What Causes Skin Patches During Pregnancy? Expert Weighs In

A woman’s body goes through different changes during pregnancy. One such change is the formation of dark skin patches (melasma) on an expectant mother’s face. These are hyperpigmentation or freckle-like spots in areas exposed to sunlight. But what exactly causes these patches during pregnancy and how to prevent or treat them? This article will answer this for you.

To understand this better, we reached out to a top gynaecologist, Dr Lavanya Kiran, Director and Lead Consultant, Obstetrics, Gynaecology, KIMS Hospitals, Electronic City, Bengaluru. 

What Causes Dark Skin Patches During Pregnancy?

Before understanding how pregnancy is linked to melasma, let us explain what melasma is. Dr Kiran says, “Melasma, also known as the ‘pregnancy mask’, is a relatively common skin disorder that afflicts many pregnant women. It manifests itself in the form of brown or greyish discoloration in symmetrical patches on the cheeks, forehead, nose, upper lip, or chin.” 

So what is the cause behind this? Answering this, the expert says, “The key trigger for this condition is the hormonal changes occurring due to pregnancy, especially the increase in the levels of oestrogen and progesterone hormones that cause activation of melanocytes or pigment-producing cells. Sunlight exposure could further aggravate this problem by activating these cells and making the discoloration more pronounced.”

“Even though melasma poses no threat to health and usually disappears gradually post-delivery, it may be problematic in terms of appearance,” she adds. 

What Study Says About Melasma During Pregnancy

A 2024 study, published in the journal Clinical, Cosmetic and Investigational Dermatology, stated that melasma is a common skin condition that is characterised by symmetrical, dark brown patches on sun-exposed areas of the face. When this condition takes place during pregnancy, it is often referred to as the ‘mask of pregnancy’. The research notes that between 36.4% and 75% of pregnant women experience this skin change. It primarily impacts those with darker skin tones. 

The study adds that while it is physically harmless and often considered a normal physiological change, it can cause significant emotional distress, lower self-esteem, and anxiety for the would-be mother. It notes that the exact cause behind pregnancy-induced melasma is complex and not entirely understood by doctors. However, it is mainly believed to be triggered by a combination of profound hormonal fluctuations, genetic predisposition, and exposure to sunlight.

Researchers add that women who have a family history of this skin condition, or those who experienced it in a previous pregnancy, are at a much higher risk of developing melasma again. Moreover, factors such as carrying multiple babies, delaying a first pregnancy, or having high levels of stress and poor sleep can further cause a spike in its risk. 

For many women, these dark patches naturally fade away within a year post giving birth. But the study adds that for up to 30% of mothers, the stubborn patches can remain for ten years or more. 

Since treating melasma during pregnancy is usually avoided to protect the developing baby, prevention is the best option. The study adds that dermatologists focus on aggressive sun protection from the very first trimester. The research shows that consistently wearing broad-spectrum, physical sunscreens can minimise the incidence of pregnancy melasma by over 90%. Expectant mothers would also wear wide-brimmed hats, seek shade, and avoid direct sunlight during peak hours to protect their skin.

Tips To Deal With Melasma During Pregnancy

Dr Kiran says prevention is the best management strategy of melasma. On this note, the expert shares some tips to deal with this skin condition:

• A pregnant woman needs to apply sunscreen lotion with an SPF of 30 or more. This measure must be followed even at home and on cloudy days, if one stays out in the sun.
• Using a wide-brimmed hat, staying in shade, and avoiding sun exposure during peak hours help greatly in preventing pigmentation.
• It is advisable to maintain gentle skin care with use of mild cleansers and moisturisers. Avoid aggressive chemical peels, bleaching agents, and retinoids during pregnancy unless prescribed by a physician. 

“In case the problem persists post-delivery, a dermatologist will provide appropriate treatment measures. The most important thing about melasma is that it is a temporary condition that does not influence the mother's or child's health,” concludes Dr Kiran.

ALSO READ- Pregnancy and Unwanted Facial Hair: Gynaecologist Explains The Hidden Link

Conclusion

The appearance of dark skin patches during pregnancy can be a source of stress for expectant mothers. Known as melasma, this skin condition is harmless and a very common physiological change driven by pregnancy hormones. Chemical treatments must be avoided during pregnancy to ensure your baby's safety. Therefore, the best way to treat melasma is its prevention through consistent, broad-spectrum sun protection. This can be your most effective defence against the ‘mask of pregnancy’. These spots typically fade on their own post giving birth, but you can always consult a dermatologist postpartum if you need help restoring your natural skin tone.