Chloasma: How pregnancy alters skin pigmentation

By Cristiano Antonino On Mar 26, 2023

Let’s talk about chloasma. During pregnancy it can happen that in some specific areas of the body, and in particular of the face, hyperpigmentation occurs which generates a chromatic alteration of the skin

We are talking about chloasma, also known as melasma: a skin imperfection that is not pathological or risky to health, but which can be perceived as a problem, especially from an aesthetic point of view.

It is also commonly called pregnancy mask, because chloasma has a higher incidence in women, some studies, in fact, have shown that only 10% of people with melasma are male (source: American Academy of Dermatology).

Furthermore, chloasma appears to be more common among people with a darker skin tone and among those who are familiar with this disorder (source: American Academy of Dermatology).

While not representing a disease, chloasma is a source of annoyance and possible discomfort for people affected by this problem, which is why it is very important to know the symptoms, causes and possible treatments.

What is chloasma?

Chloasma or melasma is a local hyperpigmentation of the skin: it is a non-contagious skin imperfection that does not represent a dangerous factor for the health of the individual.

It is therefore one of the cosmetic disorders which, although not a pathology, can be annoying and a source of embarrassment for those who suffer from it.

Chloasma modifies, albeit not definitively or substantially, the person’s aesthetic appearance and is more visible in those with a darker skin tone.

But how does this hyperpigmentation happen? Melanin, which is also the pigment responsible for tanning, accumulates in the skin because melanocytes produce a greater quantity of melanic pigment following an alteration of the synthesis mechanisms.

For this reason, the skin takes on a blotchy appearance that can be of different extension and intensity.

It is not yet clear exactly how this alteration of the synthesis mechanisms is triggered, but there are some external factors that contribute to increasing the risk of its occurrence.

What are the causes of chloasma and what is the incidence

As indicated by the American Academy of Dermatology, chloasma affects men only to the extent of 10%, 90% is represented by women, in particular during the period of pregnancy or in any case at a young age.

This does not mean that men are not at risk of suffering from melasma, but it does occur with a lower incidence.

Likewise, this blemish affects people with medium-dark skin tones to a greater extent, but that doesn’t mean that people with a light skin tone may not be affected.

The alteration of the color of the epidermis can be generated by various factors, among these there are:

hormonal alterations – particularly when high levels of estrogen are present, for this reason it mainly affects pregnant women and is therefore called a “pregnancy mask”. However, the same can also occur in conjunction with the intake of birth control pills which alter the hormonal state;
familiarity – a risk factor for developing melasma is having a first-degree relative with the disease. This means that, even if only in part, the disease has a genetic basis
exposure to the sun (and therefore to UV rays) can be a trigger since these stimulate the creation of melanin. In winter melasma usually tends to be less evident because the skin takes on a lighter color, while on the contrary in summer it is more evident. On the other hand, it cannot be said that melasma disappears in winter, because it is a chronic condition;
stress could be one of the triggers of melasma, as endorphins and enkephalins could trigger an excess production of melanin;
finally, the causes may also include thyroid disorders, the use of cosmetics with allergens or of poor quality, as well as the intake of certain categories of drugs.

What it looks like: the symptoms

At this point one wonders what the symptoms of melasma are and therefore how it presents itself.

Chloasma is most common around the cheeks, chin, upper lip, and forehead, but may also extend to the neck and behind the ears.

It presents with the characteristic hyperpigmentation therefore with spots that vary from light to dark brown.

The spots are irregular in size and shape.

The spots do not generate any kind of discomfort, they are therefore asymptomatic, but appear as an exclusively aesthetic alteration of the epidermis.

Diagnosis and treatment of chloasma

If you begin to glimpse some spots on the epidermis or areas of alteration of the normal pigmentation, it is advisable to contact a dermatologist to request a specialist visit.

Through the observation of the epidermis, in fact, the dermatologist will be able to diagnose melasma and will be able to identify its causes by asking specific questions about the patient’s familiarity, clinical history and lifestyle.

Chloasma can be a chronic disorder that occurs for a few years, or it can be permanent.

If triggered by the use of cosmetics, it can be treated with creams, ointments and solutions with a lightening action: it is always advisable to rely on the opinion of the doctor and follow the proposed therapy precisely.

The treatment of melasma, in fact, takes a long time and if the therapy were to be interrupted or not carried out adequately, it could not give the desired results.

Here are some treatments indicated for chloasma:

lightening creams, gels and ointments that act on hyperpigmented spots to make them uniform with the rest of the skin. However, these can also cause dermatitis or irritation in the most delicate skins;
the laser with thermal energy which acts on the pigmentation by destroying the melanic pigment. Also in this case it is necessary to be very careful and to carry out this treatment only with a professional, a specialist in aesthetic medicine, in order to avoid skin problems;
micro-peeling is, to date, one of the most effective treatments because it allows you to quickly regenerate epidermal cells, promoting their turnover;
finally, even if it is not a treatment but rather a tool to be able to hide the spots, you can use high quality covering creams.

There are some prevention tips to follow to prevent melasma from appearing or making the situation worse.

The main advice is to use sunscreens with a UVA/UVB filter which protect the skin from the sun’s rays and, therefore, prevent it from getting worse.

When you find yourself in situations where the sun’s rays are particularly strong and aggressive, it is advisable to cover the most sensitive parts directly with clothing: in this way you prevent the skin from being attacked by UV rays.

Furthermore, it is advisable to always use high quality cosmetics, without fragrances and also suitable for sensitive skin: we must not forget that what is used on the face contributes to determining the state of health of our body.

Finally, especially when you have particularly sensitive skin, it is not recommended to use waxing as a depilation method, as it could create skin inflammation and worsen the state of health of the skin.

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