Postpartum melasma. Pregnant women can get dark patches on their face, neck, and arms called melasma. But these dark patches can last long after your baby’s born. They’re not harmful, but they can be frustrating to deal with. Taking proper protection in the sun, switching birth control methods, and some prescription topical medications can all help you manage this common skin condition.
IN THIS ARTICLE
- What is melasma?
- What causes melasma?
- Will melasma go away on its own?
- Are there treatment options for melasma?
- Are there any ways to prevent melasma?
What is melasma?
Melasma, also known as chloasma, is a harmless condition that causes brown or gray-brown patches on the skin. Melasma typically shows up on the face (usually the cheeks, nose, and forehead), but some people can get it on their arms and neck, too. It can even show up on your upper lip, making a dark patch that’s known as a “sun mustache.”
Up to 50 percent of pregnant women get melasma, which is why it’s also known as “the mask of pregnancy.” The condition is also more common in people with darker skin tones.
What causes Postpartum melasma?
Melasma is caused by your skin making too much pigment (AKA melanin). Experts aren’t exactly sure why this happens, but some triggers include:
- Sun exposure: Ultraviolet (UV) light makes your skin produce more melanin. Melasma often gets worse in the summer and better in the winter, and can reappear even with a small amount of sun exposure.
- Hormonal changes: The extra estrogen and progesterone your body makes during pregnancy can trigger melasma. It usually goes away after you give birth. People taking hormonal birth control – say you start taking the Pill again after you give birth – can also get melasma.
- Certain prescription drugs: This is less common, but some medications, including specific antibiotics and over-the-counter painkillers (NSAIDS) may trigger melasma because they make you sensitive to sunlight. Some specific anti-seizure drugs may also cause melasma.
Will melasma go away on its own?
Any dark patches you developed during pregnancy usually fade within a few months of delivery, as your hormone levels return to normal and your body stops producing so much skin pigment.
That dark line that runs down your belly (ሊኒያ ኒግራ) as well as any freckles or birthmarks that became darker during pregnancy should gradually fade as well. (These are not the same as melasma, but rather other types of skin darkening that can happen while you’re pregnant.)
However, the dark blotches could return if you’re prone to these pigmentation changes and start using contraception that contains estrogen. Sun exposure can also trigger melasma, especially if you’re already prone to it.
Are there treatment options for melasma?
Melasma can be tough to treat, but there are some solid prescription options to help manage the condition. If your melasma doesn’t improve on its own after a few months, talk to a dermatologist about your treatment options.
The best treatment for melasma typically starts with the prescription cream hydroquinone, a bleaching agent that can help lighten the dark patches. Your dermatologist might also have you try a “combination cream” that combines hydroquinone with tretinoin (which promotes skin regrowth) and azelaic acid (a gentle exfoliant). If topicals aren’t helping your symptoms, your dermatologist may use chemical peels, light therapies, or a laser to try to lighten the areas affected by melasma.
Of course, if you’re breastfeeding or plan to get pregnant again soon, be sure to let your providers know and always check before using any over-the-counter medication or treatments.
Are there any ways to prevent melasma?
Melasma isn’t harmful, so you don’t need to do anything. But if you don’t like the way it looks, here are some tips for preventing or minimizing it.
Protect your skin from the sun
Staying out of the sun is the surest way to get your complexion back to normal. Melasma may remain as long as you continue to expose yourself to sunlight without protection.
Use a broad-spectrum sunblock (a formula that protects against both UVA and UVB rays) with an SPF of 30 or higher every day, whether or not it’s sunny. The American Academy of Dermatology cautions that your skin is exposed to a significant amount of ultraviolet light year-round, even on cloudy days. Wearing sunscreen is important, even if you have dark skin. Although dark skin doesn’t sunburn as quickly, the extra melanin in darker skin doesn’t entirely protect you from harmful UV radiation.
Even if you don’t plan to spend much time outside in the sun, apply sun protection to your face every day as part of your morning routine. Reapply about every two hours if you’re outside.
Whenever you spend time outdoors, also cover up and wear a hat with a brim as well as a shirt with long sleeves if you have increased pigmentation on your arms. Limit the time you spend in the sun, especially between 10 a.m. and 2 p.m. which is when the UV index exposure is highest. And definitely avoid tanning salons.
Be gentle with your skin
Use mild cleansers and facial creams. Products that irritate your skin may make the problem worse.
Consider switching contraceptives
Contraceptives that contain estrogen, such as birth control pills, the ring, and the patch, can cause melasma or make the condition worse for a small number of women.
Look into alternative methods, such as the progestin-only minipill, intrauterine device (IUD), birth control implants, progesterone injections (Depo-Provera), or non-hormonal methods, such as the diaphragm.
Avoid waxing
Waxing, which rips hair out by the root, can cause inflammation that makes melasma worse. Avoid waxing the parts of your body that have melasma or are prone to it and try other hair removal techniques instead.
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