Skin changes during pregnancy - melasma (2024)

What is melasma?

Melasma refers to brown patches that can appear on your skin, usually on your face. It is also known as chloasma or ‘the mask of pregnancy’.

It is very common in pregnancy, usually in the second or third trimester. People who aren’t pregnant can also develop melasma. It’s more common in females than in males. It’s also more common among people whose skin is brown or tans easily than people whose skin is fair or black.

Melasma brown patches are usually symmetrical. They often appear in a typical pattern, most commonly on your forehead, cheeks, nose and upper lip. Sometimes they can appear along your jaw and chin and occasionally on your shoulders and arms. In some people the patches may look red.

What causes melasma?

Melasma can develop when your skin makes more melanin. Melanin is the substance that gives your skin its colour. Higher melanin levels can make your skin darker.

It’s not fully understood why this happens. Some things that can lead your skin to make more melanin include:

• exposure to sunlight
• hormonal changes — these occur in pregnancy, but can also occur if you take medicines that contain oestrogen or progesterone, such as contraceptives or menopausal hormone therapy
• some medicines and cosmetics
• exposure to heat — this might be at work or from cooking

You also have a higher chance of developing melasma if it runs in your family.

Can melasma be prevented?

The best way to prevent or reduce your chance of getting melasma is to wear sunscreen and stay out of the sun as much as you can. If you already have melasma, this may stop it getting worse.

Will melasma affect my pregnancy?

If you have melasma, it won’t cause any health problems. It might be difficult to cope with emotionally, especially if it’s on your face. Some people feel self-conscious and find that melasma affects their mood, relationships and performance at work.

How is melasma treated?

It’s very important to protect your skin from sun exposure all year round. This helps make treatment more successful.

It’s best to use a sunscreen containing titanium or zinc or a tinted sunscreen that blocks sunlight. Make sure your sunscreen is rated SPF 50+ and gives broad-spectrum protection. Put it on twice a day, 20 minutes before you go outside. Read more about other things you can do to protect your skin from the sun.

Many people find that they can cover up melasma with cosmetics.

While it can be hard to treat, there are many different options that may improve melasma and they are often used in combination. Many are not safe in pregnancy, so check with your doctor or pharmacist before you start. Some treatments that can help include:

• a variety of medicines in creams or tablets
• chemical peels
• laser or light therapies

Some of these treatments can only be prescribed by a dermatologist (specialist skin doctor). You can ask your doctor for a referral.

Will melasma affect my baby?

Melasma won’t affect your baby. Some products to treat melasma may be harmful to your baby if you use them in pregnancy, such as creams containing hydroquinone or tretinoin. Check with your doctor or pharmacist that any treatment you use is safe in pregnancy.

When should I see my doctor about melasma?

See your doctor if you notice brown patches on your skin. Your doctor can check if they are caused by melasma or another skin condition. This is especially important if the brown patches appear on other areas of your body besides your face.

Your doctor or dermatologist may be able to diagnose melasma by examining your skin with special equipment, such as a Wood lamp and dermatoscope. Sometimes you might need to have a skin biopsy.

Will I still have melasma after I've had my baby?

If you developed melasma during pregnancy, there’s a good chance that it will fade over time. This may take a few months. It could come back again if your skin is exposed to the sun.

Will I have melasma in future pregnancies?

If you’ve had melasma during pregnancy, it could come back in a future pregnancy.