Melasma and Hyperpigmentation: How Pregnancy impacts Skin Melanin

Melasma after Pregnancy: Increased Pigmentation – The Mask of Pregnancy

One of the more frustrating aspects of pregnancy is the development of Melasma, a condition where your skin develops darker patches of increased pigmentation (‘brown spots’ or darker patches of skin) in highly visible areas of your face. Men can also get melasma and hyperpigmentation skin changes. But Melasma is far more common in women than men, including during pregnancy, which is why it’s often called ‘the facial mask of pregnancy.’   It is often linked with sun exposure, hormone changes and genetic factors and can be very challenging to overcome.

 

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Effective Treatments for Melasma and skin pigmentation: Read more about Dermamalen

The reason Melasma occurs more often in women than men appears related to cellular interactions in the skin between estrogen, progesterone and other hormones are known to encourage higher production of melanin.

For some women, melasma will fade on its own as long as they avoid the sun, are not taking hormone supplements and follow certain skin protocols.

Hyperpigmentation and skin conditions linked with uneven melanin distribution

Pigmentation concerns of the skin involve melanin, which is a substance produced by special skin cells known as ‘melanocytes.’

“Melanin is the brown pigment that produces the various shades and colours of human skin” (Source: Merck Manual).

People with Albino skin have no melanin production. Lighter-skinned people have relatively little melanin in their dermal layers (skin), whereas Asian skin tones and darker-skinned people produce more moderate amounts of melanin. Very dark-skinned individuals produce the highest levels of melanin.

Hyperpigmentation: Discolouration and uneven skin tone happens NOT only during Pregnancy

The skin on your body is not entirely uniform in colour (look at your palms or soles of your feed for an example of different pigmentation). In general, however, it is typically evenly coloured across your body and face.  Sun exposure increases the melanin in your skin, however. This results in some skin being MANY shades darker in areas which are frequently exposed to sunlight – such as hands, face, neck and ‘driving side’ arm. This is especially true in summer when intense sun exposure is typically at its peak.

Sometimes people end up with patches of skin (spots or blotches) that result from increased melanin distribution – freckles and aged spots are both good examples of this, and typically they are denser in areas that are exposed to the sun.

Melasma, ageing spots, sun spots and other pigmentation-rich (hyper-pigmentation) skin conditions are other examples.

What, exactly, is Melasma?

Melasma (Chloasma or ‘the ‘facial mask of pregnancy’) is an acquired skin condition that presents as darker, uneven pigmentation distribution in the skin.  Specifically, if you suffer from Melasma, you’ll end up with light brown, tan, blue-grey or dark brown spots (hyperpigmentation) across your face. It can vary in presentation, but Melasma usually presents across the bridge of the nose and cheeks (towards your ears) and sometimes on your chin or jawline – but sometimes Melasma can occur over the majority of your visible facial skin.

Some women are more vulnerable to experiencing Melasma due to hormonal fluctuations, having higher pigmentation production due to genetic factors, and sun exposure.

• Women between 20 and 50 years of age report the highest incidences of Melasma
• Melasma can present as tan, brown or even greyish-blue-looking spots or ‘blotches’
• Distribution (facial locations) and depth of hyperpigmented skin varies from person to person
• Three patterns of Melasma that are commonly seen include:
  • central face
  • cheekbone areas
  • jawline
• You can, however, have hyperpigmentation almost anywhere on your face or body
• Topical retinoid creams or skin-lightening creams can sometimes help reduce skin blotches
• Sometimes special laser treatments or other light-based treatments can help reduce pigmentation (but for some women they can increase pigmentation so they need to be performed by an experienced Dermal Clinician or Medical Practitioner)
• Melasma prevention requires dedication to sun exposure avoidance
  • you’ll want to wear very high protection physical sunscreen
  • if possible, wear a wide-brimmed hat whenever you are exposed to sunlight
  • be wary of cumulative sun exposure that occurs whilst driving or hanging out the laundry

Whilst Melasma doesn’t seem to have any detrimental consequences to your pregnancy or health, it can drastically change your facial appearance and leave you feeling self-conscious.

Hyperpigmentation and Pregnancy: The Linea Negra

Melasma on the face isn’t the only area where you’ll notice increased pigmentation production during pregnancy.

Typically, a heavily pregnant woman’s abdomen will have a vertical dark line under the navel towards the pubic area.  This dark line is called the linea negra, and is caused by an increase in estrogen and progesterone hormone levels.

The linea negra “vertical abdominal line” and evidence of melasma or other facial discolouration highlight the increased production of pigment melanin (hyperpigmentation) which may occur with hormone level changes during pregnancy.

If Melasma has left you feeling unhappy with your facial skin, please get in touch with our leading Dermal Clinicians or with our Aesthetic Surgeon or Plastic Surgery team.  There are several treatments that can help you, although you’ll want to be careful as some treatments may not be suitable for people with Melasma and can make it worse.  Our Clinicians will take a full history and carefully select a treatment plan to suit your skincare concerns.   Not every treatment is appropriate for every patient, but you’ll get a customised plan that will be monitored for effectiveness in terms of treating your Melasma.

Risks for Melasma development include:

• Oral contraceptives
• HRT (Hormone replacement therapy)
• Excessive sun exposure including a bad prior sunburn to the face
• Pregnancy
• Having darker skin or higher levels of melanin
• Inflammation

 The areas of your body that are frequently exposed to the sun are typically the areas that are prone to hyperpigmentation issues.   Darker patches of skin can occur on the face, hands, legs, back and the rest of the body that have had extensive or cumulative sun exposure – or even a very bad sunburn.  But it’s not only about the sun, and hormones and other factors can contribute to the development of pigmentation problems that leave you with dark patches on your facial skin.

How do you know if you have Melasma?

Melasma develops uniquely for each person.

If you develop Melasma, you will have visibly darker patches of skin (hyperpigmentation) on certain areas of your face.  The brown patches that arise when Melasma develops are attributed to an increased amount of pigment (colour) in your skin.

These darker patches of pigmentation (tan, brown, dark brown or even blue-black in appearance) that appear across areas of your face sometimes relate to hormone changes as well as to prior sun exposure. It’s not yet fully understood why some people get hyper-pigmentation and others don’t, but risk factors have been strongly identified. It is likely a combination of interacting genetics, lifestyle and sun exposure.

If you are prone to Melasma or other hyper-pigmentation problems, sometimes you’ll end up with blotchy-looking dark spots on your skin. Other times, the pigmentation will seem to cover broader areas of your skin or face.

If Melasma develops during your pregnancy, it will usually occur during the second or the third trimester of pregnancy.

Types of Hyper-pigmentation with Melasma:  Epidermal or Dermal or Both

Your skin has many layers and renews itself over time.  The higher levels of pigment that occur in Melasma may be located either superficially in your epidermis (epidermal melasma) OR more deeply in the dermis (dermal melasma). Sometimes it will be a combination of both.

The dermal location of the excess pigment will also often have important implications in terms of your skin treatment considerations.

Treatment for Hyperpigmentation and Melasma

Melasma is challenging to treat, but there are several treatment options that might help reduce the visible differences in pigmentation across your facial skin.

• Melasma associated with pregnancy usually fades slowly after delivery of the infant, however, sometimes it can persist for years.
• Hyperpigmentation linked with oral contraceptive medications usually fades – albeit slowly – after discontinuation of the medications.
• Treatments can help but Melasma is usually slow to resolve and often recurs with additional sun exposure, subsequent pregnancies or recommencement of oral contraceptives.
• The best treatment our Clinicians know of, that has been highly effective for treating Melasma (pregnancy mask pigmentation) is our signature Dermamalen mask protocol.

Melasma Treatment – Dermamalen Masque in Melbourne

Our team may be able to help you even out your facial skin tone more rapidly than time alone.

Our team can also give you tips to minimise melasma, such as wearing sunblocks and reducing exposure to any ultraviolet light sources including sunlight.

Solutions may include certain topical solutions that lighten the skin, high-grade sunblocks (sunscreen), special cleansers and serums – and, for suitable candidates, laser treatments such as Fraxel (but not everyone with Melasma will benefit from Fraxel).

Patience is definitely required when treating Melasma, as well as flexibility.

The first step is an assessment to see if you’re a good candidate for Dermamalen Mask treatment(s) at Coco Ruby. Phone us for details.

Sometimes different approaches will need to be investigated to get results, and Melasma can be treatment-resistant.  We offer some effective treatments for Melasma, but it’s important to understand that most treatments can take several months or more before you can see results.

Your treatment options and results will often depend on the depth of the hyper-pigmentation. If the excess pigment is located deeper in the layers of your skin (such as occurs with dermal melasma), the more challenging it can be to treat.

Ask one of our Dermal Clinicians for details – phone (03) 8849 1400 or send an enquiry form today.

Melasma: How Pregnancy Impacts Facial Melanin

If you are fond of sunbathing, lying by the beach every summer soaking up the sun, you may end up with Melasma at some stage of your life.  It does not only occur in pregnancy and many people get Melasma when they are NOT pregnant.

That noted pregnant women have a greater vulnerability to hyper-pigmentation due to changing hormones.  So do women who take contraceptive medications, and so do people with skin that naturally produces moderate to high amounts of melanin (genetics).

But sun exposure is a known risk factor for Melasma, particularly for people with a propensity towards hyperpigmentation.

When your skin is exposed to high levels of ultra-violet (UV) rays from the sun, your skin gets darker due to melanin being produced by the skin exposed to the sun – this is, essentially, tanning. But the UV exposure significantly damages your skin. It can also contribute to Melasma, or worsen its presentation in the skin.

If you have Melasma, it is crucial to stay out of the sun to help avoid it getting worse.

• Wear a broad-rimmed’/ hat and wear high-protection sunblock
• Avoid the sun and UV light exposure as much as possible
• Remember that cloudy days don’t protect you from UV exposure
• Be careful to wear sunblock also when you’re driving in your car as you can get a lot of direct sun exposure on your face, neck and arms whilst driving

During pregnancy, estrogen, progesterone & other hormones fluctuate – Estrogen and pigmentation production are linked.

Melasma appears to stem partially from the interactions between hormones and the pigmentation production processes of the skin.   Because higher levels of some hormones increase melanin (pigmentation processes), That’s why you may end up with uneven patches of darker skin in your face (and other areas of the body) when you are pregnant.

Men or women: who gets Melasman more?  90% of people who get Melasma are female

Melasma appears far more prevalent in women than men, which seems to indicate the relevance of ‘female’ hormone levels and how the skin reacts with sun exposure when these hormone levels change.

If you are pregnant, you have a far greater chance of getting hyper-pigmentation skin conditions including Melasma.

That’s because the hormone estrogen is more dominant during pregnancy; and progesterone, another hormone elevated during pregnancy, also stimulates pigmentation production processes.  Pigmentation production increases can cause dark skin patches to appear on the face or elsewhere on the body, including the abdomen (Linea Negra).

Even if you are not pregnant, there are other conditions and medications that can render you more susceptible to Melasma.

One is any time you experience hormonal changes, such as around the time of menopause.

Another vulnerability to developing Melasma is being within the higher-melanin skin phototypes of what’s called The Fitzpatrick Scale for Skin Types.  Whilst it doesn’t take into account the many varieties of shades of skin, in general, Types IV, V and VI may be more prone to hyperpigmentation issues such as Melasma.

Has your face become uneven in colour? Do you have darker patches of skin on your upper cheeks, nose and forehead? If you have developed ‘the pregnancy mask” (hyper-pigmentation/Melasma), you may have been advised it’s difficult to treat. And that is partially true.

The pregnancy mask can be difficult to treat for some skin types. But if you’re skin is prone to hyperpigmentation, don’t give up until you’ve tried Coco Ruby’s Dermamelan Masque Treatment for Melasma.  It’s a low-down time, highly effective treatment for suitable patients wanting a more even skin tone.

Phone (03) 8849 1400 and ask for a skin assessment from a Dermal Clinician to find out more. Or read on to discover WHY some people get MELASMA (“The Pregnancy Mask”) and what can be done to minimise your risks OR treat your skin pigmentation problems.

 

Risk Factors for Melasma: Top 10 Risk Factors for the “Pregnancy Mask” and Other Skin Pigmentation Problems

The so-called “pregnancy mask” (Melasma), is a pattern of hyperpigmentation that is common in Australia. It is believed to impact 1 out of every 4 females (approximately 25%) and up to 1 out of every 20 males.  Although one of the main causes of Melasma (facial pigmentation) is pregnancy, this obviously is not one of the causes for men.

Why is Melasma called a “pregnancy mask”?

Melasma is called the “pregnancy mask” because for some women, it first shows up during pregnancy. Most cases of Melasma or skin hyper-pigmentation are, in fact, unrelated to conception or pregnancy.

For facial pigmentation concerns or sunspots, a good Dermal Clinician will recommend a thorough at-home care plan and specific in-Clinic treatments to reduce the uneven skin pigmentation and give you fresher looking skin.

Treating Melasma: Reasons & Risks to needing Dermamelan Masque Treatments at Coco Ruby Skin & Anti-Ageing in Melbourne.

Here are 10 more of the most common risk factors for developing the Pregnancy Mask (Melasma) or other facial skin pigmentation problems.

1) Working outdoors can increase your Melasma risks

• Being exposed to UVA and UVB rays all day through working outside or in direct sunlight is a significant risk factor for melasma, according to this 2014 study by the British Association of Dermatologists.

• Even driving a lot in Australian’s sunlight can lead to skin pigmentation problems and sunspots.

If you are getting the Dermamelan Mask Treatment for Melasma, be sure you ask your Dermal Clinician the best way to prevent further sun damage to your skin.

2) Taking Anti-depressants can leave you vulnerable to Melasma pigmentation problems and other sun sensitivity including Sun Burn (and remember, sunburns are a risk for developing skin cancers)

• If you are taking anti-depressants or anxiolytics, you may be more sensitive to sunlight and therefore have an increased risk of melasma.
• If this is applied, it might be a good idea to talk your concerns through with your GP.
• See a Dermal Clinician for high-grade Sun Screens.

Tip: You can also purchase LYCOGEL medicated-makeup to cover pigmentation AND reduce the visibility of redness after certain skin care treatments.

3) Long-term use of oral contraceptives can lead to higher risks of developing the ‘pregnancy mask ‘ (Melasma)

• Similarly, working to AVOID pregnancy can lead to ‘the pregnancy mask’ developing due to hormonal changes created by using oral contraceptives.
• Years of using the birth control pill (oral contraceptives) also present as a greater risk factor for hyperpigmentation problems, such as melasma.

4) Family history may leave you prone to Pigmentation Problems

• Melasma has a genetic marker. So having a family history of the condition does present itself as a risk factor for developing the ‘pregnancy mask’ of Melasma.
• The 2014 study reveals that a family history of pigmentation problems such as Melasma was reported by 61% of those who had the condition.
• For example, if one of your parents OR siblings has developed the pregnancy mask, your chances of developing it are higher.

5) Living in the countryside or beach can leave you prone to greater sun damage

• If you live in Australia versus many other countries, your risks of sun damage (and skin cancers such as Melanoma) are elevated. Be sure you get your skin checked annually by a professional!
• The 2014 study mentioned above also found that rural or coastal dwellers tended to have a higher incidence of Melasma, which means risks may be higher when you live with an “outdoorsy nature” or frequent the beach or poolside.

6) Exposure to pollution may elevate skin problems

• A different study, from 2015, considered environmental pollution to be another potential risk factor for developing melasma.
• Why is this thought to be a risk factor? Apparently, polluted airborne particles enter the skin and generate reactions that trigger the ageing process.

7) Particular skin types are more prone to pregnancy mask risks (Melasma) than others

• The more pigment your skin has normally, the more likely you are to develop the pregnancy mask.
• Skin types III to VI (higher pigmentation or richer in melanin) tend to have the highest incidences of melasma and are considered to be a risk factor for Melasma.

Do you need sun protection if your skin is dark?

The answer is YES, Definitely. Even darker skin needs sun protection.

Especially if you want to stay looking younger for longer.

Dark skin tends to age better than lighter skin, which shows sun damage more readily (it is also prone to dryness and fine lines and wrinkles at earlier ages, although every person is different).

This helps debunk the myth that skin rich in melanin does not need as much UVA or UVB protection as skin with less melanin.

Everyone needs to protect their skin from ultraviolet rays and particularly those with higher risk factors for melasma – especially those of Latin, Asian, Indian, Middle Eastern, Mediterranean, and North African heritage, according to the 2015 study.

 8) People living in certain geographical locations

• Although there are just more people overall in certain countries, the 2015 study also found that people living in China, India, South East Asia and the United States had the highest number of melasma cases (and also the highest levels of air pollution).
• So air pollution DOES seem to be linked with risks of developing the pregnancy mask.
• Australia, however, has a very high rate of Skin Cancer and pigmentation problems related to coastal living and high amounts of sun exposure.

9) Activities in the sun can lead to higher risks of developing the pregnancy mask pigmentation problem.

• Spending lots of time outside doing leisure activities also presents itself in both the 2014 and 2015 studies as being a risk factor for melasma.
• This might include snow skiing, Beach Volleyball, Netball, Soft Ball, swimming, surfing, jogging, running, cycling, sailing and paddleboarding.
• Driving in the car also exposes your skin to higher risks of developing melasma.

The importance of sunscreen and, covering up and avoiding too much sun time cannot be overstated, it seems!

10) Irregular periods may mean hormonal imbalances – and hormones DO impact your photosensitivity and skin pigmentation.

• Hormonal imbalances increase photosensitivity.
• So having irregular periods (with hormone levels fluctuating) means that this is also a risk factor for melasma.

Melasma FAQs

Can Pregnancy Cause Melasma?

The simple answer is that yes, pregnancy can leave you more vulnerable to greater production of melanin which results in pigmentation changes – and darker skin doesn’t occur evenly all over your body.

Research suggests that women who develop Melasma during pregnancy will usually develop hyper-pigmentation during their second trimester (50% to 90% of women) and the remainder experience signs of pigmentation changes during their third trimester.

So what CAN be done about the pregnancy mask (Melasma)?

Although pregnant women do develop the ‘pregnancy mask’ (condition of melasma), these 10 risk factors can lead to higher risks.

The more Melasma risks you have, the greater the likelihood you may develop that pigmentation condition.  But although in the past it was very difficult to treat, here at Coco Ruby in Melbourne, we have signature treatments that use Dermamalen and customised home-care systems to get your skin back to a more even skin tone. It does take time and you’ll need to be diligent, patient and follow the sun protection guidelines your Dermal Clinician gives you.

But you’ll see results fairly quickly with Dermamelan!

Should you treat your Melasma?

Melasma may go away on its own once you give birth, change your contraceptive medications or move beyond menopause – but some women will end up with long-term facial hyperpigmentation issues that they find concerning and want to treat.

Further reading about Skincare after Pregnancy

• Skincare for New Mums

Next Steps

It is best to seek the advice of a skincare expert or medical professional about what can be done and what treatments you should avoid for Melasma.

Our Dermal Clinicians offer several treatment options for hyperpigmentation problems. They have achieved some excellent results for women with Melasma.

Treatment options may include customised Fraxel treatment regimes, serums and top cosmeceutical skincare solutions, which can help some women treat Melasma or other hyperpigmentation concerns.

If uneven facial pigmentation or sun-affected skin is becoming an issue for you in relation to your appearance or “Skin Confidence,” send an enquiry form today or phone us during Clinic Hours on (03) 8849 1400 and ask to speak with a Dermal Clinician or schedule a full facial assessment with one of our skincare Clinicians!

If you have pigmentation problems on your face – whether related to pregnancy or not – and would like to learn more about ways to reduce your risks or get your skin looking more even in tone again, please contact our Dermal Clinicians for a Skin Assessment and Dermamelan Mask treatment for Melasma.   Click here for Melasma Research Articles.

If you would like to hear more about the professional treatments that we offer for melasma and other forms of hyper-pigmentation, please complete a confidential enquiry form. Or, alternatively, you can speak to one of our Patient Care Coordinators by calling (03) 8849 1400.

 

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