What Is Melasma of Pregnancy?
According to the Cleveland Clinic, 15% to 50% of pregnant women develop a “mask of pregnancy,” also known as melasma. This skin condition is characterized by light brown, dark brown, or blue-gray patches, freckle-like spots, or discoloration. The name may sound scary. But it’s a common, harmless, and painless condition that doesn’t impact the baby or mean there’s anything wrong with the pregnancy. It’s simply a cosmetic issue.
Why Do Some People Get Melasma in Pregnancy?
It’s unclear why some pregnant people get melasma and others don’t. It may happen because you have higher levels of the hormones estrogen and progesterone during pregnancy, which can make the skin cells more sensitive to sunlight, says Hector O. Chapa, M.D., a board-certified ob-gyn at Texas A&M University College of Medicine, in College Station, Texas.
“In melasma, the cells (called melanocytes) that give your skin its color are more active,” says Hayley Goldbach, M.D., a double board-certified dermatologist at Brown University, in Providence, Rhode Island. “We don’t know exactly what causes this shift.”
What scientists do know is that melasma can be triggered by several things, including hormonal changes in pregnancy, exposure to sunlight, and certain types of medications, such as some seizure medications, Goldbach says.
Melasma can occur at any point in life, but it’s more common in pregnancy.And it can happen at any point during pregnancy, says Debra Jaliman, M.D., a board-certified dermatologist in New York City. She adds that people with dark skin, hair, and eyes are more prone to melasma than people with lighter complexions. “The more melanin you have, the more likely you will get melasma,” Jaliman says.
Melasma can affect any part of your skin that gets sunlight exposure. That’s why your symptoms may worsen if you’re pregnant during the summer. It’s most common to get melasma on your nose, chin, cheeks, jawline, skin above the upper lip, and forehead. You may find it on your neck, upper arms, shoulders, and back.
How to Prevent and Treat Melasma During Pregnancy
If you have melasma during pregnancy, the following treatments may reduce its appearance and help it clear up after you give birth.
Limiting your sun exposure is the key to preventing melasma as much as possible, Goldbach says. And it’s important if you already have melasma, too, since sunlight can exacerbate it. She says you should apply sunscreen every two hours when in the sun, wear a broad-brimmed hat, and avoid peak sun hours, from 10 a.m. to 2 p.m.
And don’t be fooled by the clouds or rain. “It is important to use a broad-spectrum SPF 30 sunscreen every single day, rain or shine, because ultraviolet light penetrates through the clouds,” Jaliman says. “Reflection off the sides of the clouds increases the UV penetration.” She says to choose a sunscreen with a high concentration of zinc oxide, at least 9% or 10%.
If you’re especially bothered by melasma, a dermatologist may recommend treatments you can do while you’re pregnant—azelaic acid, for example, naturally inhibits the production of pigment and is considered safe to use during pregnancy, Goldbach says.
After the baby is born, you have more options to treat any melasma patches that don’t fade on their own. Goldbach recommends that you see a board-certified dermatologist to discuss your options. “Chemical peels, lasers, creams, and even pills can help treat persistent melasma,” she says.
Chapa says waiting until after pregnancy to treat melasma is key. “Most treatments are unlikely to be as effective as possible because the higher estrogen levels (that are thought to contribute to the issue) are still there during the pregnancy,” he explains.
Jaliman recommends trying lotions or serums that contain niacinamide (or vitamin B3), licorice extract, kojic acid, arbutin, and/or vitamin C. These ingredients can help reduce hyperpigmentation and even your skin tone. Nevertheless, always check with your doctor before trying any new products during pregnancy.
When to See a Doctor
“Melasma isn’t dangerous, but some conditions can [look similar to] melasma that might be more concerning,” Goldbach says. If you notice dark patches on your skin, mention them to your ob-gyn, primary doctor, or dermatologist, she says, so they can rule out other problems.
The darker color of pregnancy melasma usually fades within three months after you give birth. However, it may not disappear entirely, says Mary Jane Minkin, M.D., a board-certified ob-gyn at Yale School of Medicine, in New Haven, Connecticut. If it doesn’t and you’d like it to, you can reach out to your dermatologist or general healthcare provider who may be able to help you find an effective treatment.
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