on your face. Such discolorations are often a sign “The Mask of Pregnancy”, more commonly known as melasma. Although these dark patches of skin may look worrisome, there is no reason to fret. Read on to learn the answers to some of the most pressing questions you may have.

Why Does Pregnancy Trigger Melasma?

Melasma during pregnancy is the appearance of brown or greyish spots or patches on your skin. The exact color of the patches varies depending on your skin type, and the extent of discoloration can vary from a few indistinct spots to larger, highly pigmented patches.

Discoloration can appear at any time during the term of the pregnancy but is most common during the second and third trimester. If you had melasma before your pregnancy, you might notice some additional patches develop.

Statistics indicate that up to 70 pregnancies out of every 100 will experience some level of melasma.

Doctors believe hormonal changes are the leading cause of melasma in pregnancy. Although it isn’t exactly clear why, yet, melasma and estrogen appear to be linked. It’s thought that estrogen acts on the cells in your skin that produce more pigment. Estrogen increases the amount of tyrosinase (pigment-forming enzyme) in your body. Lastly, estrogen also acts on the melanocortin receptors in your skin that makes your skin cells more sensitive to the sun.

Your estrogen levels change significantly during pregnancy, especially during the second and third trimesters. These changing hormones result in excessive melanin production and, in turn, the dark patches on your skin.

In addition to hormonal changes, genetics and race also play a role in the formation of melasma. Doctors have identified women of Latin, Middle Eastern, and Asian descent as most affected by melasma during pregnancy.

What Symptoms Can I Expect?

Melasma symptoms are brown, tan, or blue-gray discolored patches on your skin. Melasma typically appears on your face, especially around your forehead, cheeks, chin, and the bridge of the nose or upper lip.

The extent of discoloration varies from individual to individual. Some factors that may influence how much of your skin becomes hyperpigmented include:

  • Exposure to sunlight
  • Race
  • Age
  • Pregnancy trimester
  • History of hyperpigmentation or melasma.

Melasma is a benign, painless condition. If you experience accompanying symptoms like itching, redness, fever, or skin hardening in addition to melasma with your pregnancy, it’s important to seek medical advice immediately. These may be signs of an underlying condition.


Will Melasma Go Away After Giving Birth?

Melasma that is triggered by pregnancy can fade after you have given birth, particularly in cases where the mother never experienced melasma beforehand. If you had melasma before the pregnancy, however, it might not fade on its own without treatment.

It’s important to remember that melasma is a chronic skin condition, meaning that there is no cure. However, diligent treatment and sun-protective measures can lighten your melasma and restore your clear and smooth complexion.

Will it Affect My Pregnancy?

Not at all! Melasma during pregnancy is considered a cosmetic condition, meaning it only affects a thin layer of your outer skin. Therefore, from a medical perspective, you should not worry that melasma will affect your pregnancy.

The Skin Quiz

Our Dermatologist worked closely with experts to create a melasma skin quiz that guides you to the best treatments on the market 👇

What Are My Treatment Options?

Melasma during pregnancy can be treatable, but since hormonal and other unknown factors cause it, it can be challenging to treat effectively. Since this type of melasma often fades after you have given birth, it isn’t always necessary to treat this condition. However, if you are set on seeking treatment, always consult your doctor first.


What melasma treatments can I use during pregnancy?

Over the counter options

Most hyperpigmentation medications have poorly understood side effects relating to pregnancy. For example, it is not known if and how certain ingredients in standard treatments, such as hydroquinone or retinoids, may affect your unborn baby. Although there are many over-the-counter treatments for hyperpigmentation, always seek medical advice before using them.

Outpatient melasma treatments

Outpatient melasma treatments include laser treatment, chemical peels, and wave devices. These are considered more aggressive forms of treatment.

Although they can be used during pregnancy, most doctors do not recommend taking this course of action. This is because, as discussed, melasma can improve on its own after you have given birth. Since the pregnancy term is relatively short, most doctors will recommend less aggressive treatments or a wait-it-out approach.

Home treatment options

Home remedies can be useful in helping reduce skin discoloration. Some of the options available are lemon juice, turmeric powder, aloe vera gel, oatmeal, and papaya, among others. Although some may swear by these remedies, remember that any evidence of effectiveness is anecdotal and have not been proven in scientific studies.

That said, using home remedies in your daily skincare regimen can promote healthy skin, giving you a confidence boost even if the discoloration persists.


Avoid excessive sun exposure

One of the most effective things you can do to improve the appearance of your melasma is to avoid the sun. Just like hormones, UV rays are a well-known melasma trigger.

We don’t mean that you should avoid the sun for the entirety of your pregnancy. At minimum, just make sure to use sunscreen every day and stay inside during peak hours (10 am – 2 pm). Every little bit of sun avoidance will help prevent your melasma from getting worse.

How Can I Manage Melasma During Pregnancy?

The best thing you can do to improve the appearance of your melasma is to use a combination of techniques. Some easy steps you can take every day are:

  • Minimizing sun exposure during peak hours (10 am – 2 pm).
  • Wearing UV protective clothing and broad-brimmed hats
  • Applying pregnancy-safe sunscreen daily (a physical blocker is recommended)
  • Using makeup to hide dark patches of skin
  • Promoting skin health by eating a skin-healthy diet
  • Taking any vitamins or medications that your doctor has recommended
  • Avoiding skin irritants like smoke and harsh chemicals, which can worsen your melasma
  • Maintaining your skin health can help you manage your melasma and give your skin a healthy, radiant appearance

Last Words

We know that melasma can be a challenge to live with, but this condition can absolutely be managed. As you manage your pregnancy and your melasma, remember there is also a psychological perspective to consider. Make sure to engage in activities that help you maintain a positive outlook on your appearance and life as you await your little one’s arrival in the world!

Brandon Kirsch

Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the Naples Community Hospital. Kirsch Dermatology Website Dr. Kirsch started his career as a lawyer and holds law degrees from the University of Western Ontario (LL.B.) and Georgetown (LL.M. Securities and Financial Regulation). Dr. Kirsch completed his pre-medical studies at the University of Pennsylvania, medical school at Brown University, internship at the Mayo Clinic (Florida) and dermatology residency at the University of North Carolina. In partnership with the Mayo Clinic, he filed to patent a novel topical composition for the treatment of skin hyperpigmentation that he co-developed and also oversaw a successful pilot study of the formulation. Dr. Kirsch has experience with therapeutic drug development programs from pre-clinical to Phase 3 studies. He is licensed to practice medicine in California, Colorado, Florida, and North Carolina and law in New York and Ontario.

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