Hyperpigmentation, or darkening of the skin, is a common side effect of pregnancy — a reported 90% of women experience some form of it during their pregnancy. Hyperpigmentation is a result of excess melanin, the pigment in our skin. The hormones of pregnancy cause this overproduction of melanin, which manifests itself in many ways on a pregnant woman’s skin.
In general, most pregnant women will notice that their freckles, scars and moles may become darker and more pronounced than usual. Nipples and the genitals may also become darker due to hyperpigmentation. Perhaps one of the most common results of hyperpigmentation during pregnancy is melasma or chloasma, or as it is more commonly known, the “mask of pregnancy.” Approximately 70% of women will experience melasma, which sometimes gets worse with subsequent pregnancies. Melasma appears as darker skin, or splotchy dark patches in certain areas, or all over the face, and sometimes, forearms.
Melasma is the result of hyperpigmentation on the skin of the face. There are three main “patterns” of melasma, which include mandibular, centro-facial and malar. The mandibular pattern is demonstrated by darkening of the skin around the cheeks and jawline. The chin, nose, upper lip, cheeks and forehead are affected with the centro-facial pattern — hence the nickname, “mask of pregnancy.” With the malar pattern of melasma, only the cheeks and nose are affected.
Hyperpigmentation during pregnancy is also manifested by the linea negra, or “black line.” This light to dark brown line runs from the belly button down to the pubic bone, and typically appears during the second trimester of pregnancy.
The bad news is that hyperpigmentation is often unavoidable and untreatable during pregnancy. Since the sun’s ultraviolet (UV) rays exacerbate the condition, it is advisable to stay out of the sun and wear a high SPF sunscreen. If possible, wear long sleeve shirts and a wide brimmed hat to protect areas especially prone to hyperpigmentation during pregnancy. The good news is that melasma, the linea negra, and other forms of hyperpigmentation during pregnancy should fade and disappear within a few months after delivery.
If you find that your dark spots aren’t fading fast enough, or remain months to years after pregnancy, consult your dermatologist for treatment options. Hyperpigmentation may be treated with bleaching creams containing hydroquinone, topical creams such as Retin-A® and chemical peels with glycolic acid. Of course, if you’re still nursing, the hormones may prevent the spots from fading faster, and many treatments will have to wait until your baby is weaned.