Melasma, also called the mask of pregnancy, is a skin condition characterized by hyperpigmentation. Here’s what to know about causes, symptoms, and whether you can prevent it.
During pregnancy, you’ll experience lots of changes to your body, ranging from bigger breasts to stretch marks. Some people also notice that their skin—specifically on their face— looks patchy and discolored. This is usually triggered by a condition called melasma, often referred to as the “mask of pregnancy.”
Melasma is completely harmless, although its appearance can have an emotional impact on people. In many cases, it disappears soon after delivering the baby. Melasma is also pretty common; studies indicate that it appears in up to 50 to 70% of pregnant people.
Keep reading to learn more about melasma during pregnancy, including what it looks like, when it starts and ends, and whether you can prevent it.
What Is Melasma?
Melasma, also called chloasma or the “mask of pregnancy,” is a skin condition that appears when you’re carrying a baby. It’s characterized by patches on the face that look darker than your normal complexion. The hyperpigmentation is painless, harmless, and doesn’t affect your baby. The symptoms generally disappear after delivery.
What Causes Melasma in Pregnancy?
Like many body changes, you can blame pregnancy hormones for melasma. Specifically, as the levels of estrogen and progesterone increase during pregnancy, hyperpigmentation (changes in skin color) can become more likely.
“Melasma, or hyperpigmentation, can occur during pregnancy as a result of the increase in the amount of melanin caused by hormonal changes,” says Loretta Ciraldo MD, FAAD, a board-certified dermatologist in Miami, Florida. “Melanin is the substance that your body produces that gives color to skin, hair, and eyes,” she says.
Certain factors can increase the likelihood of developing this mask of pregnancy, including a family history of melasma, says Ashley Magovern, MD, board-certified dermatologist and medical director for Dermstore.com.
“Those with medium or darker skin tones are typically more prone to melasma,” adds Dr. Magovern. That’s because skin with more pigment produces more melanin.
Symptoms of Melasma During Pregnancy
In general, melasma presents as a discoloration of the skin, which appears darker than your normal complexion (usually brown, tan, or gray). The hyperpigmentation can look like small freckle-like spots or larger patches. It often shows up in the following areas:
- Cheeks
- Upper lip
- Forehead
- Nose
- Chin
Melasma isn’t accompanied by itching, swelling, or soreness. The mask of pregnancy is painless, even though it might look irritated, and it’s harmless for your developing baby.
Some people with melasma experience linea nigra, a dark line that can appear on your stomach during pregnancy. Your nipples and other areas of the skin may also darken. It’s important to speak to your doctor if you have any concerns about changes to your skin during pregnancy.
Melasma Outside of Pregnancy
Did you know that melasma can also occur outside of pregnancy? You can often blame other hormonally-based events, like perimenopause, menopause, oral contraceptives, and hormonal replacement therapy. Direct sun exposure can also cause melasma in some cases.
When Does Melasma Usually Appear?
Melasma can happen at any point during pregnancy, says Dr. Magovern. “Many pregnant people experience the mask of pregnancy during the second or third trimester when hormone levels are at their highest.”
But here’s the good news: For the vast majority of pregnant people, the symptoms of melasma will gradually fade in the weeks and months following delivery, though it can last for years. “Melasma will resolve naturally on its own once the hormone balance is restored,” says Dr. Magovern.
Can You Prevent Melasma in Pregnancy?
While melasma may not be preventable in the traditional sense (since it’s closely linked to hormonal changes during pregnancy), there are some things you can do to alleviate the appearance.
- Use sun protection. Ultraviolet (UV) rays can intensify pigment changes. Use a broad-spectrum sunscreen with SPF 30 or above, and reapply throughout the day (every two hours if you’re outside).
- Stay in the shade. Similarly, you can avoid the sun’s rays by sticking to shady spots, especially during midday, when the sun is the strongest. Wearing wide-brimmed hats can also help.
- Avoid products that contain synthetic fragrances. Synthetic fragrances often contain ingredients that cause allergic reactions and skin irritation. They may make melasma worse. Choose products labeled as noncomedogenic or hypoallergenic.
- Use products with antioxidant-dense agents: These might help with alleviating irregular pigmentation. A good ingredient to look for is lemon peel bioferment, says Dr. Ciraldo.
Treatment of Melasma During Pregnancy
The good news is that most cases of melasma will go away on their own once you deliver the baby, though it may sometimes take a few months. In the meantime, it’s important to understand that your treatment options are rather limited. That’s because many of the prescription-strength products used to treat skin discoloration are not considered pregnancy-safe products.
Things like lightening creams and topical retinoids should be avoided while expecting, says Kseniya Kobets, MD, director of cosmetic dermatology at Montefiore Medical Center. Instead, always use sunscreen or wear a hat when outdoors, which should prevent your melasma from darkening even more.
Your health care provider might give the go-ahead for melasma treatment with vitamin C or azelaic acid while pregnant. Other treatment options will become available after you’re finished with pregnancy and breastfeeding, including topical medications, chemical peels, laser treatments, and more.
If your melasma is bothersome to you, try applying a tinted moisturizer or foundation that’s well-matched to your overall skin tone. Preferably it should be hypoallergenic and non-comedogenic.