Melasma, sometimes called the mask of pregnancy, is a pigment problem that appears on the face and most commonly occurs in women of color. This skin disorder can negatively affect the psychological and emotional state of women who suffer from it. It most often presents with dark patches that develop on the forehead, cheeks and chin. Studies show that up to 70% of women will develop some amount of melasma during their pregnancy. Genetic, ethnic, hormonal, and environmental factors like sun exposure and pollution all play a role. It is most strongly associated with high levels of the hormone estrogen, which peak during pregnancy.
Treatment can be difficult, but removing factors that worsen melasma like sun exposure can be helpful. Depigmenting treatments like hydroquinone or chemical peels are somewhat useful but their side effects can be pretty bad so they are probably best avoided in pregnancy. For most pregnant women with melasma, no treatment is required other than using a good sunscreen (30 SPF or better) and avoiding bad skincare (like rubbing the skin too much or using harsh products). But can we prevent melasma from developing in pregnant women in the first place? That was the question of a first of its kind study published in the Journal of the European Academy of Dermatology.
Two hundred Moroccan women above the age of 18 and less than 3 months pregnant were selected to participate. They were examined at the start of the study by a dermatologist and then given a super-potent sunscreen with SPF of 50+. They were told to use the sunscreen every 2 hours, especially when outside, and to avoid any creams or other products that could interfere with the sunscreen’s effects. During their pregnancy and after giving birth they were examined by a dermatologist to determine if melasma had developed. They were also questioned about how much sun exposure they got and their skincare routine.
In total, 185 of the 200 completed the study. Those that dropped out mostly couldn’t keep up with the routine, which is admittedly pretty intense! The average age of the volunteers was 30 and for the majority this was their first pregnancy. About 90% were skin of color, which is defined as a women who easily tans, rarely, if ever, burns, and has an olive to dark complexion. About 15% had a history of melasma. When the study was completed at 12 months, almost 80% had lighter or the same skin color compared to when they started the study! In addition to examining them, the researchers also physically measured the amount of pigment in the skin with a high-tech device called a colorimeter, and found that there was less facial skin pigment in about 70% of the women. Of the twelve women who started the study with some amount of melasma, eight had lightening of their skin. The authors concluded that regular use of a strong sunscreen reduced the risk of developing melasma by 60%!
The use of a daily sunscreen has so many benefits: it reduces your risk of skin cancer, it slows down the formation of fine lines and wrinkles, and we now know that it can prevent melasma from developing. Melasma is a skin problem where an ounce of prevention is worth a pound of cure. Once it develops, the pigment can be very stubborn to treat. If you have a history of melasma, you should be more aggressive. Make sure to apply sunscreen every couple of hours when outdoors like the women did in the study. After giving birth, there are some treatment options, which are discussed here.