Melasma in Pregnancy: Treatment and Causes - Healthline

Your body goes through tremendous changes during pregnancy.


Your belly gets larger and your blood volume increases as your baby grows. You may experience cramping, morning sickness, and all sorts of unfamiliar aches and pains. Your hair and skin may also go through a transformation for the better — or worse. (You’re beautiful all the same.)


If you’ve noticed dark patches of skin on your face, you may have melasma. Here’s more about this condition, why it crops up in pregnancy, and how you can treat it safely.


Melasma is a skin disorder where the melanocytes (color-producing cells) in your skin produce extra pigment for some reason. In pregnancy, it’s often referred to as chloasma, or the “mask of pregnancy.”


Chloasma is a cosmetic concern. It doesn’t affect your baby in any way or indicate any other pregnancy complications.


People with more pigment in their skin — for example, those of African, North African, Middle Eastern, Latin or Hispanic, Asian, Indian, or Mediterranean descent — are more likely to develop chloasma, as they naturally have more active melanin production.


Overall, between 50 and 70 percent of people will develop some form of melasma during pregnancy.


Related: Skin color needs to be factored in when discussing skin diseases



The primary symptom of chloasma is darkening of the skin on the face. You may notice dark patches or splotches on your forehead, cheeks, chin, or around your mouth. These areas may get darker the more you’re exposed to the sun or the further along you are in your pregnancy.


Pain, itchiness, or soreness are not symptoms of melasma. If you experience these signs or develop severe irritation, you may be dealing with another condition. Bring up any additional symptoms you have with your doctor.


A dermatologist can accurately diagnose your condition using a Wood’s lamp, which helps show whether a skin condition is bacterial, fungal, or otherwise concerning.


Skin hyperpigmentation during pregnancy is very common. You may notice your nipples/areolas, armpits, or genitals become darker. You may see a line (linea nigra) extending from the pubic area over the belly, or darkening of the skin all over the body.


Changing hormones, particularly the excess of estrogen and progesterone, is the main cause of melasma during pregnancy. Beyond that, the dark patches on the face can be exacerbated by sun exposure, the use of certain skin care products or treatments, and even genetics.


Chloasma may also be worsened by hormonal imbalances that may have been present even before pregnancy.


Whatever the case, your melanocyte-stimulating hormones react to these triggers by making an excess of protective pigments (dark patches) on the skin called melanin.


Melasma may start at any point in your pregnancy, though it most commonly begins in the second or third trimester.


Again, there are a variety of factors at play when it comes to darkening pigment. Your skin color and type may make this condition more or less noticeable. How much you’re out in the sun or even the time of year when you’re pregnant may also affect when you first notice it.


The good news is that this hyperpigmentation likely won’t get worse after you deliver your child. That said, it may take time — possibly months — for it to completely fade without any targeted treatment.


Speak with your doctor about ways to treat your melasma during pregnancy. Your doctor may refer you to a dermatologist for more information.


Some experts don’t recommend treating melasma during pregnancy. One reason is that it may resolve on its own. And some treatment methods may not be safe or effective to use when pregnant.


The best course of treatment may actually be prevention, with the help of a few lifestyle changes.


Seek shade


Since the sun may trigger the development of more pigment, it’s a good idea to stay out of its rays, especially for long periods of time.


Yes, this also applies to tanning beds or any other environment where you would be exposed to UVA and UVB rays. Limit sunbathing and try relaxing under a tree or umbrella instead.


If you’re exercising, try avoiding peak sun hours in your area, generally the middle of the day. Head out early in the morning or later in the evening when the sun is low.


Wear sunscreen


This doesn’t mean you have to stay indoors when the sun is out, though. Wearing a good pregnancy-safe sunscreen with SPF 30+ is key.


Look for products that contain zinc oxide, titanium dioxide, or other physical blockers (mineral sunscreens) versus those that rely on chemical blockers. Physical blocking sunscreens tend to offer broader protection and may be less irritating to the skin.


Dress for success


Another option for sun cover is clothing with or without UV protection, such as SPF rash guards or sun protective clothing. Even if it’s hot outside, loose-fitting clothing can be comfortable and protect your skin.


What about the face? Wide brimmed hats are your best friend. And don’t forget a stylish pair of sunglasses — the bigger the better.


Use gentle skin care products


Face washes, lotions, and serums that irritate your skin may make melasma worse. Slather up with gentle products instead. Look on the label for words like “noncomedogenic,” “sensitive,” “fragrance-free,” or “dermatologist approved” if you get overwhelmed in the beauty aisle.


The same goes for makeup you may use to conceal the dark areas. Look for noncomedogenic or hypoallergenic foundations, concealers, powders, and other products.


Related: Your guide to pregnancy-safe skin care


Try at-home masks and methods


You may be able to lighten your melasma using ingredients from your pantry. While there are no specific studies on these methods for chloasma, the following topical treatments may help:



  • Lemon juice. Mix together a solution of half fresh lemon juice and half cucumber juice or water. The acid in the juice may help remove pigmentation in the top layer of the skin.

  • Apple cider vinegar (ACV). Similar idea here. Mix a solution of half ACV and half water to use as a toner on dark areas.

  • Milk of magnesia. After washing your face, apply milk of magnesia to dark areas using a cotton ball. Leave on the skin overnight and wash off in the morning.

  • Oatmeal and honey. Whip up a mask made with cooked oatmeal (let it cool down so it isn’t hot) and raw honey. Leave on the skin for 10 minutes before washing away. The mask helps to exfoliate your skin and the enzymes in the honey may lighten it a bit.


Eat well, rest, and try a few supplements


Since melasma may also be the result of hormonal imbalances, you may improve matters by giving yourself some much-needed TLC. Make sure you’re staying hydrated, eating a diet with plenty of fresh fruits and vegetables, and getting enough sleep each night.


Be sure that you’re rounding out your diet by consuming supplemental omega-3 fatty acids. And ask your doctor about any potential vitamin deficiencies. Some studies link melasma to deficiency in iron and possibly vitamin B12.


Be patient


After pregnancy, you may ask your dermatologist about other treatments if your melasma doesn’t fade on its own. Treatments include topical medications like:



  • hydroquinone

  • tretinoin

  • corticosteroids


Your doctor may also recommend certain acids that lighten the skin, alone or in combination. There are also some procedures — including chemical peels, microdermabrasion, laser treatments, and other light therapies — that may work.


It can be frustrating to deal with changes to your skin during pregnancy. Fortunately, chloasma generally fades within a few months after giving birth.


There are various lifestyle changes you can try to prevent the condition from progressing during pregnancy. Otherwise, speak with your doctor about the options for treatment and the benefits and risks of each. You’ll be glowing again before you know it!