Unmasking Melasma: The Mask of Pregnancy

ABC New Chief Meteorologist, Ginger Zee, revealed earlier this year to a national audience that she suffered from melasma, a hyperpigmentation skin condition that affects between 15 and 50 percent of pregnant women in the United States.

Melasma: The Mask of Pregnancy

Melasma is nicknamed, "The Mask of Pregnancy." It is triggered by the hormonal fluctuations caused by pregnancy, as well as the changes in hormones brought on by menopause. Some women also develop melasma as a side effect from using hormonal birth control.

These hormonal fluctuations cause the body to increase production of melanin, the amino acid responsible for skin pigmentation. Melasma causes gray or brown patches to develop on the face, typically on the cheeks, nose, forehead, chin or upper lip. For most women, these patches may fade after hormone levels return to normal after giving birth- but they may not fade away completely. Some women are left with uneven pigmentation, which may leave them feeling frustrated and self-conscious about their appearance.

Other Causes of Melasma

Melasma does not only affect pregnant women. According to the International Dermal Institute, over five million men and women across the United States are affected by the pigmentation disorder. While some of these cases are indeed related to changes in hormones, many cases of melasma develop because of sun overexposure.

The sun’s ultraviolet rays damage the skin cells, known as melanocytes, that control production of the pigment, melanin. When these cells are damaged, melanin production becomes erratic and pigmentation becomes uncontrolled and uneven.

Sun-induced melasma can develop on the face, neck, back, arms or anywhere else on the body that sees frequent or prolonged sun exposure.

Preventing Melasma

Hormone-related melasma cannot be prevented for women that develop the condition while pregnant. Women in menopause or those individuals that use hormonal birth control have options to treat their condition with hormone replace therapy or to switch to a birth control option with less hormones.  

Patients can protect themselves from developing sun-induced melasma by wearing sunscreen or clothing to cover their skin when in the sun.

"Choosing a broad-spectrum sunscreen with an SPF of at least 50 can help save the skin from damaging UV rays and minimize the risk of developing melasma," said Dr. Mona Alqulali, M.D., F.A.C.O.G., PhD.

Alqulali is an OBGYN practicing in Clinton and Bettendorf, Iowa, who has seen her share of patients with melasma.

"Melasma is a fairly common side effect of the hormonal chance of pregnancy," Alqulali said.

Treatments for Melasma

Aside from hormone replacement therapy for patients who can tolerate that type of treatment, Alqulali may recommend patients treat their melasma with prescription topical steroid creams that lighten the affected skin.

She may also recommend cosmetic treatments, like laser skin rejuvenation or intense pulse light, or IPL, laser therapy. These treatments have been proven to be effective in reducing hyperpigmentation and dark patches caused by melasma. Laser skin rejuvenation also helps lessen the patches caused by melasma for some patients.

Another effective treatment for melasma are chemical peels. During a chemical peel, an acid solution is applied to the affected area to create controlled burn on the outermost layer of the skin. Once this skin blisters and peels away, new skin is revealed. This new skin is not affected by the hyperpigmentation caused by melasma.

Many melasma patients like chemical peels because they provide results faster than topical or over the counter treatments. Most patients with melasma need two to three peels to return their skin to its normal complexion, scheduled four to six weeks apart.

Alquali provides these cosmetic treatments to patients with melasma in her practice, as well as several other cosmetic and skin care solutions to treat pigmentation problems in her patients.

Chemical peels are noninvasive procedures and are safe for pregnant and breastfeeding women.




ABC News, "ABC News' Ginger Zee Shares her Melasma Journey". ABC News. 2 February 2017.

International Dermal Institute. "Melasma Unmasked." International Dermal Institute. 2017.

American Academy of Dermatology. "Melasma". AAD. 2017

Potential Pregnancy Scare as FDA Recalls Birth Con...
Taking Care of Yourself: Your 40s and 50s