Chloasma During Pregnancy: Causes And Treatment

Pregnancy can bring about changes to your skin, nails and hair. In fact, a majority of women have said that they look and feel better than ever during pregnancy. Due to the hormonal changes that pregnancy brings in, and given the improved blood flow, you may find that your skin looks better than ever during pregnancy, resulting in smoother and radiant skin.

But, at times, pregnancy brings in side-effects too, such as increased skin pigmentation, stretch marks and hair growth. However, it is a fact that these changes are only temporary, and you will be back to normal after the birth of your child. Some women feel that their skin gets drier or are more prone to acne. Hence they feel some extra attention needs to be paid towards skincare during pregnancy.

Another skin change noticed during pregnancy is that the skin tends to darken on certain parts of the body, probably, due to the high estrogen levels and melanocyte-stimulating hormone that trigger skin pigmentation. One such skin condition that affects some women during pregnancy is chloasma. This article focuses on the possible causes, symptoms and treatment methods for this skin condition. Read on to know more.

• What Is Chloasma?
• What Causes Chloasma?
• Symptoms Of Chloasma
• Prevention And Treatment Of Chloasma

What Is Chloasma?

Chloasma, also referred to as 'melasma' or 'the pregnancy mask', is a skin condition that affects 50 to 70 per cent of women during pregnancy. It is characterized by increased pigmentation or symmetrical patches of brown skin, commonly seen around the upper lip, cheeks, chin, forehead, resembling a mask like pattern.

Generally, people with dark complexion tend to tan more and are more likely to develop this condition. However, if you are lighter skinned, it becomes more visible. Chloasma is also seen in pre-menopausal women due to the surge in certain hormones. Rarely though, some men are seen having this condition too.

What Causes Chloasma?

• Chloasma occurs due to several reasons. It may be difficult to pinpoint the exact cause. It is said that the ultraviolet rays from the sun lead to the formation of 'melanocytes', which lead to the excess formation of melanin, the pigment that gives skin its distinct colour. As the melanin in the skin increases, the skin colour tends to get darker.

• Another cause is believed to be a hormonal fluctuation that happens during pregnancy.

• It is not just the pregnant women who are susceptible to chloasma. Women taking medication for hormone replacement, or using oral contraceptives, also develop this condition.

• It is also said that women who have a blood relative with chloasma, are more prone to developing this skin condition.

• Chloasma is also increasingly noticed in patients with thyroid disease too, due to overproduction of melanocyte-stimulating hormone caused by stress.

• Rare causes of chloasma include allergic reactions, cosmetics and medications. Sometimes, repeated pregnancies are believed to worsen chloasma.

Symptoms Of Chloasma

• Chloasma appears as dark patches on the skin. The symptoms of Chloasma are usually harmless. Pigmentation of the skin on the forehead, cheeks, nose and neck is the most common symptom of Chloasma. They appear as dark brown patches on the skin.

• There may be darkening of nipples and surrounding areas of the skin, caused due to the increased blood supply.

• Sometimes, the moles and freckles get darker too. Sometimes, the pigmentation is also seen in other parts of the body such as the forearm, neck, upper lip or a dark line down the centre of the abdomen (linea nigra).

Prevention And Treatment Of Chloasma

There is no sure-cut way to avoid chloasma completely, but, you can minimize its symptoms.

Chloasma tends to fade with time. If pregnancy is the cause, then it may fade away after a woman gives birth. In case it is due to medication, it goes away when you discontinue the medication.

Sun exposure should be avoided as far as possible. One of the ways is to protect your skin using sunscreen with a Sun Protection Factor (SPF) of 15 or more, as Chloasma could worsen with sun exposure. Wear a hat, cover your arms, when stepping out in the sun. This is because avoiding photosensitivity can probably help in reducing Chloasma. A recent study showed that using highly protective sunscreens over SPF 50 helped pregnant women from developing chloasma. Reapplication of sunscreen every 2 hours is essential if you are in the sun for long hours.

In majority of the cases, the skin patches disappear on their own after childbirth without any treatment. In case, the cause of chloasma is birth control pills, you can see a difference once you discontinue the medication.

The most effective treatment for chloasma is the combination of a topical cream formulation with hydroquinone, tretinoin and a steroid component. But a systematic review shows that oral medications also have a role to play in the chloasma treatment. However, this treatment process should be done only in consultation with your doctor.

Some studies have shown that folate deficiency is related to hyperpigmentation. So include oranges, green leafy veggies, whole-wheat bread, and whole-grain cereals into your diet. Also, stop using skin care products that may irritate the skin or worsen chloasma.

In case self-treatment does not improve chloasma, skin darkening, irritation, seek help from a dermatologist. Expert treatment through the cautious use of topical retinoids, sunscreen, pigment laser and bleaching cream may help in reducing pigmentation, although it may take a few months to see the results.

Using bleaches, peels and other chemical-based skin lightening treatments are best avoided during pregnancy, as these chemicals can eventually penetrate into the skin, so it is better to be safe than sorry.