Often called the “mask of pregnancy”, melasma is a skin pigmentation condition that causes skin discolouration on the face. It is very common in women 20 to 50 years old and often shows up during pregnancy. It can also appear due to prolonged exposure to sunlight, or if the person experiences hormonal changes.
Melasma manifests as brown, blue-grey or tan patches on the face and is most commonly seen on the following areas:
- the forehead
- the bridge of the nose
- the cheeks
- the upper lip
Whether caused by pregnancy or other factors, men and women need to seek pigmentation treatment for melasma to improve skin their quality. To help you understand better about melasma, its common causes and how to deal with it, this article was prepared by Dr David Ng Cheow Hua, senior specialist, and pigmentation treatment expert at One Face Skin and Aesthetic Clinic in Singapore.
What causes melasma?

The exact causes of melasma are still unknown, but I believe, as well as many other experts, that one factor that greatly influences its appearance is a change in the body’s hormonal balance, which is very common in pregnancy. Hormonal changes can also happen if you are taking birth control pills or are undergoing hormone treatments. Other possible causes for the appearance of melasma are prolonged exposure to the sun or skin irritation due to skin products. I have also read about many studies that show that melasma may be influenced by genetics, so if you have close relatives who have melasma then you are also more likely to develop it as well.
Melasma during Pregnancy
I am writing a separate section for this because melasma is quite common in pregnant women. In fact, it affects an estimated 45% to 80% of all pregnant women globally. During pregnancy, your body secretes hormones such as estrogen, progesterone and MSH, which stimulate increased production of melanocytes. These are cells that produce pigment, and a large influx of them causes your skin to darken and become melasma.
Although melasma can fade away in time, it doesn’t happen always. During pregnancy, the usual time for melasma to disappear is around three to six months after giving birth. If you have melasma during the current pregnancy, or if you have had it in the past one, then there is a high chance you’ll have it in future pregnancies as well.
Managing melasma and other skin pigmentation issues during pregnancy
Pregnant women are not recommended to undergo cosmetic procedures while pregnant. However, there are ways to manage skin pigmentation problems during this time. I recommend the following tips for managing melasma and other skin pigmentation issues in pregnant women:
- Wear light and gentle makeup to conceal your pigmentation.
You want to avoid irritating your skin as much as you can. So, if you have to go outside and meet other people during your pregnancy, use makeup that is gentle to your skin. This will help conceal your melasma temporarily while avoiding any strong ingredients that can cause complications.
- Avoid exposure to the sun as much as possible.
As a general recommendation, I always tell my patients to stay away from the sun, even for those that do not have melasma because many skin issues are caused by prolonged exposure to sunlight. If you have to go outside, use an umbrella or wear a wide-brimmed hat for protection.
- Use a sunscreen with an SPF of 30+ regularly.

Wearing sunscreen will not only help protect you from sunlight but will also help prevent your melasma from worsening. It is important to do this every day since most sunscreens are effective for a short amount of time. Make it a habit and takes only a short time to apply.
- Use skin products that are sourced from natural ingredients.
As I’ve said before, try your best to avoid skin irritation during pregnancy. Irritation often happens when you use products that are too strong or are made of synthetic ingredients. One of the best ways to avoid irritating your skin is by using natural skin care products. Look for products that have ingredients like arbutin, kojic acid and azelaic acid, since these are safe for the bodies of pregnant women.
- Avoid any skin-bleaching creams or products.
If your cream has hydroquinone, steroids, and retinoids, then you should avoid using them as these ingredients can be harmful to a pregnant woman and her child. You want to be as gentle as you can to your sensitive skin. Look for products with vitamin C or lactic acid, as they are usually very gentle to your skin.
- Try getting a gentle chemical peel.
A gentle chemical peel can do wonders in reducing the appearance of your melasma. By doing some skin resurfacing, the pigment in your melasma patches is reduced, and multiple sessions can remove your melasma over time. Before getting one though, make sure that you’ve consulted with your doctor to ensure you and your baby’s safety.
Treatments for Melasma outside of Pregnancy
- Use a topical cream or sunscreen with hydroquinone.
Hydroquinone is a substance that works wonders in treating many skin pigmentation issues, such as melasma. The whole treatment process would take about 5 to 6 weeks, and you should expect your melasma to fully disappear or have a reduced appearance after this.
- Get a specialized laser treatment for pigmentation removal.
If hydroquinone isn’t effective, you might consider getting a laser treatment. These are quite expensive but are very effective in dealing not just with melasma, but other skin discolourations as well. What’s even better is that the treatment has very little downtime, so there’s no need to take leave from your work or studies.
One Face Skin & Aesthetics Clinic
1 Tras Link, #02-01 Orchid Hotel,
Singapore 078867
+65 6222 2262