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Pregnancy Melasma (Chloasma): Causes And Treatment

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Melasma, or chloasma, is a common skin condition characterized by the dark to gray-brown patches on the face. The patches usually occur on the forehead, nose, chin, upper lip, and cheeks, giving the condition another name, the “mask of pregnancy.” You may also notice these patches on other parts of the body, such as the forearms, chest, and neck that are exposed to the sun (1).

In this MomJunction post, learn more about melasma, why it occurs, and what you could do about it.

Is It Normal To Have Melasma During Pregnancy?

According to a research paper published in the Croatian journal Collegium Antropologicum, melasma affects around 50% to 70% of women in their pregnancy. The increased levels of estrogen, progesterone, and the melanocyte-stimulating hormone (MSH) in the third trimester could trigger melasma (2). Melasma is not a painful condition and does not lead to any pregnancy complications. But what might cause it?

Causes Of Melasma During Pregnancy

The exact cause of melasma is unclear. It is likely to develop when the melanocytes of the skin produce extra color. Those with darker complexion are likely to develop melasma as they have active melanocytes than those with a lighter complexion (3).

Some of the common melasma triggers include:

  • Exposure to the UV (Ultraviolet) light from the sun stimulates melanocytes, leading to melasma. The condition might worsen during summers (4).
  • Hormonal changes is another reason for pregnancy melasma. The increased levels of hormones such as estrogen, progesterone, and MSH in the third trimester are likely to trigger the symptoms of melasma in pregnant women (5) (6).
  • Other factors include genetic history (if someone else in the family has been suffering from it), skincare products, drugs, multiple pregnancies, and older maternal age.

Melasma that occurs during pregnancy tends to go away after a few months of delivery when the hormonal activity stabilizes (7).

Ways To Reduce The Melasma Patches

Although melasma disappears with time, certain things might help in minimizing the flare-ups on your skin.

  • Stay out of the sun: The foremost step is to avoid sun exposure as much as possible, to prevent skin damage. If your work forces you to go out in the sun, apply a broad-spectrum sunblock. Choose sunscreens or blocks with SPF 25 or higher that may help to prevent exacerbating chloasma (8). Also, wear a wide-brimmed hat, long-sleeved dress, and sunglasses, and avoid tanning salons.
  • Avoid skincare products: Facial cleansers, skin creams, and make-up products may irritate your skin, making melasma worse. Avoid them until you have given birth, or the melasma disappears.
  • Do not wax: Waxing for removing hair might worsen melasma as it could cause skin inflammation. The effect may be high, especially in the areas affected by pigmentation.

Can Pregnancy Melasma Be Treated?

Besides taking precautions to prevent flare-ups, you could talk to a dermatologist about the treatment options to minimize the patches. However, the treatment options are limited for pregnant women.

  • Topical medications such as retinoids and hydroquinone are usually prescribed for melasma, but their safety during pregnancy is not studied (9).
  • Plant products with vitamin C, glycolic acid, arbutin, azelaic acid, licorice extract, or soybean extract could be helpful. Again, you may only use them when their benefits outweigh their risks (8).

Most women see a natural improvement in their skin tone postpartum, as the hormones return to normal levels. However, it is better to talk to your doctor for the right treatment, especially if you are on birth control pills after pregnancy.

Can You Prevent Melasma Or Chloasma In Pregnancy?

Preventing melasma during pregnancy may not be possible if the condition is due to hormonal changes or genetics. You might, however, take the precautions discussed above to prevent the patches from darkening further.

Does Melasma During Pregnancy Tell Something About The Baby’s Gender?

No. It is just folklore that pigmentation in a pregnant woman could indicate the gender of the baby. There is no scientific evidence to support this. 

Remember that melasma requires time to heal. Also, the medications used for treatment need time to act on alleviating the symptoms. Do not panic, and rush into things that might not work, or aggravate the skin pigmentation. Talk to your doctor if the discomfort is severe, or you see other symptoms that are worrying you.

References:

1. Melasma; U.S. Department of Health and Human Services National Institutes of Health (2018)
2. Bolanca I et al.; Chloasma–the mask of pregnancy; Collegium Antropologicum (2008)
3. David J. Leffell; Skin And Pregnancy; Yale School of Medicine
4. ajira Basit et al.; Melasma; StatPearls Publishing (2019)
5. Jp Ortonne et al.; A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma; University of Texas Southwestern Medical Center
6. Gertrude-Emilia Costin and Stanca-Ariana Birlea; What is the mechanism for melasma that so commonly accompanies human pregnancy; IUBMB Journal – Wiley Online Library
7. Melasma; British Association of Dermatologists; The British Skin Foundation
8. Debabrata Bandyopadhyay; Topical Treatment of Melasma; Indian J Dermatol (2009)
9. Pina Bozzo et al.; Safety of skin care products during pregnancy; Can Fam Physician (2011)

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