How is melasma different in pregnancy?

Melasma causes flat brown, grey-brown, or tan patches, often across the cheeks, forehead, nose, or upper lip. Pregnancy-related hormone shifts can start the patches or make existing areas more noticeable. Sunlight and visible light can deepen the colour, even when exposure feels brief. The patches are usually smooth rather than scaly, sore, or raised, and they do not affect the baby. Colour can fade after pregnancy, although it may take time and some pigmentation can remain.

Use shade, a wide-brimmed hat, and broad-spectrum sunscreen suitable for pregnancy every day; reapply as directed when outdoors. A gentle cleanser and moisturiser can reduce irritation, while picking or scrubbing may make darkening last longer. Do not start bleaching creams, retinoids, peels, or laser treatment without your maternity clinician or dermatologist checking them first. A clinician can confirm that the pattern fits melasma and suggest pregnancy-compatible care. See the overview of [Melasma](/conditions/melasma/).

Arrange a skin assessment if a patch changes quickly, becomes raised, bleeds, crusts, hurts, or looks unlike the other patches. Seek prompt medical advice for a new pigmented mark near the eye with vision symptoms, or for a widespread rash with swelling or breathing difficulty. These features need assessment because they are not typical features of straightforward melasma.

Ask whether the pattern is consistent with melasma, which sunscreen and skincare ingredients fit your pregnancy, and which treatments should wait until after delivery or breastfeeding. You can also ask how to recognise irritation or another pigmentation condition.