Developing flat brown or gray patches of skin during pregnancy? You might be one of the millions of women experiencing a unique type of hyperpigmentation called melasma. According to Dr. Jenna Koblinski of U.S. Dermatology Partners Phoenix, “Melasma, also known as the ‘mask of pregnancy,’ is a common pigmentation change during pregnancy. However, common doesn’t mean it isn’t frustrating. I see many expectant mothers with spots and splotches on their foreheads, cheeks, upper lip, and other areas that often catch the sun’s UV rays. The good news is these hyperpigmented areas are harmless, and there are pregnancy-safe prevention and treatment options available. It all starts when you have a conversation with your dermatologist.” In this blog, Dr. Koblinski talks about preventing and treating melasma during pregnancy and provides tips to keep skin beautiful.
What Is Melasma During Pregnancy?
Melasma is a form of hyperpigmentation that occurs when melanocyte cells, that produce pigment in skin, increase in reactivity. As hormones fluctuate and skin is exposed to sunlight, these overactive melanocyte cells produce an abundance of melanin and cause dark patches to develop. Melasma usually forms on the face, especially in symmetrical patterns over the cheeks, across the forehead, and on the upper lip. Melasma may also appear on sun-exposed areas like the neck, shoulders, hands, and arms.
What Causes Melasma in Pregnancy?
When it comes to the cause of melasma in pregnancy, Dr. Koblinski says, “Hormonal changes and sun exposure are the two main causes of melasma during pregnancy. Specifically, increases in estrogen and progesterone during pregnancy stimulate melanocyte cells and boost melanin production. With melanocyte cells already producing more melanin, exposure to the sun’s UV rays, which also trigger melanocytes, makes matters worse for women trying to prevent mask of pregnancy from developing or worsening.”
In addition to these two main underlying causes, melasma may also be triggered by the following:
- Using hormonal birth control prior to or immediately after pregnancy.
- Using products with irritating chemicals, fragrances, or preservatives.
- Having a family history of melasma.
How to Manage and Prevent Melasma Safely
Preventing and addressing melasma during pregnancy requires a two-pronged approach combining gentle skincare and sun protection. Skin is more sensitive during pregnancy, so it’s important to streamline your skincare routine and use gentle products. Simply clean with a mild cleanser and apply a fragrance-free moisturizer morning and evening. You may also want to incorporate serums or topical treatments with niacinamide, vitamin C, azelaic acid, or mild exfoliating ingredients, especially if you notice signs of hyperpigmentation. Most importantly, don’t skip sunscreen. Apply a broad-spectrum sunblock with an SPF 30 or higher every morning and reapply at least every two hours when outdoors. Tinted sunscreen with the ingredients ferric (iron) oxide or titanium dioxide are also helpful as they further provide protection against visible light, which can further contribute to hyperpigmentation. In addition to using sunscreen, it’s important to take steps to prevent sun damage by:
- Minimizing time in the sun.
- Avoiding the outdoors between 10 am and 4 pm when the sun’s rays are strongest.
- Wearing protective clothing, hats, sunglasses, and gloves as needed to protect skin.
- Seeking shade regularly to allow skin time to rest during prolonged sun exposure.
Does Melasma Go Away After Pregnancy?
Following pregnancy, Dr. Koblinski says, “Almost all melasma spots fade within six months following pregnancy as hormone levels balance. It’s important to keep skin protected from sun damage during and after pregnancy to reduce the appearance of melasma. If you have a genetic predisposition for melasma, engage in frequent or prolonged sun exposure, or use hormonal birth control postpartum, melasma may be more stubborn and take longer to clear up.”
Pregnancy-Safe Treatment Options
Dermatologists work with each patient to develop a personalized plan and understand how to treat melasma safely. Below, Dr. Koblinski discusses some of the most common at-home products to use during pregnancy and more advanced treatments for melasma after pregnancy as well as treatments to avoid when pregnant.
At-Home Melasma Treatment Options
- Vitamin C products – vitamin C serums and treatments are completely safe to use during pregnancy. Applied topically to hyperpigmented areas, vitamin C brightens skin, accelerates skin cell turnover, supports collagen production, and gradually reduces hyperpigmentation.
- Azelaic acid – one of the best options for reducing the appearance of melasma during pregnancy, azelaic acid decreases inflammation, slows melanin production, is non-irritating to sensitive skin, and can improve other common pregnancy-related skin concerns like acne.
- Niacinamide – this ingredient works to regulate pigment transfer, supporting a healthy skin barrier and more even skin tone. Used consistently, products with niacinamide reduce the appearance of dark spots and prevent the formation of new melasma lesions.
- Exfoliation – choose a gentle exfoliant with lactic acid or polyhydroxy acids to dissolve away dead and damaged skin cells, revealing healthier new skin below and maintaining an even skin tone and texture. It is important to use lower strengths of these topicals, so we would recommend discussing this further with your dermatologist prior to starting.
Professional Treatment Options After Pregnancy
- Prescription-strength topical hydroquinone may be used short-term to resolve stubborn post-pregnancy melasma.
- Chemical peels are a great way to remove the damaged and hyperpigmented outer layers of skin, revealing healthier skin below.
- Laser therapy can be used to diminish the appearance of hyperpigmented patches of skin.
- Microneedling uses microscopic injuries to stimulate healing and improve skin tone and texture.
Treatments to Avoid During Pregnancy
- Hydroquinone is safe for use postpartum, but it should not be used during pregnancy as it is absorbed into the bloodstream.
- Retinoids and retinols are teratogenic, meaning they can cause harm to the baby upon absorption. These should be stopped until after pregnancy.
- Lasers and chemical peels are usually performed after the completion of pregnancy for safety concerns.
When to See a Dermatologist
According to Dr. Koblinski, “Melasma isn’t a harmful condition, but I understand when my patients don’t like the way it looks and want to reduce the appearance. I’m always happy to help them address this discoloration, so they feel their best. During a consultation, I examine the spot, discuss potential treatments, and offer a range of solutions for melasma and other skincare concerns.” It’s important to consult a dermatologist if you notice any of the following:
- Pigmentation is spreading rapidly.
- Melasma spots are darkening.
- Patches are irregularly shaped or asymmetrical.
- Hyperpigmented spots are changing in color or are multiple shades.
It is important to remember there are many pigmentary disorders that may mimic melasma, so it is important to be evaluated by a board-certified dermatologist.
Discuss Melasma with a Dermatologist
Whether you want to clear up melasma or discuss options for keeping skin healthy throughout your pregnancy, U.S. Dermatology Partners has you covered. Simply take a few moments to request a consultation with one of our board-certified dermatologists. We use an easy online scheduling request form. Once our local dermatology team hears from you, they’ll be in touch to finalize the details of your upcoming visit.
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