How to Treat and Manage Melasma During Pregnancy

The mask of pregnancy is real

Updated 09/24/19
A pregnant woman wearing a cold shoulder sweater with fringed sleeves.
Daniel Zuchnik/Getty Images

There's an inexplicable joy when you first discover you're pregnant, and it's often combined with an indescribable (often irrational) amount of fear, too. It was just a year into my marriage when I became pregnant with my son. The pregnancy was unplanned, and my husband and I were completely blindsided. (We weren't ready, but who is, right?) Despite all the planning we could manage, there were so many unexpected things we couldn't prepare for, and one of those was pregnancy melasma, a bothersome skin condition that causes unsightly brown patches to form on the face.

While this tricky skin problem is more common in women (it even occurs in those who aren't pregnant), men experience it, too. But pregnancy, especially, and the hormonal changes one undergoes during that nine-month period, can trigger the sudden emergence of darker skin pigmentation, aka "the mask of pregnancy."

So, exactly what is melasma, and how can you eradicate it when most chemical-based skincare treatments during pregnancy are off-limits?

Melanie Grant—a dermal therapist, "celebrity skin whisperer," and mother-of-two—dishes on her best at-home tips for the treatment and management of pregnancy melasma and the best products to use after baby is born to stave it off for good.

Black and white portrait of a woman with her hand resting underneath her chin.
Nicole Bentley, courtesy of Melanie Grant

Demystifying Melasma

"Melasma is a form of hyperpigmentation induced by hormones and light," explains 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 pigmentation often presents during pregnancy, hormone replacement therapy, or while taking birth control pills. It can also appear without any of the above risk factors."

Causes of Melasma

Grant says that melasma during pregnancy is common, especially during the summer, when more exposure to daylight and heat can stimulate the condition. "Hormones stimulate the production of melanocytes, the cells responsible for producing pigment, and natural light stimulates them to produce excessive pigment," she explains. It's a perfect storm of, "too many melanocytes and an influx of light to constantly stimulate them," Grant says.

Many women wonder if this unwanted pigmentation will eventually fade post-birth. Grant notes that if the melasma starts during pregnancy, then there's a high chance it will self-resolve within three to six months after 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.

How to Treat Melasma During Pregnancy

"I don't recommend leaving melasma untreated until after you’ve finished having children," stresses Grant. "Many women do, but the skin just gets worse over time, especially when exposed to light and heat." If your melasma doesn't self-resolve, Grant suggests "maintaining your skin with gentle peels, light therapy, and microdermabrasion during pregnancy." Then, "once you've finished having babies or expect to have a break in between, use a depigmentation peel like Dermamelan." Grant is fond of Dermalean because it is designed to remove (or reduce) hyperpigmentation, "while inhibiting the excessive production of further melanin," she explains. "For a Dermalean treatment to be successful, and prevent the condition from returning, the topical depigmentation cream must be applied for a minimum of four months after."

While you're pregnant, Grant recommends taking the following five steps to keep melasma at bay:

  1. Use sunscreen. "This is crucial to treating and preventing further darkening of melasma," says Grant. "Every day, apply a broad-spectrum, physical sunscreen (with a high SPF) under a mineral makeup sunscreen."
  2. Avoid sun exposure. "Stay out of the sun, especially in the middle of the day," cautions Grant. "Wear wide-brimmed hats and sunglasses, and avoid saunas and steam rooms, as excessive heat will also stimulate pigmentation."
  3. Try a gentle acid peel. "AHA peels, and light therapy, too can lessen the intensity of the pigment by increasing the turnover of skin cells, which in turn, hastens the removal of unwanted pigment," she says. "And light therapy minimizes inflammation."
  4. Buy plant-based products. "Shop for treatments containing ingredients such as kojic acid, arbutin, and azelaic acid, as all may be used during pregnancy—but I always recommend checking in with your doctor," she advises. "These products will help minimize the intensity and severity of melasma by inhibiting pigment production."
  5. Skip traditional skin-bleaching and -lightening creams. Especially those containing hydroquinone, retinoids, and steroids, cautions Grant. "They're no-nos during pregnancy."
A long haired woman applying cream underneath her eyes.
VladimirFloyd/Getty Images

Grant's At-Home Melasma-Management Regimen

Grant recommends keeping skincare routines simple, especially for busy moms. "This ensures consistency, which is key in achieving and maintaining great skin," she says. Here's a list of Grant's must-have products to add your anti-melasma arsenal:

Lactic Acid Cleanser

White tube of face wash with blue writing.
Biologique Recherche Lait VIP 02 $229
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"Lactic acid cleansers purify, exfoliate, and brighten skin in one step. Lactic acid is gentle enough for most skin types and won’t strip or dehydrate the skin," says Grant. Also try Cosmedix Purity Clean Exfoliating Cleanser.

Vitamin C Serum

A dropper bottle with a white label and black and blue writing.
SkinCeuticals CE Ferulic With 15% L-Ascorbic Acid $166
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After cleansing in the morning, Grant recommends applying a vitamin C serum: "Vitamin C offers antioxidant protection and it has wonderful brightening and firming capabilities," she says. Also try The Ordinary Ascorbyl Glucoside Solution 12%.

Sunscreen

A white bottle of sunscreen with yellow and gray writing.
ISDIN Eryfotona Actinica Ultralight Emulsion $55
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"A broad-spectrum sunblock with a high SPF is essential," Grant notes. "Kill two birds with one stone and find one with a built-in moisturizer." Also try ASAP Moisturizing Daily Defence SPF 50.

Makeup With SPF

An open blue compact full of tan foundation and a sponge applicator.
Physicians Formula Mineral Cushion Foundation SPF 50 $16
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"Makeup with built-in physical SPF is great for layering over your primary sunscreen," she says. Also try Colorescience Tint du Soleil SPF 30 Whipped Foundation.

Brightening Serum

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Kiehl's Midnight Recovery Concentrate $49
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"Apply a restorative, hydrating, and brightening serum every day," advises Grant. "Our skin repairs and regenerates itself while we sleep, so an overnight serum or sleeping mask can yield powerful results, too." Also try SkinCeuticals Resveratrol BE.

Moisturizer

A gray bottle of skin serum with a silver top next to a blue box with white writing.
SkinMedica HA5 Rejuvenating Hydrator $178
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"Moisturize morning and night, even if your skin is oily," instructs Grant. "There are so many great oil-free moisturizers that won't clog pores or cause blemishes. Fine lines and sallow complexions are often caused by dehydration, so keep your skin moist and supple." Also try The Ordinary Hyaluronic Acid 2% + B5.

DIY Facial 

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Wedderspoon Raw Monofloral Manuka Honey $23
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"I also love creating custom DIY facials," says Grant. "First, double-cleanse your skin and follow up with a gentle exfoliant. Next, apply a cream, clay, or sheet mask and leave it on for roughly 20 minutes." No store-bought masks on hand? Grant says Manuka honey and natural yogurt work well as masks, too. "Remove your mask with a warm washcloth before massaging face oil or serum into your face in upward, circular motions. Be careful not to pull or drag," she advises. "Finish with your favorite moisturizer, eye treatment, and lip balm." Also try Fage Total 5% Milk Fat Greek Strained Yogurt.

Best Post-Pregnancy Melasma Treatments & Products

Although there's no true cure for melasma, it can still be effectively managed and controlled, often via in-office visits. "When the condition doesn't self-resolve post-pregnancy," says Grant, "I treat skin with a Cosmelan or Dermamelan depigmentation peel, microdermabrasion, gentle AHA peels, light therapy, and brightening infusions."

Post-pregnancy melasma management and prevention always begins with regular application of broad-spectrum physical sunblock (as opposed to chemically-based sunscreen) with SPF 50. After that, Grant recommends the following products to help fight it and prevent it from coming back:

Powerful Skin-Lightening Cream

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Cosmelan Mesoestetic Cosmelan 2 Maintenance Depigmentation Cream $166
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A Cult Favorite

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Biologique Recherche P50 PIGM 400 $245
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