Pregnancy Spots & Melasma: Explained By a Dermatologist

While being pregnant is a beautiful life event, it’s no secret that the female body undergoes drastic changes throughout the duration of pregnancy, many of which are not necessarily welcomed by most women. Aside from endless changes to the body, it can also be common to experience changes in skin, such as developing melasma or dark spots while being pregnant. We sat down with Board-Certified Dermatologist and Musely Medical Director, Dr. Brandon Kirsch to ask him about some common concerns regarding melasma and pregnancy. Here is what he had to say:

What are some of the common skin changes that happen during pregnancy?

For most women, pregnancy will bring about many changes to the skin, hair, and nails. Some of these changes are highly desirable, such as radiant skin, blushing cheeks, and lustrous hair. Unfortunately, some of the changes are much less welcome, including hyperpigmentation (dark spots) and acne. In fact, nearly all pregnant women experience some degree of hyperpigmentation during pregnancy. Melasma (chloasma or mask of pregnancy) is one of the most common and frustrating skin conditions associated with pregnancy. Melasma describes dark patches on the face, particularly the forehead, cheeks and upper lip. It affects up to 70 percent of pregnant women (and also may occur in women taking oral contraceptives). In addition to melasma, linea nigra can also occur. Linea nigra is a dark line that forms vertically across the lower abdomen. Both of these changes are usually more pronounced in women with a darker complexion. The areolae and genitals, as well as pre-existing scars and moles may also darken. Acne may flare during pregnancy as well. The additional hormones your body creates during pregnancy can stimulate your oil glands to become more active, which can result in acne breakouts.

Why do dark spots and patches appear on the skin during pregnancy?

Pregnant women produce more hormones. These hormones stimulate the creation of additional melanin (pigment) by your melanocytes (pigment-producing skin cells). They will also make your skin more sensitive to the melasma triggers of sun exposure and heat.

How can I prevent melasma from getting worse during pregnancy?

Even short exposure to sunlight and heat can substantially worsen the appearance of melasma. The regular use of broad-spectrum, mineral sunscreens (zinc oxide and titanium dioxide) is highly recommended to prevent worsening of melasma during pregnancy. In addition, it is advisable that you decrease the amount of time you spend in the sun as much as possible, especially during peak hours between 10AM and 2PM, and that you always wear a broad-brimmed hat.

Are there any prescription treatments that are safe to use while pregnant or nursing?

Prescription-strength azelaic acid is the principal active ingredient in Musely's HQ-free formula of The Spot Cream. It is produced by certain plants and yeasts, and is found in wheat, rye and barley. It is considered safe for use during pregnancy and nursing. Azelaic acid is a natural inhibitor of tyrosinase, the enzyme that produces pigment in the skin, and it is a keratolytic, comedolytic, and antibacterial agent as well. This makes azelaic acid an excellent choice for the treatment of skin hyperpigmentation and acne in pregnant and nursing women. Studies have shown an equivalent lightening effect compared with low-dose hydroquinone. In addition, topical kojic acid and tranexamic acid can be effective for the treatment of hyperpigmentation, and are also considered safe for use during pregnancy and nursing.

Will my melasma go away after delivery?

While most pregnancy-related dark spots and acne breakouts will resolve a few months postpartum or after you finish nursing, some can be very persistent. You might also experience recurrence with future pregnancies and the use of oral contraceptives. You can use Musely's HQ-free formula of The Spot Cream throughout your pregnancy and while you are nursing.

What can I do to get rid of melasma after I’m done nursing?

After nursing, you can switch to a more intensive, and highly-effective, Musely formulation containing one or more of the following prescription-strength ingredients: hydroquinone, tretinoin and corticosteroids.

Pregnancy comes with physical changes that can be difficult to ignore such as hormonal changes, changes in physique and hyperpigmentation. If you are struggling with dark spots or melasma as the result of pregnancy, it may be time to start thinking about treatment. Musely offers proven solutions to effectively treat dark spots and melasma on the face, body and private areas. Musely also has formulas designed for women who are currently pregnant or nursing; The Spot Cream HQ Free and The Spot Cream HQ Free+. No matter what stage of your melsma journey you are in, Musely has a solution fit for you! Click here to learn more about our dark spot treatments.