Melasma & Pregnancy: How to safely treat

Dr Davin Lim | Dermatologist The Melasma Clinic, Brisbane | Sydney

3.5 minute read for clearer skin

  • Melasama can occur in up to 50% of pregnancies
  • Melasma pigment fades in most cases after 12 months of giving birth
  • Safe ingredients include ascorbic & azelaic acid, niacinamide, & botanicals
  • Our pick for effective home remedies include glycolic acid peels, vitamin C serum & azelaic acid, read more about how to use these whilst pregnant
  • Post pregnancy, our specialists can treat the remaining pigment with lasers, peels & skin care

How to Safely Treat Melasma During Pregnancy

Pregnancy is a time of immense joy and anticipation, but it also brings about changes in a woman’s body, including hormonal fluctuations that can affect the skin. One common skin concern that many pregnant women face is melasma, also known as the “mask of pregnancy.” 

Melasma presents as dark, discolored patches on the face, particularly on the cheeks, forehead, and upper lip. While melasma is typically harmless, it can cause distress and impact a woman’s self-esteem during this transformative time. In this comprehensive guide, we will delve into the causes of melasma during pregnancy, explore safe & effective DIY treatments & provide tips for managing melasma while expecting.

Treatment summary, melasma during pregnancy

  • The top two skin care ingredients in pregnancy are azelaic acid 20% & vitamin C 15%
  • Glycolic acid peels can be effective & safe when performed conservatively & correctly, max concentration is 25% for home use
  • SPF 50+ tinted sunscreen can reduce pigment flares
  • Postpartum, the use of pico lasers & clinical peels can effectively treat remaining pigment 
  • Retinol & retinoids are not advisable during pregnancy 

Understanding Melasma During Pregnancy

Melasma is a common skin condition characterized by the development of dark, irregularly shaped patches on the skin, primarily on the face. It occurs when melanocytes, the cells responsible for producing pigment in the skin, become overactive and produce excess melanin. While the exact cause of melasma is not fully understood, hormonal changes, particularly increased levels of estrogen and progesterone, play a significant role. Additionally, exposure to sunlight, genetic predisposition, and certain medications or skincare products can contribute to the development of melasma.

Melasma typically manifests in four patterns.

  • Malar: Dark patches on the cheeks and nose.
  • Centrofacial: Dark patches on the forehead, cheeks, nose, and upper lip.
  • Mandibular: Dark patches along the jawline and chin.
  • Extrafacial: Involving the arms.

Melasma is more common in women, particularly those with darker skin tones, and it often becomes more pronounced during pregnancy due to hormonal fluctuations. While melasma poses no health risks to the mother or baby, it can cause emotional distress and impact a woman’s quality of life.

Safe and Effective Treatment Options for Melasma During Pregnancy

Managing melasma during pregnancy requires a cautious approach, as certain treatments may not be safe for expectant mothers. However, several safe and effective treatment options can help lighten dark patches and improve the overall appearance of the skin. 

Skin care ingredients that are safe

Azelaic acid

Ascorbic acid

Citric acid


Glycolic & lactic acid

Botanicals, green tea, licorice root extract, bearberry extract

Skin care ingredients to avoid

Kojic acid




High dose arbutin

Salicylic acid

Dermamelan, Cosmelan peels

Sun Protection

Sun protection is paramount for managing melasma, as exposure to UV radiation can worsen pigmentation. Opt for a broad-spectrum tinted sunscreen with SPF 50 or higher, and reapply every two hours, especially when outdoors. Don’t forget hats, sunglasses & cover. 

More on what sunscreen to use, & how to here. 

melasma during pregnancy

Topical Treatments that are safe in pregnancy

Niacinamide: also known as vitamin B3, has been shown to inhibit the transfer of melanin to the skin’s surface, thereby reducing pigmentation. Look for skincare products containing niacinamide as a key ingredient.

Ascorbic acid: also known as vitamin C, is our favorite. It works by reducing pigment production, as well as acts as an antioxidant to decrease the amount of melanin stimulated by UV, visible light & heat. 

Azelaic acid is a gentle exfoliant that can lighten pigmentation and improve skin texture. It is safe for use during pregnancy under the guidance of a healthcare professional.

Licorice Extract: Licorice extract has natural skin-lightening properties and can help fade dark spots when applied topically. 

Chemical peels

Some chemical peels can be safely applied in pregnancy, namely lactic or glycolic acid peels. These agents are found naturally in sour milk & sugar cane. 

Peels that do NOT have safety data in pregnancy include Cosmelan, Dermamelan, retinoic acid & salicylic acid peels. 

What about lasers?

Lasers are safe as they are essentially monochromatic light that is amplified, however most dermatologists will advise you to wait until you have given birth as circulating hormones can play havoc with your laser therapy. 

What about diet & supplements?

The most common supplements for melasma include glutathione & polypodium extract, however the safety data is lacking for use in pregnancy, so it is advisable to give these two a miss. You can incorporate foods rich in antioxidants, however there is no evidence that this reduces pigmentation & melasma. Food groups high in antioxidants include fish, citrus fruits, vegetables, legumes, nuts and whole grains.

glycolic pregnancy safe peel

What about glycolic acid peels at home?

Performing a glycolic acid peel at home can be an effective way to exfoliate the skin, improve its texture, and address various skin concerns, including acne, hyperpigmentation including melasma and fine lines. However, it’s essential to approach this procedure with caution to ensure safety and minimize the risk of adverse reactions. Here’s a comprehensive guide on how to perform a glycolic acid peel at home safely:

Understanding Glycolic Acid Peels

Glycolic acid is a type of alpha hydroxy acid (AHA) derived from sugarcane & hence is safe in pregnancy. It has small molecular size, allowing it to penetrate the skin deeply and exfoliate the outermost layer, revealing smoother, brighter skin underneath. Glycolic acid peels are available in various strengths, typically ranging from 10% to 70%, with higher concentrations providing more intense exfoliation. As a guide for DIY peels, stick to 10% to 25%, not higher. 

Benefits of Glycolic Acid Peeling
  • Exfoliation of dead skin cells
  • Improves texture
  • Brightens & lightens skin
  • Reduces pigmentation & melasma
  • Potentiates absorption of chemicals
  • Stimulates collagen production & reduces sun damage
How to peel

Before performing a glycolic acid peel at home, there are several important considerations to keep in mind:

  1. Patch Test: Perform a patch test on a small area of skin to assess sensitivity and ensure you don’t have an adverse reaction to the peel.
  2. Choose the Right Strength: Select a glycolic acid peel with an appropriate strength for your skin type and concerns. Beginners should start with a lower concentration (e.g., 10%) and gradually increase as tolerated.
  3. Sun Protection: Glycolic acid increases skin sensitivity to sunlight, so it’s crucial to apply a broad-spectrum sunscreen with SPF 50 or higher daily, even on cloudy days.
  4. Avoid Active Ingredients: Discontinue the use of exfoliants, and other active skincare ingredients for several days before and after the peel to prevent excessive irritation.
  5. Follow Instructions: Read and carefully follow the manufacturer’s instructions included with the glycolic acid peel kit to ensure safety and optimal results.
Performing the Glycolic Acid Peel:

Now, let’s walk through the steps of performing a glycolic acid peel at home safely:

Step 1: Cleanse the Skin

Start by cleansing your face with a gentle, non-abrasive cleanser to remove dirt, oil, and makeup. Pat the skin dry with a clean towel.

Step 2: Prep the Skin

Apply a pre-peel solution or toner (eg. acetone) to degrease the skin and remove any remaining impurities.

Step 3: Apply the Glycolic Acid Peel

Using a cotton pad or fan brush, apply a thin, even layer of the glycolic acid peel solution to the skin, avoiding the eye area, lips, and any areas of irritation or broken skin.

Step 4: Monitor the Skin

Keep a close eye on your skin during the peel application. You may experience a tingling or stinging sensation, which is normal. However, if you experience severe burning, itching, or discomfort, immediately neutralize the peel and rinse the skin with cool water.

Step 5: Neutralize the Peel

After the desired peel time (typically 1 to 5 minutes), neutralize the peel by applying a neutralizing solution or rinsing the skin with cool water. This helps stop the exfoliating process and soothe the skin.

Step 6: Rinse and Moisturize

Gently rinse the skin with lukewarm water to remove any remaining peel solution. Pat the skin dry and apply a soothing, hydrating moisturizer to replenish moisture and minimize post-peel dryness.

Step 7: Post-Peel Care

In the days following the peel, avoid direct sun exposure, exfoliants, and harsh skincare products. Use a gentle cleanser, moisturizer, and sunscreen to protect and nourish the skin as it heals.

Safety Precautions and Tips
  • Start with a lower concentration and gradually increase as tolerated. Max out at 25% for DIY peels. 
  • Limit the frequency of glycolic acid peels to once every 10 to 14 days to prevent over-exfoliation.
  • Avoid contact with mucous membranes, eyes, and lips during the peel application.
  • Discontinue use if you experience prolonged irritation, redness, or other adverse reactions.

In summary, performing a glycolic acid peel at home can be a safe and effective way to improve skin texture & melasma pigmentation. This peel is relatively safe in the context of the concentration used & correct end points as outlined in the summary above. 

What is our favorite combo for treating melasma in pregnancy?

Ascorbic (vitamin C) & azelaic acid. Here is how-

AM: Vitamin C, SPF.

PM: Azelaic acid.

Glycolic acid peel; 10-25% every 10 to 14 days. 

Vitamin C or L-ascorbic acid

Using a vitamin C serum for melasma can be an effective part of your pregnancy skincare routine. Vitamin C is known for its antioxidant properties and its ability to brighten and even out skin tone. 

Here are step-by-step instructions on how to use a vitamin C serum for melasma:

Look for a vitamin C serum specifically formulated for the face and suitable for your skin type. Opt for a serum with a stable form of vitamin C, such as L-ascorbic acid, as it is most effective in treating melasma. We endorse vitamin C by iS Clinical, Synergie, Obaji, Zo, & Skinceuticals. Optimal concentrations range from 10 to 20%.

Before applying the serum to your face, perform a patch test on a small area of your skin to check for any adverse reactions or sensitivities. Apply a small amount of serum to the inside of your wrist or behind your ear and wait 24 hours to see if any irritation occurs. Vitamin C is best used in the morning as part of your routine before applying sunscreen. 

vitamin c for pregnancy

iS Clinical Super Serum Advance+ 

Azelaic acid 

Azelaic acid for melasma can be an effective part of your skincare routine. Azelaic acid is a naturally occurring acid found in grains like barley, wheat, and rye. It is known for its ability to lighten dark spots, even out skin tone, and reduce inflammation. Here are step-by-step instructions on how to use azelaic acid for melasma:

Look for a topical azelaic acid treatment specifically formulated for the face and suitable for your skin type. Azelaic acid is available in various forms, including creams, gels, and serums. Opt for a concentration of around 10-20%, which is commonly used for treating melasma. Azclear is our favorite brand. 

Postpartum there are many stronger formulations with better pigment removing properties, but for now, consistency & compromise (safety first) is key when using pigment correctors for melasma. It may take several weeks or even months to see noticeable improvements in pigmentation. Be patient and continue using the treatment as directed for optimal results.

What can dermatologists do for melasma postpartum?

Lots! Lasers, chemical peels & prescriptive skin care are safe & effective postpartum. Most are compatible with breastfeeding, so don’t stress.

In summary 

Melasma is a common skin concern during pregnancy, but with the right approach, it can be effectively managed and treated. By following sun protection measures, incorporating safe and effective skincare products, expectant mothers can safely address melasma and enjoy a healthy, radiant complexion during this special time. Remember to prioritize self-care and embrace the beauty of pregnancy, including its unique skin changes.