Understanding Melasma during Pregnancy

*Melasma has many names, such as chloasma and ‘pregnancy mask’. It is a common skin condition that occurs for up to 50%-70% of pregnant women [1]. Melasma refers to the brown or greyish skin pigmentation which commonly occurs on the face.*

*Its name comes from the Greek words for ‘black’ being melas, and the word for greenish being cholas. Melasma is more common for people of colour or those who tan quickly but can occur to anyone. Melasma is often completely harmless. It is not cancerous, nor is it an infection, contagious or due to any allergies.*

## Which hormones are causing my skin pigmentation?

It may not be shocking to know that the very two hormones primarily responsible for your mood swings may also be responsible for the ‘pregnancy mask’ or glow. Progesterone and Oestrogen have been steadily increasing throughout your pregnancy. In the second trimester, this may result in the ‘pregnancy mask’ as they stimulate the melanocyte-stimulating hormone [2]. This triggers your skin's melanocyte cells to produce melanin, which gives your skin colour. This is what may then cause patches of pigmentation on your skin.

## How to minimise the appearance of pregnancy mask?

It’s best to avoid any creams or medications advertised to reduce melasma whilst pregnant unless you have spoken to your doctor first. The best practical tips are to avoid direct sun exposure, as this can make the pigmentation more pronounced [3].

Applying a suncream with an SPF of 30 or higher every day, all day would be beneficial, even if you aren’t going outside as harmful rays can still enter through the windows. If you do decide to go outside, sporting a pair of sunglasses and a wide-brimmed hat would be useful.

For many women, pregnancy mask will disappear on its own after giving birth when their hormones have returned to their pre-pregnancy levels [4].

However, some products can be used to help fade pregnancy mask if it is not disappearing on its own which include:

- Over-the-counter creams that contain up to 2% hydroquinone

- Prescription creams that contain 4% hydroquinone

- Sunscreen

- Bleaching agents

- Corticosteroids

Remember, you should not use any of these medications until after you have finished breastfeeding and should always get advice from your doctor.

## Boosting Self-Confidence

Skin pigmentation at the best of times can impact our self-confidence and body image, but whilst pregnant there are also many other bodily changes going on that can all become quite overwhelming. I nice tip to try and improve your self-confidence is to keep a compliment journal. This can be a notebook, a Google document or Word document. In the journal you not only compliment yourself, but you can screenshot or quote down compliments you have received.

When things become overwhelming it can be useful to read through this journal and remind yourself that you are beautiful and worthy of affection and praise. Both giving and receiving compliments can increase mood and general well-being so there’s nothing to lose in complimenting yourself and saving the compliments you get given by others [5].

Melasma is very common amongst pregnant women and is nothing to be concerned about. However, the change in appearance may impact your self-confidence so engaging in positive mood-boosters such as writing and keeping a compliment journal could be beneficial to your overall wellbeing.