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Melasma 101: Everything You Need to Know About “The Mask of Pregnancy”

May 31, 2019

Melasma 101:  Everything You Need to Know About “The Mask of Pregnancy”

If you’ve noticed dark patches on your cheeks, forehead, or upper lip, melasma may be the culprit. Despite its prevalence, many people have never heard of melasma: a common skin problem that causes a patchy darkening of facial skin.

So, what exactly is melasma?

Often called ‘sun ‘stache’ or ‘the mask of pregnancy,’ melasma is a common skin pigmentation disorder that’s reserved mostly for women. According to the American Academy of Dermatology (AAD), only 10% of melasma sufferers are men.

The condition manifests itself as brown spots or patches on the face and most commonly occurs after some type of hormonal change (i.e. starting a birth control pill, hormone replacement therapy, fertility treatments, or pregnancy).

While melasma is benign, it can be frustrating to live with and skin discoloration and dark spots can can be difficult to conceal. Melasma can sometimes clear up on its own, but if it doesn’t resolve itself, here’s what you need to know.

What causes melasma?

Melasma is often the result of multiple factors, so it can be difficult to diagnose on your own. To rule out other skin conditions, a dermatologist can remove a small bit of skin (called a skin biopsy) and provide a firm diagnosis along with a treatment plan.

According to the AAD, experts believe that melasma likely occurs when color-making cells in the skin (melanocytes) produce too much color. People with darker skin are more prone to melasma because they have more active melanocytes than people with light skin.

Some of the most common melasma triggers include:

  • Sun exposure: Melanocytes are stimulated by UV rays from the sun, so even a small amount of unprotected sun exposure can cause melasma to worsen.
  • Hormonal changes: This is what distinguishes melasma from traditional hyperpigmentation and makes it tougher to treat.
  • Skincare products: Any product that causes skin irritation may exacerbate melasma symptoms.

What are the best treatment options for melasma?

The first step in treating melasma is to confirm your diagnosis with a dermatologist and determine the cause. Depending on the trigger, melasma symptoms can fade as soon as you deliver your baby or switch to a different type of birth control.  

For others, common treatments include brightening creams, topical treatments, fruit acid peels, and mild laser treatments.

Hydroquinone is often recommended by doctors as the first line of treatment. It is available over the counter as a lotion, cream, or gel, and doctors can also prescribe stronger creams for more serious cases.

If you’re interested in a more natural treatment plan, you will find many brightening alternatives to hydroquinone. Plant extracts, such as mulberry, and arbutin both break down into hydroquinone when absorbed into the skin.

Other prescription medications include fluocinolone, which is a corticosteroid (steroid medication), and tretinoin, a retinoid (related to Vitamin A), according to the Mayo Clinic.

The following tricks can also help minimize melasma symptoms:

  • Up your folic acid intake. Studies have shown that a folate deficiency can be related to hyperpigmentation, so fill up on foods that contain folic acid (leafy greens, citrus fruits, beans, and whole wheat). Prenatal vitamins are a great source of folic acid as well.
  • Wear sunscreen with a high SPF. According to Harvard Medical School, melasma will be quick to return if you don’t follow a strict sunscreen regimen. Protect yourself by wearing SPF 30 (or higher!) all day, everyday.
  • Consider concealer. Choose a corrective formula that’s hypoallergenic and designed to cover hyperpigmentation. Make sure you go a shade lighter than your usual product (or your skin tone) and apply to the patchy areas. Then apply foundation to the rest of your face and blend.

    Ingredient Spotlight:

    Vitamin C inhibits an enzyme called tyrosine from converting into melanin (the pigment that darkens skin), so skin gets brighter. vitamin C serum can help improve dark discoloration and promote bright, youthful skin.

    Are any melasma treatments off-limits during pregnancy?

    Don’t use any chemically-based lightening treatments (like peels or bleaches) during pregnancy or while you’re breastfeeding, as they can penetrate the skin. You’ll also want to steer clear of lasers, which can cause irritation.

    As with many skin conditions, everyone’s experience will be somewhat unique and no treatment plan will be 100% effective for everyone. If you’re not sure where to start, consult your doctor to discuss treatment options and strategies.