Known as the mask of pregnancy, melasma is a common skin condition during pregnancy...but why does it happen, and how can you treat it?



By Dr. Kenosha Gleaton

We know that pregnancy is a beautiful journey that can bring about a lot of changes (some great, some not-so-great). You’ve had morning sickness, read about swollen ankles, and now may notice subtle changes in your skin. 

What is melasma?

Meslasma refers to a skin condition marked by brown or gray patches on the skin, most commonly found on the cheeks, forehead, and nose. Melasma is frequently caused by sun exposure and hormonal changes such as pregnancy or taking birth control pills. Usually, hormonal melasma will fade with time. 

Why is melasma more likely to occur during pregnancy?

Pregnancy involves a lot of hormonal changes, including an influx of estrogen, progesterone, and melanocyte-stimulating hormone (MSH). Melanocytes are skin cells that are responsible for depositing pigment, so when they’re overly stimulated during pregnancy, the result is often extra pigmented spots on the face. 

Ways to prevent and manage melasma

Fortunately, most UV-induced melasma is prevented by limiting sun exposure and wearing sunscreen. However, hormonal-induced melasma may require topical medications.

Topical corticosteroids help prevent excess pigmentation and inflammation and are safe in small doses for use while pregnant. There’s also evidence that natural topical compounds like ascorbic acid and azelaic acid can be beneficial and are mostly safe for use while pregnant in small doses. We recommend asking your doctor before using any medications or substances while pregnant or breastfeeding. Every pregnancy is different, and your doctor will know what’s best for you and your baby.

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As with many pregnancy-related conditions, melasma treatment options are limited due to few high-quality studies showing significant benefit and insignificant risk. Hydroquinone and topical retinoids are topical agents that can prevent melanin production and help with melanocyte degeneration and are used to treat melasma. However, they are NOT recommended for use during pregnancy or while breastfeeding.

On a positive note, melasma, even without treatment, is likely to fade on its own when the stimulus (pregnancy hormones) goes away. So give it some time, and you’ll likely notice a significant improvement in your skin after pregnancy

The unruly mask of pregnancy

Commonly referred to as the “mask of pregnancy,” melasma is an extremely common skin condition that arises due to hormonal changes. There aren’t many ways to prevent or manage melasma while pregnant due to possible harmful effects of some medications, but limiting sun exposure and using pregnancy-safe topical agents may help. After pregnancy and once you’ve weaned your baby, give hydroquinone or retinoids a try if your melasma doesn’t disappear on its own. 


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