# Melasma — Mask of Pregnancy

Source: https://www.pregnancypowerhour.com/conditions/melasma
Last updated: 2026-07-15

> Melasma, often called the "mask of pregnancy," is a common skin pigmentation that appears as dark patches on the face during the second and third trimesters.

Melasma, also known as chloasma or the "mask of pregnancy," is a common skin change characterized by dark, discolored patches, typically appearing on the face during pregnancy.

## What it is

This particular type of facial pigmentation is a normal physiological change for many pregnant people. Evidence suggests it affects a significant number of pregnancies, with rates notably higher in those with darker skin tones. Melasma is primarily caused by the hormonal shifts of pregnancy, specifically the increase in estrogen and progesterone, which stimulate melanocytes – the cells responsible for producing pigment in your skin. While hormones are the internal trigger, exposure to ultraviolet (UV) light is understood to be the strongest external factor that can amplify and worsen melasma. Just as your body might experience other hormonal shifts, like [Leaking Colostrum](/conditions/leaking-colostrum) later in pregnancy, melasma is another manifestation of these powerful internal changes.

## What it tends to feel like

For many, melasma appears as symmetrical, brownish patches on the cheeks, forehead, nose bridge, chin, and above the upper lip. It's a visible change, and it's completely understandable if you have feelings about it. While melasma is not harmful to your health or your baby's, noticing changes to your appearance can sometimes bring a sense of unease. As a doula, I often remind clients that acknowledging these feelings is part of navigating pregnancy, and understanding what's happening can bring a sense of clarity and calm.

## What the evidence says helps

When it comes to managing melasma during pregnancy, the focus is on gentle, evidence-based approaches to minimize its appearance and prevent it from worsening. The single most important intervention is diligent sun protection. This means using a broad-spectrum mineral sunscreen with an SPF of 30 or higher daily. Mineral sunscreens, containing zinc oxide or titanium dioxide, are often preferred by organizations like EWG and integrative dermatologists during pregnancy due to concerns about the systemic absorption of chemical filters (like oxybenzone or octinoxate) found in other sunscreens. Beyond sunscreen, physical protection offers even greater defense: think wide-brim hats, seeking shade, and wearing sunglasses. These physical barriers often outperform sunscreen alone.

It's important to know which treatments to avoid during this time. Retinoids (like tretinoin or retinol), hydroquinone, and chemical peels are generally not recommended during pregnancy and are best reserved for postpartum treatment. If you are looking for a topical option that may help with mild hyperpigmentation during pregnancy, azelaic acid (at 15–20% concentration) is considered a pregnancy-safe choice. Many people find that melasma fades significantly within months after giving birth, though it may not fully resolve for everyone. It's also worth noting that hormonal contraception after pregnancy can sometimes cause melasma to reappear or worsen for some individuals, which is a conversation to have with your provider when considering your postpartum options, much like discussing [Pelvic Floor Dysfunction](/conditions/pelvic-floor-dysfunction) or other postpartum wellness topics.

## Working with your care team

Navigating skin changes, alongside other common pregnancy experiences like [Low Blood Pressure in Pregnancy](/conditions/low-blood-pressure-pregnancy), is a collaborative effort with your care team. Your OB or midwife is your best resource for discussing any concerns about melasma or other skin changes you observe. They can help you understand your specific situation and weigh the options for managing it safely during pregnancy. Remember, you get to decide what feels right for your body and your peace of mind. Our role is to provide you with evidence-based information so you can make informed decisions with confidence.