Brown or greyish patches appear on your cheeks, forehead, nose bridge, and upper lip. This is melasma, often called the mask of pregnancy. It affects up to 70% of pregnant women and is directly caused by pregnancy hormones - particularly estrogen and progesterone - stimulating melanocytes (pigment cells) to produce more melanin.
What Causes Melasma
Estrogen and progesterone both activate melanocytes. UV exposure then triggers these already-primed cells to produce dark pigment rapidly. This is why melasma is significantly worse in sunny climates and almost always darker after sun exposure.
| Body Area | How Often Affected |
|---|---|
| Cheeks | Most common |
| Forehead | Very common |
| Upper lip | Common |
| Chin | Less common |
| Neck and forearms | Occasionally |
Managing It During Pregnancy
Most skin-lightening treatments (like hydroquinone, retinoids, and chemical peels) are not safe during pregnancy. The safest and most effective approach during pregnancy is prevention.
- Apply SPF 50+ broad-spectrum sunscreen every morning - even on cloudy days
- Wear a wide-brimmed hat outdoors
- Avoid peak sun hours (10am-4pm) where possible - especially in Singapore
- Use a physical sunscreen (zinc oxide or titanium dioxide) rather than a chemical one - better tolerated during pregnancy
- Azelaic acid (safe in pregnancy) can mildly lighten patches over time
Does It Fade After Birth
For most women, melasma fades significantly within 3-12 months of delivery as hormone levels normalise. However, sun exposure can trigger it to return, especially if you go on to use hormonal contraception. Professional treatments like laser, chemical peels, and prescription creams can be used safely after delivery and breastfeeding.