Why Do I Have Brown Patches of Skin During Pregnancy?

Posted in Skin Conditions | November 30, 2016

melasmaYou may not know the term, but chances are you’ve had pregnant friends who have had brown or grey-brown patches of skin on their face and other areas of the body that receive sun exposure. The condition is called melasma and is relatively common in women who are pregnant. Sometimes it is deemed to be “the mask of pregnancy,” although that sounds like some sort of Edgar Allan Poe story.

We treat melasma at Deschutes.

Who gets melasma?

Melasma is mostly an issue for women. It tends to affect people with darker skin tones and there seems to be a genetic element. If you’ve had a blood relative with melasma, you’re far more likely to get it as well.

What causes melasma?

The exact causes of many skin conditions, such as hives and rosacea, can be tricky to pinpoint. It’s no different with melasma. The condition is likely the result of the melanocytes — the skin cells responsible for pigment — overproducing color. That’s why it is believed that people who already have more pigment in their skin are more prone to melasma because their melanocytes are more active than people with fair skin.

Although causes are somewhat of a mystery, there are triggers that are understood:

  • Hormonal changes — Hormones and melasma have a relationship. To that end, pregnant women, with their complement of raging hormones, get the condition. In a similar fashion, birth control pills and hormone replacement medicines can trigger melasma.
  • Sun exposure — The ultraviolet light from the sun triggers the melanocytes in the exposed skin to produce pigment as a safety mechanism. This is why human skin tans. Once a person with melasma is exposed to some sun, an area that has faded will often become darker again. Because of this, more cases of melasma occur during the summer.
  • Cosmetics — Sometimes cosmetics can cause an irritation in the skin. When this happens, melasma is more likely to come with it.

Signs of melasma

Melasma shows itself in brown or grey-brown patches on the skin’s surface. It’s not at all health threatening, just cosmetic.

These are the most common areas:

  • Cheeks
  • Forehead
  • Above the upper lip
  • Chin
  • Bridge of the nose
  • Forearms and neck (less common)

How we treat melasma

Melasma often fades on its own, especially if the patient protects herself from sun exposure. Other triggers such as hormonal fluctuations during pregnancy resolve themselves after delivery or the trigger is removed. If it doesn’t go away, we have various treatments at Deschutes.

  • Hydroquinone — Our first option is usually prescription-strength hydroquinone. When applied to the darkened areas, it lightens the skin.
  • Tretinoin and corticosteroids — Beyond hydroquinone, these are the next two steps in enhance skin lightening. Sometimes we will use a cream with all three medicines (hydroquinone, tretinoin, and corticosteroid).
  • Other topical medicines — Azelaic acid and kojic acid also lighten the skin.
  • Procedures — If topical applications don’t seem to be generating the results you seek, we can opt for chemical peels (usually glycolic peels), microdermabrasion, or dermabrasion.

Melasma can be stubborn to eliminate, and it may recur. Sticking with the treatment plan we create is important.

If you’re seeing the brown patches on your skin, particularly if you’ve finished your delivery but still see them, call us at Deschutes, 541-330-0900, and let’s talk about treating your melasma.


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