Melasma, also known as chloasma or the mask of pregnancy, is a condition which is very common in pregnant women. This does not mean that only pregnant women can get melasmas; women of all ages can be affected by this condition - and so are men sometimes.

Melasma is a condition in which certain areas of the skin become darker than the surrounding skin. This darkening of the skin is called hyperpigmentation, and it usually occurs in the face, particularly the forehead, cheeks and above the upper lip. These dark patches can appear on both sides of the face in almost identical patterns, and can be any shade of colour between tan and deep brown.

It’s very rare for these dark patches to appear in other sun-exposed areas of the body than the face. Hormonal imbalance is considered to be the main reason behind melasamas, which explains why it’s common in pregnant women. Because melasmas affect appearance, having dark patches on your face - especially during pregnancy, when most women face mood swings - can be quite distressing and can even affect your quality of life.

However, it’s very important to remember that melasmas are caused by hormones, and once the hormonal upheaval is done - after you deliver your baby - the dark patches will likely disappear by themselves. If they do not, you should consult a dermatologist, and he or she will give you therapeutic recommendations to cure the melasma.

Read more: After delivery care for the mother

  1. Symptoms of melasma in pregnancy
  2. Causes of melasma in pregnancy
  3. Diagnosis of melasma in pregnancy
  4. Treatment of melasma in pregnancy
Doctors for Melasma in pregnancy

Melasma causes patches of pigmentation which are darker than your original skin tone, and they usually appear during the first trimester of pregnancy. You’re likely to notice them appearing in the 9th week of pregnancy or even the 11th week of pregnancy, and they’re going to last for the entirety of your pregnancy if they do. The patches are symmetrical and usually appear on both sides of the face. These patches of pigmentation are more likely to appear on the following parts of the body:

  • Cheeks
  • Forehead
  • Chin
  • Bridge of the nose
  • Neck (rare)
  • Forearms (rare)

If you see melasmas appearing during your first trimester of pregnancy - or any time after that - do consult your doctor and talk to a dermatologist as well. 

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The precise causes behind melasma is not known, but it’s usually associated with changes in hormonal status. Now these changes could be for a number of reasons. The following are some of the reasons doctors usually believe are responsible for the appearance of melasmas in general:

Pregnancy is a time of natural hormonal changes. Estrogen, progesterone, human chorionic gonadotropin and human placental lactogen - all these types of hormones shoot up to maintain the pregnancy and help your body support the growth of another life within it.

Naturally, this is a time of huge hormonal upheaval, and this is the main reason why melasmas appear during pregnancy. If you have a family history of melasmas, or have stress, hypothyroidism, etc. the chances of melasmas during pregnancy increase manifold.

Read more: Female hormones: Tests, imbalance, symptoms and how to balance

A simple visual examination done by an obstetrician or dermatologist can confirm that you have melasma during your pregnancy. If you’re not pregnant, however, your doctor will want to conduct tests to find out the underlying causes of melasma. Apart from getting a hormone profile done, your doctor might recommend a skin biopsy or check the affected skin under a special type of light to check for fungal infections or bacterial infections

Read more: Home remedies for pigmentation

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For most pregnant women, melasmas disappear on their own once the baby is delivered and the hormone imbalance settle down back to normal. This can take a few weeks or months after delivery to happen completely and for your skin to clear out. Women who live in sunny climates, like India, might take more time to heal if they are exposed to the sun. 

The same goes for women who are exposed to UV rays or artificial light, in studios and movie sets for example. If your melasma persists a few months after delivery or if you’re worried about it, talk to a dermatologist about topical treatments via UV blocking creams, sunscreens, etc. This type of treatment might not be recommended to you while you’re breastfeeding your baby for the first few months. Patience is clearly the best and perhaps the only way to treat melasma in pregnancy.

Read more: How and when to stop breastfeeding your baby

Dr Sujata Sinha

Dr Sujata Sinha

Obstetrics & Gynaecology
30 Years of Experience

Dr. Pratik Shikare

Dr. Pratik Shikare

Obstetrics & Gynaecology
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Dr. Payal Bajaj

Dr. Payal Bajaj

Obstetrics & Gynaecology
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Obstetrics & Gynaecology
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  1. Harvard Health Publishing: Harvard Medical School [Internet]. Harvard University, Cambridge. Massachusetts. USA; Unmasking the causes and treatments of melasma.
  2. Harvard Health Publishing: Harvard Medical School [Internet]. Harvard University, Cambridge. Massachusetts. USA; Melasma (Chloasma).
  3. Handel, Ana Carolina. et al. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014 Sep-Oct; 89(5): 771–782. PMID: 25184917
  4. British Skin Foundation [Internet]. London. United Kingdom; Melasma
  5. American Academy of Dermatology [Internet]. Rosemont (IL), US; MELASMA: DIAGNOSIS AND TREATMENT
  6. Bolanca, Ivan. et al. Chloasma--the Mask of Pregnancy. Coll Antropol , 32 Suppl 2, 139-41. PMID: 19140277
  7. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Hormones During Pregnancy
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