5 ways to fight Melasma: ‘The mask of pregnancy’

Unrecognizable female suffering from hyperpigmentation (melasma) is about to use face serum for skin brightening. She has dark spots on her face and her eyes are closed.

Every pregnancy is different. My second pregnancy is definitely different from the first one, one of the reasons being that I developed melasma this time. It is a distressing cosmetic condition, and other changes in the body are themselves enough to make us self-conscious, so melasma was definitely uncalled for. But being a doctor, I was aware of the condition and also about the temporary nature of the same so there was some assurance. However, I understand that not many moms, especially new moms are unaware of melasma and may find themselves overwhelmed by yet another change in their appearance. Hence, I wrote this blog to increase awareness and also to reassure that this too shall pass ?

What is melasma?

Melasma is brownish-bluish discolored patches on the face, develops gradually, and can resemble freckles. The most commonly affected areas are the cheeks, chin, nose, forehead, or around mouth. The lesions develop symmetrically on both sides of the face and thus are also called ‘the mask of pregnancy’. The lesions are painless, non-itching, and non-irritant and around 50-70% of pregnant women have melasma.

Why does melasma manifest in pregnancy?

Melasma develops in pregnancy due to hormonal changes, specifically because of the Increase in estrogen and progesterone levels. Though it is more common in the second or third trimester of pregnancy as the hormone level increases, it can occur anytime.

Who is more likely to have melasma during pregnancy?

People from African, Asian, Middle-Eastern, Mediterranean or Latin countries who already have increased melanin pigment in their skin are more likely to have this condition. Also, people who have blood relatives with melasma are more susceptible to it. 

How can melasma be prevented?

There are many ways that can affect the development of melasma, though none of these are foolproof and you may develop melasma even if you are taking all precautions. A few preventive tips to avoid melasma are:

  • Stay away from the sun: Avoid sunbathing, and tanning beds and seek shelter from long exposure to the sun. The sun should particularly be avoided when the rays are strongest, between 10 am and 4 pm.
  • Regular use of sunscreen: Sunscreen which is pregnancy safe, has SPF of 30+, and relies more on physical blockers like zinc oxide, titanium dioxide, or other physical blockers rather than chemical blockers. Sunscreen has to be applied on the face even if you are inside as harmful UV rays can come through the windows. When outside the sunscreen should be re-applied every two hours,
  • Physical protection: Wide-brimmed hats, oversized sunglasses, and protective clothing are a savior
  • Chose skincare products wisely: Use gentle skincare products that read non-comedogenic, fragrance-free, chemical-free, or those for sensitive skin

Can melasma in pregnancy be harmful to the baby?

No, it is merely a cosmetic condition and does not harm the baby in any way.

5 ways to fight melasma during pregnancy:

Though some experts suggest that melasma during pregnancy should not be treated as the treatment options are either unsafe or ineffective, there are seven ways to get some respite:

  1. Use a chemical exfoliant: You should consult your healthcare provider before applying anything if you are pregnant. Some milder remedies are safe to use during pregnancy like:
    • Azelaic acid act as an anti-inflammatory and exfoliant. Though most lightening agents are off-limit during pregnancy, azelaic acid is safe to use and is used to treat hyperpigmentation and acne during pregnancy
    • Kojic acid acts as a bleaching agent
    • Hydroquinone reduces melanin production
  2. Home remedies: Use home remedies like lemon and cucumber juice, cooked oatmeal with honey, or diluted apple cider vinegar. These will soothe the skin, act as gentle exfoliates, and lighten the skin. During pregnancy or while breastfeeding, you should avoid at-home peels, bleaches, or other chemical-based lightening treatments, since they can all potentially penetrate the skin. Lasers, which can be irritating incredibly during pregnancy, are a no-no too.
  3. Supplementation: Few studies link melasma with a deficiency of vitamin B12 or Iron. Supplementation is important in pregnancy and essential fatty acids; iron and vitamin supplements should be consumed regularly as the doctor suggests.
  4. Topical vitamin C: Vitamin C is a potent antioxidant that brightens the skin along with boosting collagen production. It is safe to use during pregnancy and breastfeeding.
  5. Cover it up: If melasma is causing a great deal of distress then use pregnancy-safe makeup. Look for non-comedogenic or hypoallergenic foundations, concealers, powders, and other products.

Conclusion

Melasma, also known as “the mask of pregnancy,” can be a frustrating and confidence-damaging condition. However, with the right approach and treatments, it can be managed and even treated. By incorporating a combination of sun protection, skin-lightening products, chemical peels, and a healthy diet, you can help to reduce the appearance of melasma and improve the overall health and appearance of your skin.

Most cases resolve completely after a few months of delivery despite no treatment. But, you may consult your dermatologist about other treatments if your melasma doesn’t fade on its own.