Melasma or "The Pregnancy Mask": What You Need To Know - Baby Chick
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Melasma or “The Pregnancy Mask”: What You Need To Know

Discover the factors that contribute to melasma and learn about its prevention and treatment, including medications and skin treatments.

Updated August 27, 2024

by Rachel MacPherson

Certified Personal Trainer and Exercise Nutrition Coach
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Melasma is a skin condition that causes hyperpigmentation, meaning darkened patches of skin.3,4,7 These patches most commonly occur on the face but can occur elsewhere.1,4,8 Women are more susceptible to this skin condition than men, especially since hormonal changes (such as pregnancy) can cause it.1,3,4 For this reason, melasma is often called “the mask of pregnancy.”3,4,8 In this article, you’ll learn what factors contribute to melasma and how to prevent and treat it, including medication and skin treatment options.

What Causes Melasma?

Although melasma can occur at any time, pregnancy is a common instigator for its appearance.1,3,4,9 The exact causes of melasma are relatively unknown, but hormonal changes such as birth control medications, hormone replacement therapy, and pregnancy are common factors.1,3,4,6,8,10

Melasma appears as patches or as freckled brown, blue, or grey skin.1,3,4 It’s most commonly found on the nose, forehead, upper lip, chin, or any area where your skin has regular exposure to the sun, such as your neck and forearms.1,4 This skin condition is rare in men.1 Those with darker skin and certain groups of people are more likely to get it, including Latin, Asian, and Black women due to their higher amount of pigment-producing cells.8,11,12 In Indians, melasma is the most common skin condition.2 Melasma can occur at any time of life but most often first shows up during your 20s and 30s.3

Melasma has no other symptoms besides skin patches but can cause emotional distress.3,4,7 Approximately 6 million women in the United States experience this skin condition, with an estimated 15-50% of women getting it during pregnancy.3,4

Prevention and Treatment

The best way to prevent melasma is to avoid direct sunlight.1,3,4,5,13 Sun exposure activates pigment-producing cells, and when those cells become hyperactive, they produce too much pigment in certain skin areas. This results in melasma.3,4

Even if you’re prone to developing melasma, it may not appear unless exposed to the sun. For this reason, wearing a wide-brimmed hat (especially during the summer months) and always wearing sunscreen could help you avoid it.1,3,13 When choosing a sunscreen, opt for the kind that acts as a physical barrier rather than a chemical one — sunscreens containing ingredients such as zinc oxide physically block the light waves from your skin.3,14 However, sunscreen may not be enough. Wearing sunscreen is vital for protecting against skin cancer, but melasma may result from heat and visible light, regardless of sunscreen use.3

If you do end up getting melasma, here are some treatment options that you may find helpful:

Medications for Melasma

There are medications for melasma that you can ask your doctor about. Topical treatments such as retinol and retinoids can help boost cell turnover and fade the skin’s darkened patches.3 However, the melasma will likely return. A popular treatment is prescription hydroquinone (HQ), which blocks melanin production.15 You should use HQ with care, as these creams can cause lightened patches of skin to appear.1,3 If you use HQ, keep the following information in mind from one review on melasma:5

  • Typical concentrations range from 2-5%, and you apply them once daily.
  • Most people have good results, but these results are reversible.
  • Effects can take five to seven weeks to show.
  • You must continue treatment for at least three months and up to a year for the best results.
  • For better results, your dermatologist may prescribe a combination of HQ, topical steroids, sunscreen, glycolic acids, and retinoids.

Note: This same review found that various side effects of HQ can occur, such as stinging, irritation, contact dermatitis, nail discoloration, and depigmentation.5 If you experience these effects, be sure to consult with your doctor.

Use caution when seeking out skin-lightening treatments, as they’re often ineffective and can even be dangerous.16,17 Be especially careful of injectable treatments such as glutathione. These can cause kidney and thyroid problems and aren’t approved by the United States Food and Drug Administration (FDA).17,18 Additionally, many topical treatments for melasma aren’t approved for use during pregnancy and breastfeeding.3,15 There isn’t enough research to be sure of their safety, so it’s best to avoid them!

Skin Treatments for the Pregnancy Mask

There are some skin treatments for melasma that can help fade the patches, including:1,6,17,19,20

  • Chemical peels
  • Dermabrasion
  • Microdermabrasion
  • Laser treatment and intense pulse light therapy (IPL)

However, these skin treatments are often only temporary if the underlying hormonal issue isn’t resolved and if you continue to be exposed to sunlight.1

It May Clear Up on Its Own

Melasma may fade and clear up on its own without treatment, especially during less sunny seasons. Although emotionally difficult, melasma has no health risks, and you can cover it with makeup.4 Avoiding direct sun exposure is the least invasive treatment and is a smart practice for avoiding other issues such as sunspots, wrinkles, and skin cancers.1,21 If melasma is an issue for you, speak to your healthcare provider about what the best treatment for you may be.

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Rachel MacPherson
Rachel MacPherson Certified Personal Trainer and Exercise Nutrition Coach
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Rachel MacPherson is a certified personal trainer and nutrition coach who's passion is helping families feel energized to lead vibrant, fit lives. She writes about balancing a healthy lifestyle with self-care and positive body image and creates fresh, healthy meal prep recipes on her site RadicalStrength.ca. Rachel lives in Montreal with her partner, super active kiddos, and three kitties.

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