How to Manage Melasma During Pregnancy (2024)

Melasma is so frequent in pregnant people that it's sometimes called the "mask of pregnancy." Melasma, which causes patchy areas of discoloration that sometimes resemble freckles, is most likely to appear on the cheeks, but it can also develop elsewhere. Melasma is not dangerous or cancerous, but it may affect how you feel about your appearance.

Read on to learn about what causes melasma during pregnancy and how to treat it.

Why Does Melasma Develop During Pregnancy

Experts think that increases in the levels of the hormones estrogen and progesterone during pregnancy may trigger melasma.

The spots develop when the hormones trigger cells called melanocytes, which go into overdrive and produce more of a substance called melanin. Melanin is what gives skin its color.

Melasma is more common in people with medium to darker skin and seems to run in families.

Estimates vary, but up to 70% of pregnant people develop melasma.

What Does Melasma Look Like?

Melasma can present with blotches or freckles—usually on the face—that are darker than the rest of your skin tone. They are generally tan or brownish in color, but can look blue-gray on people with naturally darker skin color.

Melasma appears slowly, and the spots are usually larger than those from sun damage or age.

There are three types of melasma, categorized by how deep the darker pigment goes into the skin:

• Epidermal: Dark brown spots with a well-defined border
• Dermal: Light brown or bluish spots with a blurry border
• Mixed melasma: A combination of bluish-grey and brown patches (the most common form)

Symptoms of Melasma in Pregnancy

During pregnancy, melasma usually appears on the face as patchy or spotted areas of skin that are tan, brown, or sometimes blue-gray. It usually develops in one or more of these areas:

• Cheeks (both sides)
• Chin
• Forehead
• Bridge of nose
• Above the upper lip
• Jawline

Melasma can also develop on your arms or neck, though it's less common.

Melasma does not cause any itching or pain and has no other physical symptoms. However, it can make people self-conscious about their appearance.

When Might Melasma Develop During Pregnancy?

Melasma appears most often during the second or third trimester, as hormonal changes increase.

Estrogen and progesterone, which are thought to trigger it, start building after 12 weeks and peak around 32 weeks. Melasma can develop at any time during your pregnancy, however.

Pregnancy-Safe Melasma Treatment

Since melasma often goes away on its own within a few months of giving birth, your healthcare provider may recommend that you don't treat it. The side effects of melasma treatments aren't entirely understood, and treatments may not be safe for you to use while you're pregnant.

There are some milder products that may fade the spots safely, but don't take or use anything without consulting with your provider.

Potential treatments include:

• Azelaic acid: Anti-inflammatory and exfoliant
• Kojic acid: Bleaching agent
• Hydroquinone: Reduces melanin production
• Laser treatments or peels: Can block the path of melanin to the skin

You may be able to prevent or minimize melasma by wearing a high-SPF sunscreen and a hat with a brim when you are in the sun.

If your melasma doesn't go away after you have your baby, you can discuss melasma treatment with your provider. Most treatments take time to work, so the spots will fade gradually. Sometimes melasma will return and needs further treatment.

Summary

Melasma is a skin condition causing uneven, darkened areas or spots that look like freckles. It is very common in pregnant people and tends to appear during the second or third trimester. It's unlikely that a healthcare provider will recommend treatment, as melasma often goes away on its own a few months after giving birth.

Melasma can potentially be prevented by always wearing sunscreen and a hat while in the sun. If the spots don't fade within a few months after having the baby, there are treatments to help fade them.

A Word From Verywell

Pregnancy comes with a host of emotions and physical changes. Adding a skin condition like melasma to the mix can be frustrating, especially if it's making you self-conscious about your appearance. Remember that it's likely to go away after giving birth. In the meantime, take good care of your skin and talk to your healthcare provider about possible pregnancy-safe treatments if the spots are really bothering you.