Melasma in Pregnancy: When It Starts and If It Goes Away

Melasma in pregnancy, also called chloasma or the "mask of pregnancy," is a common skin change that causes brown or gray-brown patches, usually on the cheeks, forehead, nose and upper lip. It's linked to rising pregnancy hormones plus sunlight, and it's harmless. For many people it goes away on its own after the baby arrives, though for some it lingers.

Here's why it happens, when it tends to start, whether it goes away after pregnancy and breastfeeding, and how to care for your skin in the meantime.

What is the mask of pregnancy?

The mask of pregnancy is the everyday name for melasma that appears during pregnancy. Its medical name is chloasma, sometimes written chloasma gravidarum. It shows up as flat, blotchy patches that are darker than your natural skin tone, often in a symmetrical, mask-like pattern across the cheeks, forehead, nose and upper lip.

Melasma is so common during pregnancy that it earned its own nickname [1]. It can happen on any skin tone, and it's more likely, and often more noticeable, on medium to deep skin, where pigment cells respond more strongly to triggers [1][2].

Many people notice other pigment changes at the same time, such as a dark line down the belly (linea nigra) [5] or darker skin on the nipples, underarms or neck. These are common in pregnancy too.

Is chloasma the same as melasma?

Yes. Chloasma and melasma are the same condition. "Chloasma" is used most often when patches appear during pregnancy, and "melasma" is the general term. For the full background, see what is melasma.

Why do you get melasma when pregnant?

During pregnancy, levels of estrogen and progesterone rise, and these hormones are thought to make pigment cells more active [2][3]. When that primed skin meets sunlight, visible light or heat, it can respond by making extra melanin in patches. Genetics matters too: if relatives had melasma, you're more likely to get it.

Here's how the pieces fit together:

• Hormones: estrogen, progesterone and melanocyte-stimulating hormone all rise in pregnancy. Exactly how they affect pigment isn't fully known, but they're thought to play a key role [4].
• Light: UV and visible light both stimulate pigment, so patches often darken after time outdoors [4].
• Heat: many people notice patches look darker after heat, even without much sun. Here's more on whether heat makes melasma worse.
• Family history: melasma often runs in families [2].

Not everyone who is pregnant gets melasma. It usually takes a mix of hormones, light and your own genetics.

When does melasma start in pregnancy?

There's no set week: melasma can appear in any trimester. Pregnancy hormones rise as the months go on and are highest late in pregnancy [4], so patches often show up or get darker as pregnancy progresses. Many people notice them most after sunny days or in summer. If you had melasma before pregnancy, it may get darker.

When it first starts, melasma in pregnancy often looks like:

• A faint, uneven shadow on the cheeks or forehead, like a tan that doesn't match the rest of your face
• A darker area above the upper lip
• Patches that look more obvious in bright daylight or in photos

If you're not sure whether a new patch is melasma, a sun spot or something else, our guide to melasma vs sun spots vs hyperpigmentation can help you describe it to your doctor.

Is melasma dangerous in pregnancy?

No. Melasma itself is harmless. It's a change in skin color, it isn't cancer, and it can't hurt you or your baby [1]. It doesn't itch or hurt. Still, it's worth mentioning any new skin change at your next prenatal visit, and any spot that bleeds, itches, grows or looks different from the rest should be checked by a dermatologist.

One separate note: intense itching during pregnancy, especially on the palms and soles, isn't melasma. Tell your OB or midwife about it right away.

Melasma can still affect how you feel. Pregnancy already changes so much about your body, and seeing new patches on your face can be frustrating. Those feelings are valid, and there are gentle, pregnancy-friendly ways to care for your skin, which we cover below.

Does melasma go away after pregnancy?

Often, yes, but not always. For many people, melasma from pregnancy becomes less noticeable in the months after giving birth as hormone levels settle, and for some it goes away completely [1][4]. For others it lingers for years, especially with regular sun exposure, and it can come back in a later pregnancy or with hormonal birth control.

A few things tend to shape how it goes:

• Sun exposure: unprotected sun can keep patches dark long after birth.
• Skin tone and depth: pigment on medium to deep skin, or pigment that sits deeper in the skin, can take longer to settle.
• Time: changes happen over months, not weeks, so try to be patient with your skin.

What about after breastfeeding?

Breastfeeding isn't known to cause melasma, but your hormones take time to settle after birth, and there's no reliable timeline for when patches change. Some people see a difference once they stop breastfeeding or their cycle returns; others don't. If melasma still bothers you after pregnancy and breastfeeding, a board-certified dermatologist can talk you through prescription options and procedures, including which ones are okay while you're nursing.

Thinking about birth control after birth?

Hormonal birth control can trigger or darken melasma in some people [2]. That shouldn't stop you from choosing what's right for you. Just mention your melasma when you talk about contraception with your doctor. Here's more on whether birth control can cause dark spots.

How can you care for melasma while pregnant?

The safest approach during pregnancy is simple: protect your skin from light every day and keep your routine gentle. The American Academy of Dermatology suggests waiting until after your baby is born to try melasma-specific products, partly because it's hard to know which ones are safe in pregnancy, and partly because melasma may improve on its own after birth [1].

1. Wear sunscreen every day. Choose a broad-spectrum SPF 30 or higher, even on cloudy days, and reapply at least every two hours when you're outside [6].
2. Consider a tinted mineral sunscreen. Mineral filters (zinc oxide and titanium dioxide) are often preferred during pregnancy, and tinted formulas with iron oxides add protection from visible light [4][5][6]. Our guide to the best sunscreen for melasma explains what to look for.
3. Wear a wide-brimmed hat and seek shade, especially in the middle of the day.
4. Keep cool when you can. Heat may make patches look darker, so take breaks from hot kitchens and steamy rooms.
5. Keep skincare gentle. Use a mild, fragrance-free cleanser and moisturizer, and skip scrubs, strong peels and anything that stings. Irritation can make pigment darker [6].
6. Check every ingredient first. Before you start any new skincare product or ingredient while pregnant or breastfeeding, check it with your OB or dermatologist. That includes products you can buy without a prescription.
7. Use makeup if it helps you feel like yourself. A tinted sunscreen, foundation or concealer can even out how your skin looks while you wait [6].

Melasma in pregnancy is common, it isn't your fault, and for many people it's temporary. Steady sun protection and a gentle routine are enough for now. For more quick answers, browse our melasma FAQ.

References

1. American Academy of Dermatology. "Melasma: Overview." aad.org
2. American Academy of Dermatology. "Melasma: Causes." aad.org
3. Ogbechie-Godec OA, Elbuluk N. "Melasma: an up-to-date comprehensive review." Dermatology and Therapy (2017). PMC5574745
4. Bolanca I, Bolanca Z, Kuna K, et al. "Chloasma: the mask of pregnancy." Collegium Antropologicum (2008). PubMed 19140277
5. Lim HW, Piquero-Casals J, Schalka S, et al. "Photoprotection in pregnancy: addressing safety concerns and optimizing skin health." Frontiers in Medicine (2025). PMC11984416
6. American Academy of Dermatology. "Melasma: Self-care." aad.org

This article is for general information and isn't medical advice. If you have a skin condition or concern, talk to a doctor or dermatologist.