Yes, the "Mask of Pregnancy" Is Real—How to Treat and Manage Melasma
There's an inexplicable joy when you first discover you're pregnant, combined with an indescribable (and often irrational) amount of fear too. It was just a year into our marriage when my son decided to make an appearance in our lives. It was unplanned and, as you can imagine, my husband and I were completely blindsided. We weren't ready, but who is, right? Despite all the planning, there are so many unexpected things you can't prepare for (I'll detail those in a separate story), and one of those is melasma.
While this skin concern is very common among women (and men) who aren't pregnant too, the change in hormones during those nine months can trigger the darker pigment to appear on the face (isn't that nice?). So what is melasma exactly, and how do you get rid of it during a time when most chemicals and treatments are off limits?
"Melasma is a form of pigmentation induced by hormones and light," explains dermal therapist, skincare expert to the stars, and mother of two Melanie Grant. "It usually appears across the forehead, cheeks, and upper lip in a butterfly pattern but can also appear in single spots or patches. This type of pigment often presents during pregnancy, hormone replacement therapy, or for those of us on the pill. It can also appear without any of the above factors."
Grant shares her best at-home and in-salon tips for how to treat (and manage) melasma during pregnancy (because it will always be there underneath the skin), and the best products to use after your baby is born to keep it at bay.
Why We Get It
Grant tells me melasma during pregnancy is common, especially during summer when there's more light and heat to stimulate the condition. "Hormones stimulate the production of melanocytes, which are the cells responsible for producing pigment, and natural light stimulates these cells to produce excessive pigment," she says. "So we have two problems: too many melanocytes and light that's constantly stimulating them."
In a recent thread on the MyDomaine Moms Facebook group, many of you asked if these spots will eventually fade post-birth. Grant says if the melasma starts during a pregnancy, then there's a high chance it will self-resolve within three to six months of giving birth "but not always." And if you've suffered melasma with your first pregnancy, it's highly likely it will reappear in subsequent pregnancies too.
"In saying this, I don't recommend leaving your pigment untreated until after you’ve finished having children," stresses Grant. "I see many women do this, and it just gets worse over time, especially if exposed to light and heat. If your melasma doesn't self-resolve, I'd suggest maintaining your skin with gentle peels, light therapy, and microdermabrasion during your pregnancies and in between if you're having your children close together. Once you've finished having babies or expect to have a break in between, I'd suggest a depigmentation peel such as Dermamelan."
How to Treat It During Pregnancy
The first step is to block light. "This is crucial to treating and preventing further darkening of melasma," says Grant. "Layer a broad-spectrum, physical sunscreen with a high SPF each and every day under a mineral makeup sunscreen such as Colourscience Sunforgettable."
Secondly, avoid sun exposure at all costs. "Stay out of the sun, especially in the middle of the day, wear wide-brimmed hats and sunglasses, and avoid saunas and steam rooms, as excessive heat will also stimulate the production of pigment." Grant says using sunscreen and avoiding sun exposure is crucial.
Try gentle microdermabrasion. "AHA peels and light therapy can lessen the intensity of the pigment by increasing the turnover of skin cells, which in turn hastens the removal of the unwanted pigment," she says. "And light therapy will minimize inflammation."
Invest in gentle plant-based lightening products. "Look for ingredients such as kojic acid, arbutin, or azelaic acid, as all may be used during pregnancy," she says. "However I always recommend checking with your doctor. These products will help to minimize the intensity and severity of the condition by inhibiting the production of pigment. Vitamin C is wonderful for brightening and also offers antioxidant protection. Definitely use a vitamin C serum in the morning underneath your sunscreen."
Don't use traditional bleaching creams with hydroquinone, retinoids, and steroids. "These are not suitable for use during pregnancy," explains Grant. "For corrective treatment, I'd suggest waiting until after you have your baby to see what happens. If you think your melasma is caused from the pill, see your doctor straight away. I advise where possible to stop taking the medication causing the pigment straight away, as the longer you take it, the harder it is to treat the melasma; kind of like a stain." If it's from hormone replacement therapy, then Grant recommends speaking to your doctor about taking your dose in the evening so peak levels occur overnight.
The Best Treatments Post-Pregnancy
Unfortunately, melasma is one of the most difficult conditions to treat. There's no true cure, however, Grant says it can definitely be managed and controlled. "For those women who aren't as lucky (where the condition doesn't self-resolve), I will usually treat their skin with a Cosmelan or Dermamelan depigmentation peel, along with microdermabrasion, gentle AHA peels, light therapy, and brightening infusions."
So what exactly is Dermamelan? According to Grant, it's a chemical peel with ingredients such as azelaic acid, kojic acid, phytic acid, ascorbic acid, arbutin, and titanium dioxide. "This peel removes or reduces the discolouration whilst also inhibiting the excessive production of further melanin," she explains. "For this treatment to be successful and prevent the condition from returning, it's essential to use the topical depigmentation cream for a minimum of four months after the treatment."
Manage Your Melasma
The Best Products Post-Pregnancy
Without a doubt, the first step in managing (and preventing) melasma is plain old physical broad-spectrum SPF 50 sunscreen. But on top of that, Grant also has a few other suggestions that will help fade those spots and keep them from coming back.
- Cosmelan Depigmentation Cream
- SkinMedica Lytera Brightening Serum
- SkinCeuticals CE Ferulic Serum
- Biologique Recherche Lotion P50 PIGM 400
- Chanel LeBlanc Brightening Concentrate (the TXC formula) "The entire LeBlanc range is great as it gently lightens without irritation."
For severe cases, Grant suggests a prescription-strength hydroquinone bleaching cream, however, use these treatments with caution as they can cause other issues and are not suitable for long-term use.
Before: My Skin With Melasma the Day Our Son Was Born
Courtesy of Sacha Strebe
I had no idea that melasma would even occur during pregnancy, so when it did appear, I was really taken aback at how much I developed. While it is a little hard to tell in this photo, the pigment swept across my cheeks, forehead, upper lip, and chin area, causing uneven skin tone all over my face. About two months after my son's birth, I went in for some IPL (intense pulsed light) treatments; however, Grant wouldn't advise this. "I don't generally recommend laser or IPL for melasma," she says. "The heat from these treatments may induce further pigment and I've seen better results with depigmentation peels. IPL and laser are great for sun-induced pigment."
After: My Skin Now After In-Salon Treatments and a Brightening Home Care Routine
I am one of the lucky few (can you hear that sarcasm?) whose melasma didn't disappear post-pregnancy. But thanks to regular visits with a dermal therapist for in-salon treatments, such as laser genesis (I frequent Kate Somerville for this), monthly lactic or salicylic acid peels, and brightening skincare products at home, I have kept my melasma under control. But it's work, and, unfortunately, it always rears its brown-colored head around my period each month. But if you're invested and determined to manage your melasma, the good news is you can. It just takes discipline (but it's worth it).
Melanie Grant's Top At-Home Skincare Regimen to Manage Melasma
For busy moms, Grant recommends keeping your skincare regimen simple. "This will ensure consistency, which is key to achieving and maintaining great skin," she says. See, I told you!
Lactic Acid Cleanser
"Try a lactic acid cleanser to purify, exfoliate, and brighten your skin in one step. Lactic acid is gentle enough for most skin types and won’t strip or dehydrate your skin."
Vitamin C Serum
"A vitamin C serum in the morning will offer antioxidant protection as well as brightening and firming."
"A broad-spectrum sunscreen with a high SPF is essential to a great regimen. Try finding one that has a built-in moisturizer to kill two birds with one stone."
Makeup With SPF
"Makeup with a built-in physical SPF 50 is great for those prone to pigment as a second layer over your primary sunscreen. Colourscience has some good powder and liquid options. The powder is a great way to reapply throughout the day as well."
"Try a restorative, hydrating, or brightening serum for nighttime. Our skin repairs and regenerates itself while we sleep, so a nighttime serum or a sleeping mask can yield some powerful results overnight."
"Moisturize morning and night even if you’re skin is oily. There are so many great oil-free hydrators that won't congest your skin or cause blemishes. Fine lines and sallow complexions are often caused by dehydration. So keeping your skin moist and supple will prevent this."
"I also love an at-home DIY facial in the bath. Double cleanse your skin and follow with a gentle exfoliant. Next apply a cream, clay, or sheet mask depending on your skin's condition and leave for around 20 minutes. If you don't have a mask on hand, you can apply Manuka honey or natural yogurt. Remove your mask with a warm face towel and massage a face oil or serum into your skin using upward, circular motions with your ring and middle fingers. Be careful not to pull or drag your skin. Finish with your favorite moisturizer, eye treatment, and lip balm."
Did you develop melasma during pregnancy too? How do you manage it? Share your story and the skincare that worked below!