Is melasma safe in pregnancy?

Melasma causes flat brown, grey-brown or tan patches, commonly on the cheeks, forehead, upper lip or jawline. Pregnancy-related hormone changes can make pigment-producing cells more active, and sunlight or visible light may deepen the colour. Melasma does not usually cause pain, scaling or an open sore, and it does not harm the developing baby. A rash that is raised, very itchy, blistered, painful or bleeding may have another cause and needs separate assessment.

Use shade, a wide-brimmed hat and clothing that covers exposed skin. Apply broad-spectrum sunscreen to the face and other exposed areas, and reapply according to the label, particularly after sweating or washing. Choose gentle, fragrance-free cleansing and moisturising if the skin feels sensitive. Before using a fading cream, peel, prescription product or device treatment, show the ingredient list to your obstetric clinician or dermatologist. Avoid starting a treatment simply because it was recommended before pregnancy; the timing and formulation may matter.

Arrange a routine review if the patches are spreading, the diagnosis is uncertain, or the colour change is affecting your wellbeing. Seek prompt care for a spot that changes quickly, becomes raised, bleeds, ulcerates, hurts or develops a persistent crust. Get urgent help for facial swelling with breathing difficulty or a rapidly spreading blistering rash. A clinician can distinguish melasma from other pigment disorders and tailor advice around pregnancy and breastfeeding plans.

Does this pattern fit melasma, or should another cause be checked? Which sunscreen and skin-care ingredients are suitable for me now? Which treatments should wait until after pregnancy or breastfeeding? How should I respond if the patches darken despite protection?