Melasma (chloasma)

What is melasma?

Melasma are brown patches that can appear on your skin, usually on your face. Melasma is also known as chloasma or 'the mask of pregnancy'.

Melasma is very common in pregnancy. Usually it develops during your second or third trimester.

You can also develop melasma when you are not pregnant. It's more common in females than in males. It's also more common among people whose skin is brown or tans easily than people whose skin is fair or black.

What are the symptoms of melasma?

Melasma appear as brown patches that are usually symmetrical. They often appear in a typical pattern, most commonly on your forehead, cheeks, nose and upper lip. They can also sometimes appear along your jaw and chin and occasionally on your shoulders and arms.

If you developed melasma during pregnancy, there's a good chance that it will fade over time. This may take a few months. It could come back again if your skin is exposed to the sun.

If you have had melasma during pregnancy, it could come back in a future pregnancy.

What causes melasma?

Melasma can develop when your skin makes more melanin. Melanin is the substance that gives your skin its colour. Higher melanin levels can make your skin darker. Doctors don't fully understand why this happens.

Some factors that contribute to the development of melasma include:

• your genetics —you have a higher chance of developing melasma if it runs in your family
• hormonal changes — these occur in pregnancy, but can also occur if you take medicines that contain oestrogen or progesterone, such as oral contraceptives or menopausal hormone therapy
• exposure to sunlight
• some medicines and cosmetics
• exposure to heat

When should I see my doctor or midwife?

See your doctor or midwife if you notice brown patches on your skin. They can check if they are caused by melasma or another skin condition. This is especially important if the brown patches appear on other areas of your body besides your face.

Your midwife may refer you to a doctor to examine your skin.

Read more about when you should be checked for skin cancer.

How is melasma diagnosed?

Your doctor or dermatologist will diagnose melasma after examining your skin. They will look at the colour and distribution of the pigment on your face. They may use special equipment, such as a Wood's lamp or a dermatoscope. Sometimes you might need to have a skin biopsy.

How is melasma treated?

Melasma can be hard to treat. To get the best results, you may need to use several treatment approaches. The treatment your doctor recommends will depend on why you have melasma.

Treatment options may include:

• a variety of medicines, including tablets or creams such as hydroquinone or tretinoin
• chemical peels
• laser or light-based treatments
• stopping the oral contraceptive pill or removing a hormonal IUD (intrauterine device) if doctors suspect hormones have contributed to your melasma

Some of these treatments can only be prescribed by a dermatologist (specialist skin doctor). You can ask your GP for a referral.

Self-care tips

Many people find they can cover up their melasma with makeup.

In addition to any treatment, it's important to protect your skin from the sun all year round. This includes wearing SPF50 or SPF50+ water-resistant sunscreen. Apply sunscreen twice daily, 20 minutes before any sun exposure. Always wear a broad-rimmed sunhat outdoors during the day. This helps make treatment more successful.

Read more about sun protection.

Read more about other things you can do to protect your skin from the sun.

Some products used to treat melasma may be harmful to your baby if you use them in pregnancy. This includes creams containing hydroquinone or tretinoin. Check with your doctor or pharmacist before starting any treatment in pregnancy.

Read more about medicines during pregnancy.

What are the complications of melasma?

If you have melasma, it won't cause any health problems or complications for you and your baby.

You might feel self-conscious and find it difficult to cope emotionally. For some people, melasma affects their mood, relationships and performance at work. Seek support from your doctor or midwife. Mental health helplines can also provide support. You do not need to go through this alone.

Can melasma be prevented?

The best way to prevent or reduce your chance of getting melasma is to wear sunscreen and stay out of the sun as much as you can. If you already have melasma, this may stop it from getting worse.

Resources and support

• If you are pregnant or breastfeeding and would like to find out more about your medicines call Medicines Line on 1300 633 424.
• Read about self-care for expecting and new parents at PANDA.
• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists have a helpful resource answering some common questions people have in pregnancy.

Other languages

Healthy Horizons has resources in a range of community languages on many general health conditions. These include several skin diseases, reproductive health and mental health.

Aboriginal and/or Torres Strait Islander peoples

You can find out more about Aboriginal and/or Torres Strait Islander pregnancy health on Stronger Bubba Born or watch the How to Have a Safer Pregnancy video.

Looking for information for sexually and gender-diverse families?

PANDA provides inclusive and appropriate support for LGBTIQA+ expecting and new parents.