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Melasma - The Mask of Pregnancy

Katlyn Joy | 9, January 2012


Melasma, also called the mask of pregnancy, actually affects more than just pregnant women. Even men can get this skin condition as well as those receiving hormone treatments or taking birth control pills or injections. The hormones to blame are estrogen and progesterone. Some people get these spots due to sun exposure with no other known triggers or conditions.

However, pregnant women get melasma at high rates. Up to 75 percent of all expectant mothers experience the skin condition and the rates are highest among dark-skinned women such as those from African-American, Middle Eastern, Asian, Indian, North African, Hispanic and Mediterranean descent. Those with close relatives with the condition are at increased risk.

In pregnant women, it's thought the big increase in estrogen is to blame for the skin darkening associated with melasma. Sunlight will definitely make matters worse, but the good news is you can expect the patches of darkened skin to fade to your normal shade once you've delivered. Some women however continue experiencing melasma until they wean their babies, if breastfeeding.

Signs of Melasma

You'll know you are dealing with the mask of pregnancy if you observe the following:

- Brown or gray-brown patches or spots on your skin particularly your face.

- Areas affected typically include bridge of the nose, cheeks, forehead, chin and above the top lip.

- Occasionally patches of discoloration can also be seen on the neck or arms.

- Not associated with any other symptoms but sun exposure usually worsens the darkened patches.

- Worse in summer or when sun exposure is most abundant.

Preventing Melasma

While you can't necessarily prevent melasma from occurring, taking certain steps will definitely minimize it.

- Stay out of the sun particularly during the brightest parts of the day. However even on winter or cloudy days you can get too many rays.

- Use sunscreen containing an SPF of 30 or more that protects against both UVA and UVB rays and zinc oxide or titanium oxide products are best.

- Wear a wide brimmed hat and big sunglasses for more protection.

- Reapply sunscreen every couple hours and wear it every day even if indoors. Windows permit sunlight to penetrate enough to cause melasma in some women.

Treating Melasma

While pregnant, your best bet is patience and preventing worsening of the condition once it's developed by limiting sun exposure. Harsh chemicals or laser treatments are out while carrying an unborn child. Also, in most cases the condition will reverse itself once the hormone levels have returned to their normal state which is usually once the baby is born.

Should the mask of pregnancy stay past weaning your infant, consult a dermatologist. Options for treatment include creams containing tretinoin, kojic acid, azelaic acid or corticosteroids. Other topical agents such as hydroquinone are available in weaker concentrations without a prescription or at higher strength with a doctor's order.

In the unlikely case these medications don't resolve the melasma, other procedures such a microdermabrasion, dermabrasion or a chemical peel should be effective.

However, it's important that a person who is susceptible to getting the condition to continue to protect the skin from sun exposure to prevent a reoccurrence.

Some people need maintenance therapy to relieve the condition and the initial treatment may take a few months or sometimes more.

If you are breastfeeding, you will want to consult your dermatologist and possibly your ob-gyn as well before taking on any treatment plans for melasma. If you experience symptoms such as irritation of the skin, skin discoloration or other unexplained problems, talk to your doctor.

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