If you’ve noticed new, skin splotches on your face that are darker than your natural complexion, you may have melasma — which is often called the “mask of pregnancy.” But you’re not alone: an estimated 50 to 75 percent of expectant mothers develop it during their pregnancies.
What is melasma (pregnancy mask)?
Melasma is a skin condition that can appear during pregnancy, often on the face. Some women may have small spots resembling freckles, while others may have a few larger, blotchy, confetti-like patches.
The discoloration — tan, brown or gray spots — is usually symmetrical and is most common on the cheeks and nose, but it’s also found on the forehead and upper lip. It won’t, however, cause symptoms like itchiness or pain.
Melasma is especially common in darker-skinned women or those of Asian and African descent, who have more pigment in their skin than fair-skinned people. Exposure to sunlight can make it more noticeable.[1]
What causes melasma (pregnancy mask)?
Melasma appears when a steep rise in estrogen and progesterone levels stimulates excess melanin production, also known as hyperpigmentation.[2]
If you have melasma, your freckles and moles may also look darker, there's probably a dark line down the center of your abdomen (the linea nigra), and your areolas could be a deeper shade.
When does melasma appear?
Melasma usually develops in the second or third trimesters, when the levels of estrogen and progesterone are typically higher.
What can you do about pregnancy mask?
There are a few tricks you can try to minimize melasma, including the following:
1. Protect yourself
Exposure to the sun will make your pregnancy mask more pronounced. Wear abroad-spectrum sunscreen with an SPF of 30 or higher on your face all day, every day, even if you’re not going outside, since harmful rays can come right through your windows.
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Stay out of the sun when the rays are strongest — from 10 a.m. to 2 p.m. And make a fashion statement by sporting glam sunglasses and a wide-brimmed hat when you leave the house. When you are outside, reapplysunscreen once every two hours.
2. Conceal it
Make a good concealer your best friend. Choose a corrective foundation and concealer that are non-comedogenic, hypoallergenic and designed to cover hyperpigmentation.
Match the foundation to your skin tone, but use a concealer that’s a shade lighter. First, apply the concealer to the patchy spots. Then apply your foundation to the rest of your face, avoiding the patches.
If concealer causes other problems — for example, if you’ve got oily or sensitive skin — turn to pressed powder to lighten the spots. Many compacts come in a wide range of colors for all skin tones.
3. Try topical vitamin C
Applying this powerful antioxidant to your skin can help brighten melasma while providing other anti-aging benefits, like increased collagen production. It's considered safe during both pregnancy and breastfeeding.
4. Talk to your doctor about azelaic acid
Although most skin-lightening ingredients are off-limits during pregnancy, talk to your doctor about whether you can apply topical azelaic acid to your skin for melasma. It’s often used to treat hyperpigmentation as well as rosacea and acne during pregnancy.
One of the only topical lightening ingredients that’s considered safe to use during pregnancy, it's available in prescription form and over-the-counter gels, foams and creams.
That said, prescribing instructions note thatazelaic acid should be used during pregnancy only if clearly needed. It takes a month or two to work, and it may cause burning, stinging, itching or tingling.
What skin solutions are off-limits during pregnancy?
If you opt for a spa treatment during pregnancy, be sure to let your esthetician know that you’re pregnant.Retinoid treatments and many chemical peels sometimes used to treat hyperpigmentation in facial treatments are a no-go when you’re expecting.
During pregnancy or while you’re breastfeeding, you should also avoid at-home peels, bleaches or other chemical-based lightening treatments, since they can all potentially penetrate the skin. Steer clear of lasers too, since they can be especially irritating during pregnancy.
Does pregnancy mask go away?
The good news:Melasma is usually temporary and fades after delivery or, in some cases, after you finish breastfeeding.
If melasma persists even after you’ve weaned, ask your dermatologist about your options. You may get the green light for any number of treatments — including chemical peels, lasers, intense pulsed light therapy and topical medications — that can help minimize melasma but simply aren’t safe to use if you’re pregnant or nursing.
From the What to Expect editorial team andHeidi Murkoff,author ofWhat to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading ourmedical review and editorial policy.
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