Melasma is a skin condition that causes dark spots or blotches, often on the face. Many pregnant moms experience the discoloration, which can worsen with sun exposure. In fact, an estimated 50% to 75% of expectant mothers develop this "mask of pregnancy."

"I get melasma on my chin/around my mouth with every pregnancy," says What to Expect Community mom rbowers3. "It's visually unbearable to me, but everyone says they don't notice. I'm like, how? LOL."

summary icon
Key Takeaways
  • Melasma is a common pregnancy-related skin change. Driven by hormonal shifts, it causes dark, symmetrical patches — most often on the face — and affects up to 75% of expectant moms.
  • Sun exposure can make it worse, so protection is key. Daily SPF, limiting peak sun exposure, and protective accessories can help prevent melasma from becoming more noticeable.
  • Treatment options are limited during pregnancy, but melasma is usually temporary. While most lightening treatments aren't safe while expecting, options like vitamin C (and possibly azelaic acid with a doctor's guidance) may help — and melasma typically fades after pregnancy or breastfeeding.

How can I tell if my skin discoloration is melasma?

Some women with melasma have small spots resembling freckles, while others have a few larger, blotchy, confetti-like patches. The discoloration:

  • May appear tan, brown, or gray — darker than your usual skin tone
  • Is usually symmetrical
  • Often appears on the cheeks and nose but can also show up on the forehead and upper lip
  • Is not painful or itchy
  • May appear more prominent after sun exposure[1]
  • Is especially common in women with dark skin tones, including those of Asian and African descent, who have more pigment than fair-skinned women

If you have melasma, your freckles and moles (if you have them) may also look darker. You may also notice a dark line down the center of your abdomen (the linea nigra), and your areolas could be a deeper shade.

melasma
DermNet NZ; Science Source
 

"With my first baby, I got it bad on my cheeks and above my upper lip, and it faded a lot," says Community mom kpp9. "Now, this pregnancy, my upper lip and forehead are so dark!"

What causes melasma (pregnancy mask)?

Melasma occurs when a steep rise in estrogen and progesterone levels stimulates excess melanin production, also known as hyperpigmentation.[2] That's why melasma usually develops in the second trimester or third trimester, when these hormone levels are typically higher.

Dealing with melasma or other surprising pregnancy skin changes? The What to Expect app has expert advice, safe treatment tips, and a supportive community of moms who've been there.

What can you do about pregnancy mask?

While you're unlikely to completely get rid of it while you're pregnant, there are things you can do to minimize the appearance of melasma. Here are some strategies:

1. Protect yourself

Sun exposure can make your pregnancy mask more pronounced. Wear a broad-spectrum sunscreen with an SPF of 30 or higher on your face every day, even if you're not going outside, since harmful rays can pass through windows.

Stay out of the sun when rays are strongest (10 a.m. to 2 p.m.). When you do go outside, wear sunglasses and a wide-brimmed hat, and reapply sunscreen every two hours.

2. Conceal it

Make a good concealer your best friend. Choose a corrective foundation and concealer that are non-comedogenic, hypoallergenic, and designed to cover hyperpigmentation.

Match the foundation to your skin tone, but use a concealer that's a shade lighter. First, apply concealer to the darker patches, then apply foundation to the rest of your face, avoiding those areas.

If concealer doesn't work for you — for example, if your have oily or sensitive skin — try a pressed powder to help lighten the spots. 

3. Try topical vitamin C

Applying this antioxidant can help brighten melasma while providing other skin benefits, like supporting collagen production. Topical vitamin C is considered safe during both pregnancy and breastfeeding.

"I started using vitamin C, daily sunscreen, and face moisturizer," says Community mom cmv613. "It has helped sooooo much!"

4. Talk to your doctor about azelaic acid

Most skin-lightening ingredients are off-limits during pregnancy, but ask your doctor whether topical azelaic acid may be right for you. It's often used to treat hyperpigmentation, as well as rosacea and acne during pregnancy.

Azelaic acid is one of the few lightening ingredients considered safe to use during pregnancy and is available in prescription form and over-the-counter gels, foams, and creams.

That said, it should only be used during pregnancy if clearly needed. It takes a month or two to work, and it may cause burning, stinging, itching, or tingling.

What skin solutions are off-limits during pregnancy?

Not all treatments for melasma are safe when you're expecting. Avoid:

  • Retinoid treatments. If you opt for a spa treatment during pregnancy, let your esthetician know you're pregnant. Retinoids and many chemical peels used for hyperpigmentation in facial treatments are not safe when you're expecting.
  • At-home peels, bleaches, or other chemical lightening treatments. These can penetrate the skin and aren't considered safe during pregnancy or breastfeeding.
  • Laser treatments. Your skin can be more sensitive during pregnancy, and lasers may cause irritation.

Does pregnancy mask go away?

The good news: Melasma is usually temporary and often fades after delivery or, in some cases, after you finish breastfeeding.

"I had pretty intense melasma with my first two babies," says Community mom elbells. "Mine naturally faded away postpartum — I didn't need to do anything."

If melasma persists even after you've weaned your baby, ask your dermatologist about your options. You may may be able to consider treatments like chemical peels, lasers, intense pulsed light therapy, or topical medications — options that aren't recommended during pregnancy or nursing.