What is the pregnancy mask?

The pregnancy mask, also called melasma in medical language, is characterized by the appearance of symmetrical pigmented spots on the areas of the face generally exposed to the sun such as the forehead, nose, cheeks and upper lip. In some cases, this skin hyperpigmentation can also develop on the décolleté and forearms.

Women are particularly affected, especially during pregnancy, but men can also experience this skin pigmentation disorder.

What causes melasma to appear?

Melasma is most often due to an overproduction of melanin by melanocytes. The causes of the excessive activity of these cells are mainly hormonal, which is why the spots appear most often in women who take oral contraception or during pregnancy. According to a study published in 2015 by the Korean Association of Dermatology ⁽¹⁾ , between 10 and 15% of pregnant women would be affected. It can also happen that the pregnancy mask occurs after childbirth, although this is rarer.

Genetics, heredity, phototype, propensity to expose oneself to the sun and taking certain medications that increase the skin's sensitivity to UV rays are also risk factors for the appearance of melasma.

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See the article "What Should Be Considered in Treatment of Melasma" on National Library Medicine

At what point in pregnancy does the pregnancy mask appear?

Melasma most often appears between the 4th and 6th month of pregnancy, or during the 2nd trimester of gestation, and generally disappears or fades several months after delivery. It can also persist for several years and become chronic.
Despite its name, the pregnancy mask is not always limited to the 9 months after fertilization: it can continue during the breastfeeding period and even appear suddenly after childbirth, when no pigment spots had appeared during pregnancy!

How to get rid of the pregnancy mask?

When the spots are already clearly visible, certain cosmetic products and/or dermatological treatments can help to fade or make the pregnancy mask disappear more quickly, and also prevent it from coming back at the slightest ray of sunshine!

Depending on the option chosen (some can even be combined), treatment may begin during pregnancy, after childbirth or at the end of breastfeeding, if applicable. A dermatologist will be best able to provide quality support and answer all questions about skin hyperpigmentation, so do not hesitate to make an appointment for a consultation.

What anti-blemish skincare routine should I use against melasma?

To combat hyperpigmentation and even out your complexion, you can adopt an anti-blemish skincare routine. These lotions, serums and facial creams, which can sometimes be used during pregnancy on medical advice, should be applied once or twice a day for several weeks. They contain active ingredients known for their effects on the quality and radiance of the skin:

• Vitamin C protects the epidermis against free radicals, which can cause melasma, and stimulates cell renewal.
• Glycolic acid, by exfoliating the superficial layers of the skin, helps to reduce spots and smooth skin texture.
• Azelaic acid acts directly on melanin production to fade the pregnancy mask.
• Niacinamide, or vitamin PP, blocks the transfer of melanin to the skin.
• Alpha-arbutin inhibits melanin synthesis to even out and lighten skin tone.
  

Depigmenting creams

If the pregnancy mask does not disappear despite an appropriate facial care routine, a dermatologist can prescribe a depigmenting cream to fade the spots. Depending on the product, it may contain hydroquinone, tretinoin (a vitamin A derivative), azelaic acid or even corticosteroids to regulate melanin production. The first effects are generally visible after 3 weeks of treatment.

Chemical peels

Performed by a dermatologist, chemical peeling, most often based on trichloroacetic acid or glycolic acid, exfoliates the superficial layers of the skin and reduces spots. Depending on the extent of the pregnancy mask and the intensity of its coloring, several treatments may be necessary to obtain a good result.

The laser

To reduce the most persistent epidermal pregnancy masks, some lasers have the ability to target and eliminate melanin. Depending on the machine used by the doctor and the depth of the melasma, several sessions may be necessary to restore an even complexion.

Intense pulsed light

Intense pulsed light (IPL) sessions may also be recommended to destroy superficial pigment spots and even out the complexion. This technique is particularly recommended for light and sensitive skin, as well as to treat fragile areas (eyelids, décolleté, etc.). As with laser, several sessions may be necessary, spaced several weeks apart.

Change your method of contraception

Taking a contraceptive pill can cause the appearance of brown spots (1) due to the increase in estrogen levels, so checking in with a gynecologist or midwife may also be useful, especially if the pregnancy mask persists.

How to prevent the appearance of melasma?

Prevention is the key to combating the appearance of melasma on the face.

In fact, certain measures can help reduce the risk of skin hyperpigmentation:

• Apply a minimum SPF 30 sunscreen daily, even when the weather is cloudy.
• Do not expose yourself to the sun between 12 p.m. and 3 p.m., when UV radiation is strongest.
• Wear sunglasses and a wide-brimmed hat in sunny weather.
• If exposure to the sun cannot be avoided, reapply sunscreen every 2 hours and also after swimming or sweating.
• Avoid using cosmetics containing photosensitizing active ingredients (retinol, fruit acids, essential oils, etc.).
  

Are anti-blemish creams effective against pregnancy mask?

Used alone or in addition to dermatological or aesthetic medicine treatment, anti-blemish creams can achieve good results on the pregnancy mask by acting on the production of melanin, on the elimination of pigments or even on the renewal of skin cells.

Applying an anti-blemish face cream every day means putting all the chances on your side to regain a more even complexion. And to complete its effects, using sun protection all year round is strongly recommended.

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