Melasma after Pregnancy: The Increased Pigmentation “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 get melasma and hyper-pigmentation skin changes also. 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.
The reason Melasma occurs more often in women than men appears related to cellular interactions in the skin between estrogen, progesterone and other hormones 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.
Hyper-pigmentation and skin conditions are 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 colors 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 more dense in areas that are exposed to the sun.
Melasma, ageing spots, sun spots and other pigmentation-rich (hyper-pigmentation) skin conditions are other examples.
Hyper-pigmentation and Melanin
- If you have pigmentation concerns or melasma, you’re not alone.
- Hyper-pigmentation concerns in relation to facial skin are relatively common.
- In fact, skin discolouration, sun damage and blotchy skin are some of the leading reasons people seek treatments and skin care solutions at Coco Ruby Skin & Anti-Ageing.
One of the more challenging conditions that people face is Melasma, which relates to increased melanin production in the skin of the face.
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-gray 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 grayish-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
- You can, however, have hyper-pigmentation 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 sun light
- 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 skin care 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 sun burn to the face
- Having darker skin or higher levels of melanin
The areas of your body that are frequently exposed to the sun are typically the areas that are prone to hyper-pigmentation issues. Darker patches of skin can 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 (hyper-pigmentation) 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 occurs 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 Hyper-pigmentation 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.
- Hyper-pigmentation 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.
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 sun blocks and reducing exposure to any ultraviolet light sources including sunlight.
Solutions may include certain topical solutions that lighten the skin, high-grade sun blocks (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 sun bathing, 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 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 hyper-pigmentation.
When your skin is exposed to high levels of ultra violent (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 it’s 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 sun block
- 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 sun block 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 it 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-melalin 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.
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.
Should you treat Melasma?
Melasma may go away on it’s own once you give birth, change your contraceptive medications or move beyond menopause – but some women will end up with long-term facial hyper-pigmentation issues that they find concerning and want to treat.
It is best to seek the advice of a skin care 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 hyper-pigmentation problems. They have achieved some excellent results for women with Melasma.
Treatment options may include customised Fraxel treatment regimes, serums and top cosmeceutical skin care solutions, which can help some women treat Melasma or other hyper-pigmentation 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 skin care Clinicians!