What to know about melasma in pregnancy

Melasma produces flat brown, grey-brown or tan patches, commonly across the cheeks, forehead, nose or upper lip. Pregnancy hormones can make pigment-producing cells more active, while sunlight and visible light may deepen the contrast. It is usually a cosmetic condition rather than a dangerous one, but other causes of facial pigmentation can look similar. New, one-sided, raised, scaly or bleeding marks need a clinician's assessment instead of being assumed to be melasma.

Use shade, a wide-brimmed hat and broad-spectrum sunscreen on exposed skin, applying and reapplying it according to the label and your clinician's advice. Choose a gentle cleanser and moisturiser, and avoid scrubbing or picking at the patches. Discuss every brightening product, peel, laser or prescription with your obstetric clinician or dermatologist before use; some ingredients and procedures are not suitable during pregnancy. Makeup can camouflage colour safely if it does not irritate your skin.

Arrange a review if pigmentation is rapidly changing, itchy, painful, scaly, raised, bleeding or confined to one unusual spot. Seek care for a rash with swelling, blistering or breathing difficulty. A clinician can check whether the pattern fits melasma and tailor options to pregnancy and any other medicines or skin conditions.

Ask which sunscreen and skin-care ingredients are appropriate for you, whether treatment should wait until after pregnancy, how to manage irritation, and what changes would require a separate examination.