Pregnancy and Pigmentation Changes

Dre Emilie Bourgeault

Wednesday, January 5, 2022

Many pregnant women will have questions regarding their skin and it is perfectly normal. Pregnancy is indeed a period of intense hormonal change that can lead to skin, hair and nail alterations. Most of these changes are normal and don’t require any treatment. However, some skin conditions will need to be treated and followed up on.

The most common skin alterations reported by pregnant women include skin pigmentation changes, such as:

  • Pregnancy mask

  • Hyperpigmentation of specific areas

  • Pregnancy line

What is the pregnancy mask?

Melasma, also called “the mask of pregnancy” or “pregnancy mask”, is a form of skin pigment alteration. In addition to hormonal changes, sun exposure is likely to play a role. The face is usually the most affected area, but the condition may also be present on the arms and chest. After giving birth, melasma tends to persist in women with darker skin and gradually fades in women with a fairer skin tone.

What is hyperpigmentation?

Hyperpigmentation, or darkening of certain areas of the skin, is present in 85-90% of pregnant women. Most pregnant women notice a darker color on skin areas that are darker to start with, such as breast, genitals and skin around the navel. Usually, hyperpigmentation becomes more apparent towards the end of the second trimester and can persist up to one year after birth.

What is the cause?

The phenomenon responsible for hyperpigmentation is not yet understood but its development is linked to many factors including a genetic predisposition, hormonal changes and UV exposure. The hormonal stimulation induced by pregnancy raises the production of melanin, which leads to skin hyperpigmentation.

What is the pregnancy line?

Linea nigra, or pregnancy line, is a localized hyperpigmentation. It shows as a brown line on the lower abdomen and joins the navel to the pubis. This line arises at the same place the abdominal muscles separate, which is called “abdominal separation” or “diastasis recti”.

What to do during pregnancy?

  • Apply sunscreen FPS 45 or more daily, especially to prevent pregnancy mask. Rain or shine, summer or winter, it is important to wear sun protection every day.

What to do after giving birth?

  • These pregnancy-related changes in skin pigmentation will gradually fade after the baby is born. Patience is required since it can take up to one year for the color to fade.

  • As mentioned above, certain patients will experience enduring melasma. It is then advised to seek appropriate dermatology treatment. For a start, strict sun protection is crucial. Following the assessment, the dermatologist may prescribe a specific cream (hydroquinone) to be applied every night to help reduce the activity of pigment cells. This cream will yield results after 3 or 4 months. Laser treatment is another alternative which gives very good results.

  • It is also important to know that melasma can be difficult to eliminate. It is recommended to go see a dermatologist before getting pregnant again in order to reduce the appearance of the patches as much as possible. Melasma is harder to get rid of when there is an accumulation of patches resulting from successive pregnancies.

This article is adapted from a post written in collaboration with Marie Fortier (French only).

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