Pregnancy is supposed to be one of the most joyful times of your life. You shouldn’t have to spend it concerned about dark, uneven coloration on your face.
If you’ve noticed brown patches long after your summer tan has faded or hyperpigmentation that suddenly appeared while you were pregnant, you may be suffering from a condition called melasma. You are not alone. Nearly 200,000 new cases appear in the US every year, with women bearing the brunt of this number.
While not dangerous or painful, melasma can feel like a cause for alarm. Usually triggered by sun exposure or an influx of hormones (hence the nickname “pregnancy mask”), it causes patches and dark blotches on the bridge of the nose, cheeks, forehead, chin, and above the lips. Oral contraceptives are a frequent cause of melasma also.
This hyperpigmentation can make sufferers feel conscious or uncomfortable about their complexion. Fortunately, there are safe and non-invasive treatments that can reduce the appearance of melasma.
Diagnosing Pregnancy Mask
Typically, your dermatologist will be able to tell whether or not you’re living with melasma with a simple visual examination and relevant information about your lifestyle and current health. In some cases, they may also use a black light to determine how deeply the condition has penetrated your skin.
In very rare cases, your dermatologist may request a skin biopsy to rule out other conditions.
One of the most important treatments is to avoid additional sun exposure which will cause further hyperpigmentation. Broad spectrum, physical sunscreens must be used and reapplied frequently.
In some cases, particularly when the condition appeared along with the influx of hormones, melasma will fade on its own. For example, many women find that the patches fade once they’ve given birth, and their hormone levels have evened out. This may take months to years to fade. Switching or stopping oral contraceptives is often necessary to improve the melasma.
In other cases, additional treatment may be necessary. Topical treatments include:
- Pigment lightening agents which stop new pigment from forming. Typically, they block one or more enzymes or steps in the formation of melanin. They must be used daily and lightening of the treated areas will take 4-6 weeks at a minimum. Sunscreen must be used in conjunction with the lightening creams. There are many different lightening agents which can be combined. Many times they are combined with an exfoliating agent such as tretinoin or glycolic acid. Some of the more common pigment lightening agents include hydroquinone, kojic acid, arbutin, licorice extract, azelaic acid, sabi white, and tumeric. Antioxidants such as Vitamin C and ferulic acid are also very effective.
- Hydroquinone which can be applied as a cream, lotion, or gel. Lower concentrations (2%) are available in over the counter creams while, stronger concentrations (4% or higher) are prescription. While some are available over the counter, your dermatologist can prescribe medicine with a higher concentration of active ingredient.
- Sometimes, corticosteroids are used in conjunction with hydroquinone to enhance its skin lightening effect. In some cases, your dermatologist may prescribe a “triple cream,” which provides hydroquinone, corticosteroids, and tretinoin in one medicine.
If topical treatments don’t work, other procedures are available. Chemical peels, microneedling, microdermabrasion, IPL, and laser treatments may be effective following your pregnancy, if hyperpigmentation persists. See your dermatologist regarding other treatments.
If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.