Melasma is also called the mask of pregnancy and Choasma faciei and is a condition that is more frequently found in pregnant women and women under oral and patch contraceptives, as it is caused by the presence of high amounts of estrogen and progesterone. The condition causes darker spots on the surface of the skin and may affect the facial area or the forearms.

Melasma and Pregnancy

Melasma occurs mostly during pregnancy, as it is a result of the presence of female sexual hormones (estrogen and progesterone). These hormones will stimulate the melanocytes, which will produce more pigments than usual, resulting in dark patches. However, these patches occur only if the skin is exposed to sun.

The condition is more common in women with a fairer complexion or a light brown skin type. There are also women who are genetically predisposed to developing melasma. Stress and thyroid dysfunctions may contribute to the occurrence of melasma.

Symptoms of Melasma

Melasma manifests through irregularly shaped dark patches which are most visible on the forehead, cheek, nose, lips or the upper lip. The discoloration is typically gradual and may evolve, so the patches will become darker. There will be no other symptoms such as pain or itchiness.

Diagnosing Melasma

A melasma may be detected by using the Wood’s lamp, which is a device that employs light with wavelength between 340 and 400 nm. The lamp will reveal the presence of excess melanin on the skin.

Treatment Options

The melanoma will typically disappear without treatment after delivery. This may happen a few weeks to a few months after giving birth, as the estrogen and the progesterone will get back to normal levels.

However, there are a few treatments that may lighten the melasma including:

  • Topical ointments that will lighten the pigmentation such as Hyrdoquinone (HQ), which shouldn’t be used in concentrations over 4%; HQ inhibits the production of an enzyme known as tyrosinase, which contributes to the formation of melanin
  • A diluted solution of azelaic acid (in concentration of up to 20%) may decrease the production of melanin
  • Different facial chemical peels that employ alpha or beta hydroxyacids
  • Glycolic acid peels
  • Laser treatments such as fractional resurfacing or the Fraxel treatments
  • Treatment with mandelic acid (i.e. Triluma cream)
  • Natural treatments with lemon juice or parsley juice

These topical ointments will not eliminate the melasma, but will lighten the dark patches. Only the laser treatments may remove the melasma.

Talk to your dermatologist to establish if these solutions may be applied in your condition and to recommend you the best solution. Some of these solutions shouldn’t be applied during pregnancy.

Melasma Prevention

The best way to avoid melasma is to stay away from sun during pregnancy, as the sun will stimulate the production of pigments. Use a high protection factor sun screen and make sure these contain physical blockers (i.e. titanium dioxide or zinc dioxide).