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Melasma: Skin darkening during pregnancy


Melasma cause causes causes causes skin darkening during pregnancy. It is a type of skin pigmentation also known as chloasma. Mostly common in pregnant women with a tan or dark skin discoloration around the neck and face.

Melasma is thought to be caused by sun exposure, genetic predisposition, hormone changes, and skin irritation.

Melasma: skin darkening during pregnancy

Although it can affect anyone, it is particularly common in women during pregnancy. Additionally, seen in women taking oral or patch contraceptives or hormone replacement therapy.

 Causes of Melesma

Melasma skin darkening during pregnancy can be caused by so many factors majorly of hormonal changes and too much Melanin.


Melasma is thought to be the stimulation of melanocytes (cells in the dermal layer, which transfer the pigment melanin to the keratinocytes of skin) when the skin is exposed to ultraviolet light from the sun.

When your skin get exposed to the sun, it can make melasma return to the skin after it has faded, which is why people with melasma often get it repeatedly.

Birth control pills

Many pregnant women often get melasma, or chloasma, known as the mask of pregnancy. Birth-control pills and hormone replacement therapy also can trigger melasma.

The discoloration usually disappears spontaneously over a period of several months after giving birth or discontinuation of oral contraceptives or hormone treatment.


Genetic predisposition is also a major factor in determining whether someone will develop melasma. People with the Fitzpatrick skin type III or greater from African, Asian, or Hispanic descent are at a much higher risk than others.

In addition, women with a light brown skin type who are living in regions with intense sun exposure are particularly susceptible to developing this condition.

Thyroid disease

The incidence of melasma also increases in patients with thyroid disease. It is thought that the overproduction of melanocyte-stimulating hormone brought on by stress can cause outbreaks of this condition.

Allergies to Cosmeticeuticals

Allergies from certain actives ingredient in products can cause melasma in some people who react negatively when they have contact. Other rare causes of melasma include allergic reaction to medications and food.

Treatments to hasten the fading of the discolored patches include:

Topical depigmenting agents

Depigmenting agents such as hydroquinone (HQ) either in over-the-counter (OTC – 2%) or prescription (4%) strength.

HQ inhibits tyrosinase, an enzyme involved in the production of melanin.
Pregnant women should avoid HQ so they don’t cause harm to their unborns.


Tretinoin is a type of a retinoid, helps to increase cell turnover (keratinocyte). This treatment is not used during pregnancy due to risk of harm to the fetus.

Azelaic acid

Azelaic acid (20%) is thought to decrease the activity of melanocytes effectively.

Tranexamic acid

Oral tranexamic acid has shown to provide rapid and sustained lightening in melasma by decreasing melanogenesis in epidermal melanocytes.

Cysteamine hydrochloride

Cysteamine hydrochloride (5%) present in any over-the-counter product will work for melasma.

Mechanism of action seems to involve inhibition of melanin synthesis pathway.

Kojic acid

Kojic acid (2%) Over the Counter product work for hyperpigmentations melasma, dark spot and uneven skin.


Methimazole is an antithyroid cream or an oral tablet. People who are resistant to hydroquinone can use methimazole.

Flutamide (1%)

Flutamide is a hormone therapy. It is classified as an “anti-androgen.

Niacinamide (4%)

This work showed that niacinamide 4% is an effective agent for the treatment of melasma, as assessed by objective methods and clinical evaluation.


This antioxidant comprises three amino acids (cysteine, glutamic acid, and glycine).  When taken in an oral or injected form, glutathione decreased melanin in people with melasma.

Chemical peels

Microdermabrasion to dermabrasion (light to deep). The chemical solution applied to the affected area causes the top layer of skin to shed, removing with it the unwanted melanin causing the dark patches.

Glycolic acid

The glycolic peel for melasma is the most common chemical peel treatment option. Derived from sugar cane, other form of AHAs are lactic acid, malic acid, mandelic acid. Glycolic acid is an organic compound with a proven application for treating melesma.


Galvanic or ultrasound facials with a combination of a topical crème/gel, either in an aesthetician’s office or as a home massager unit.

Many negative side effects can go along with these treatments, and treatments often are unsatisfying overall.

Patients should avoid melasma triggers including hormonal triggers.  You can use makeup to conceal  them.

Can melasma go away on it own?

In most cases, experiencing the mark of pregnancy is a temporary thing that fades after the baby is born. If your melasma didn’t go away see a dermatologist.


It’s common to have blotchy spots of darker skin when you’re pregnant, a condition called melasma or chloasma.

Women with darker complexions are more likely to have melasma than women with lighter skin. Changes in skin pigmentation due to melasma usually disappear on their own after delivery.

How can I prevent melasma from getting worse during pregnancy?

Skin pigmentation can be difficult to remove, however, you can do a few things to safely minimize darkened spots on your skin during pregnancy:

Use sun protection.

This is crucial because exposure to the sun’s ultraviolet (UV) rays triggers melasma and intensifies pigment changes.

Use a broad-spectrum sunblock (a formula that protects against both UVA and UVB rays) with SPF 30 or higher daily before you go out.
Although dark skin has more melanin (pigment) than lighter skin and doesn’t sunburn as quickly, it’s not enough to protect you from harmful UV radiation.

Limit the time you spend in the sun, especially between 10 a.m. and 2 p.m.

Don’t wax if it causes skin discolouration for you.

Use hypoallergenic skin care products. Cleansers and face creams that irritate your skin may make melasma worse.

Apply concealer. If the darkened spots bother you, cover them up by using makeup.

Don’t use skin-bleaching products while you’re pregnant, and talk to your doctor before starting them if you are breastfeeding.

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