Recovery
Results
Treatment Time
Aftercare
Treatment science score 
The Science of Melasma Treatment in Pregnancy
- Melasma also known as chloasma or the mask of pregnancy is the most common form of facial pigmentation
- It affects up to 70% of pregnant women
- It will not affect the pregnancy, however has an emotional impact on women
- Safe treatment options are available during pregnancy
- Sunscreen, skincare & chemical peels can effectively treat melasma in pregnancy
- Pigmentation commonly improves after delivery, however this may take 12 months
- Subsequent pregnancies can usually result in recurrence
Using safe, naturally derived products, our clinicians can reduce melasma pigmentation in pregnant & breastfeeding women.
What does melasma look like?
Melasma presents as patchy pigmentation on the forehead, upper cheeks, & the top lip. These areas may get darker the more you’re exposed to the sun or the further along you are in your pregnancy. Pigmentation starts in the first trimester, increasing in severity in the second & third stages of pregnancy. Atypical cases affect the jawline, neck & outer aspect of the arms.
Why does melasma flare up in pregnancy?
The 3 main causes of melasma are genetics, hormones & sun exposure. This common condition occurs in 50-70% of pregnant women.
You’re also more likely to develop it during pregnancy if someone in your family has had it, if you have dark skin, or if you spend significant amounts of time exposed to the sun.
Will melasma settle down postpartum?
50% of melasma sufferers will have a significant reduction in melasma postpartum. It often takes up to 12 to 18 months before maximal pigment fading occurs.
Pigment correctors, lasers & chemical peels can accelerate pigmentation clearance after delivery.
Should I treat melasma while pregnant?
Whilst most cases of melasma will settle within one year after delivery, you may elect to safely treat melasma whilst pregnant. We understand that pigmentation may have a significant impact on your emotional well being & hence offer various treatment options to effectively fade pigment.
How do we treat melasma in pregnancy?
Safely. It’s a balance of safety & efficacy. Our clinics two step melasma treatment involves-
- Pigment correcting skincare. A mix of skincare ingredients are prescribed to pregnant patients. Refer below for options. The optimal combination depends on your skin tone & pigmentation severity.
- Chemical peel or laser program. We use a combination of AHA peels & or laser light modalities to reduce pigmentation. The optimal combination depends on your type & level of pigmentation.
What results can I expect?
The prognosis for melasma treatments in pregnancy is different from postpartum treatments, primarily because of the safety aspects during term.
For pregnancy associated with it, our success rate is around 50%, whilst post-partum the success rate goes up to 85%.
How can melasma be treated after pregnancy?
This is when other more potent pigment correctors can be prescribed, in addition to other treatment options such as retinoic acid peels/Cosmelan/ Dermamelan peels.
Postpartum, you will not be limited to treatment options as treatments are compatible with breastfeeding.
Will breastfeeding affect my treatment?
No. Our team will safely prescribe skin care products that are compatible with breastfeeding. These include vitamin C, azelaic & glycolic acids.
Will melasma recur in subsequent pregnancies?
Most likely, with a confidence interval of greater than 87%. Simple skin care can reduce the intensity of pigmentation.
How do I prevent recurrence?
The two most important factors that predispose you to subsequent melasma recurrences are factors that you can not control, namely genetics (no cure for DNA) & hormones, which is synonymous with pregnancy. This leaves you with sun protection, which is reinforced throughout this website.
Our clinicians can guide you as to the correct sunscreens to use, in addition to a customized skincare routine that involves pigmentation correctors. Lasers & chemical peels can also be used to help prevent (or in the very least, reduce) it pigmentation.
What skin care ingredients are compatible with pregnancy?
Safe ingredient include-
- Vitamins: niacinamide, vitamin C, E
- Botanicals: licorice root, green tea, soy, flavonoids, bearberry
- Acids; azelaic, ascorbic, lactic, glycolic, citric, salicylic & mandelic acid.
Our Gallery of Results
Hori, faded (not completely) in only 2 sessions with Picosure Pro
.
👉End point> Stippled frosting focally over my usual end point of gray/oedema. More aggressive settings give faster clearance, albeit higher risks of post inflammatory hyperpigmentation
.
👉Ideally 2 more sessions
.
Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasmaclinic #hori #horinaevustreatment #drdavinlim #sydneydermatologist #pigmentationclinic
Hori, faded (not completely) in only 2 sessions with Picosure Pro
.
👉End point> Stippled frosting focally over my usual end point of gray/oedema. More aggressive settings give faster clearance, albeit higher risks of post inflammatory hyperpigmentation
.
👉Ideally 2 more sessions
.
Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasmaclinic #hori #horinaevustreatment #drdavinlim #sydneydermatologist #pigmentationclinic
Pigment is a glow distractor
.
👉Understanding the level of pigment > first step in optimizing your outcome
.
👉Match a wavelength to the level > predictable outcome
.
👉Match an ‘ingredient’ to pigment output > better outcome
.
👉Match an injectable to the level > the icing on the cake
.
👉Reducing UV & visible light > an essential step
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasmaclinic #melasma #drdavinlim #sydneydermatologist #pigmentation
Pigment is a glow distractor
.
👉Understanding the level of pigment > first step in optimizing your outcome
.
👉Match a wavelength to the level > predictable outcome
.
👉Match an ‘ingredient’ to pigment output > better outcome
.
👉Match an injectable to the level > the icing on the cake
.
👉Reducing UV & visible light > an essential step
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasmaclinic #melasma #drdavinlim #sydneydermatologist #pigmentation
For melasma, it does not mean the deeper you go, the better the results💯
.
👉Superficial peels: slow & steady with glycolic over lactic acid
.
👉TCA: outdated, though 8-10% single to double coating can reduce pigment in some cases
.
👉Phenol: for recalcitrant cases, with the risk of PIH & long lasting hypo
.
👉Novel Peels: probably gives the best results, with a hit rate of around 60+%, best used with medical therapy
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#tcapeel #cosmelanpeel #viprecisionpeel #chemicalpeel #melasmatreatment #melasmaclinic #drdavinlim #phenolpeel #pigmentation
For melasma, it does not mean the deeper you go, the better the results💯
.
👉Superficial peels: slow & steady with glycolic over lactic acid
.
👉TCA: outdated, though 8-10% single to double coating can reduce pigment in some cases
.
👉Phenol: for recalcitrant cases, with the risk of PIH & long lasting hypo
.
👉Novel Peels: probably gives the best results, with a hit rate of around 60+%, best used with medical therapy
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#tcapeel #cosmelanpeel #viprecisionpeel #chemicalpeel #melasmatreatment #melasmaclinic #drdavinlim #phenolpeel #pigmentation
As with everything medical, advice is based upon probability not possibility, taking into account outliers
.
🧴Creams: can flare melasma. More potent creams containing a mix of estrogen, especially estradiol over estriol (acknowledging that estriol is the predominant form in pregnancy) has a higher chance of flares. The greatest risk is in sun exposed areas
.
💊HRT tablets / systemic/ patches: Has a higher risk compared to creams. Dose related threshold that depends on individuals. Estradiol has a higher risk compared to estriol
.
👉Vaginal Estrogen Creams: risk is very low as systemic absorption is limited
.
🤷🏻♂️Non-hormonal estrogen receptor modulators (Emepelle): risk unquantified
.
👉💯Tips: avoid creams on sun exposed areas, including face /chest / arms
.
👉Are you on HRT, & has your melasma flared up because of it?
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #HRT #hormonereplacement #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist #menopauseclinic #menopause #menopausemelasma
As with everything medical, advice is based upon probability not possibility, taking into account outliers
.
🧴Creams: can flare melasma. More potent creams containing a mix of estrogen, especially estradiol over estriol (acknowledging that estriol is the predominant form in pregnancy) has a higher chance of flares. The greatest risk is in sun exposed areas
.
💊HRT tablets / systemic/ patches: Has a higher risk compared to creams. Dose related threshold that depends on individuals. Estradiol has a higher risk compared to estriol
.
👉Vaginal Estrogen Creams: risk is very low as systemic absorption is limited
.
🤷🏻♂️Non-hormonal estrogen receptor modulators (Emepelle): risk unquantified
.
👉💯Tips: avoid creams on sun exposed areas, including face /chest / arms
.
👉Are you on HRT, & has your melasma flared up because of it?
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #HRT #hormonereplacement #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist #menopauseclinic #menopause #menopausemelasma
In the past 10 years there has been a tremendous increase in knowledge regarding the cause/s of melasma, enabling better treatments with longer remission times & higher clearances
.
👉Peels: are a novel way to reduce pigment. They can be effective in 50-60% of cases. We perform Cosmelan, Dermamelan, Vi Precision, AHAs & Jessner. In some cases they provide a slightly faster clearance rate compared to lasers, however their ‘hit’ rate is not as good, providing devices are dialed in correctly. As per diagram, there are many other pathways to consider when treating melasma pigment 💯
.
🙏🏼🙏🏼🙏🏼Sunscreen: correct application overlooked by the majority of patients. This is step on in the algorithm, get this correct before embarking on peels, skin care & lasers
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #cosmelan #chemicalpeelmelasma #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist
In the past 10 years there has been a tremendous increase in knowledge regarding the cause/s of melasma, enabling better treatments with longer remission times & higher clearances
.
👉Peels: are a novel way to reduce pigment. They can be effective in 50-60% of cases. We perform Cosmelan, Dermamelan, Vi Precision, AHAs & Jessner. In some cases they provide a slightly faster clearance rate compared to lasers, however their ‘hit’ rate is not as good, providing devices are dialed in correctly. As per diagram, there are many other pathways to consider when treating melasma pigment 💯
.
🙏🏼🙏🏼🙏🏼Sunscreen: correct application overlooked by the majority of patients. This is step on in the algorithm, get this correct before embarking on peels, skin care & lasers
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, 🇦🇺
Australia
.
#melasma #cosmelan #chemicalpeelmelasma #themelasmaclinic #melasmaclinic #drdavinlim #sydneydermatologist
Effectively building & keeping collagen in the upper layers of skin can potentially prevent & treat some forms of pigmentation, especially the ones related to aging. This includes late onset melasma & ‘dermal’ dropout, more common in darker skin types
.
👉How to? Topical retinoids can potentially provide very low levels of collagen, more efficient modalities include lasers, RF microneedling (correct depth & settings) as well as HIFU & biostimulatory injectables. The ideal biostimulus depends on the clinical presentation & age of the patient🙌🏼
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasma #melasmaclinic #biostimulator #skin #melasmatreatment #sunscreens #bioremodelling #drdavinlim #dermatologistsydney
Effectively building & keeping collagen in the upper layers of skin can potentially prevent & treat some forms of pigmentation, especially the ones related to aging. This includes late onset melasma & ‘dermal’ dropout, more common in darker skin types
.
👉How to? Topical retinoids can potentially provide very low levels of collagen, more efficient modalities include lasers, RF microneedling (correct depth & settings) as well as HIFU & biostimulatory injectables. The ideal biostimulus depends on the clinical presentation & age of the patient🙌🏼
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney,
Australia🇦🇺
.
#melasma #melasmaclinic #biostimulator #skin #melasmatreatment #sunscreens #bioremodelling #drdavinlim #dermatologistsydney
90% of CALM or cafe au lait macules can respond to pico or QSL.
.
👉This patient: treated with 532 Hollywood Spectra nano laser, sessions spaced 8-10 weeks apart. Anecdotally facial lesions respond better than extra-facial lesions
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#spectralaser #lutronic #calmbirthmark #birthmarktreatment #cafeaulaitbirthmark
#birthmarkremoval #drdavinlim #davinlim #sydneydermatologist
90% of CALM or cafe au lait macules can respond to pico or QSL.
.
👉This patient: treated with 532 Hollywood Spectra nano laser, sessions spaced 8-10 weeks apart. Anecdotally facial lesions respond better than extra-facial lesions
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#spectralaser #lutronic #calmbirthmark #birthmarktreatment #cafeaulaitbirthmark
#birthmarkremoval #drdavinlim #davinlim #sydneydermatologist
🍊Vitamin C is useful, only if your skin can tolerate it. Why? High bioavailable vitamin C has an acidic formulation with a low pH, much lower than the already acidic environment of skin. This can lead to irritation, which means more potent pigment correctors can’t be applied
.
👉Formulations: L -ascorbic acid, preferably in the morning under make up & a thick layer of tinted sunscreen
.
👉Tips: concentrate on getting your sunscreen application correct before product selection, 90% of melasma sufferers haven’t got this step correct
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #vitaminc #ascorbicacid #vitamincskincare #themelasmaclinic #sydneydermatologist #drdavinlim #themelasmaclinic
🍊Vitamin C is useful, only if your skin can tolerate it. Why? High bioavailable vitamin C has an acidic formulation with a low pH, much lower than the already acidic environment of skin. This can lead to irritation, which means more potent pigment correctors can’t be applied
.
👉Formulations: L -ascorbic acid, preferably in the morning under make up & a thick layer of tinted sunscreen
.
👉Tips: concentrate on getting your sunscreen application correct before product selection, 90% of melasma sufferers haven’t got this step correct
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #vitaminc #ascorbicacid #vitamincskincare #themelasmaclinic #sydneydermatologist #drdavinlim #themelasmaclinic
What skin care ingredients are not compatible with pregnancy?
The main group are retinoids, namely retinol, tretinoin, tazarotene, adapalene & retinoic acid. In laboratory settings super high doses in rats have been shown to cause fetal malformations. Hydroquinone is also not compatible with pregnancy.
Can lasers be used during pregnancy?
Yes. Lasers are energy based light systems that are not systemically absorbed. They are safe in pregnancy however there are other factors to consider. Most importantly, skin in pregnancy is hyper sensitive to laser light because there are global increases in pigment & that the cells that produce pigment are sensitive to circulating hormones.
Taking into consideration the hormonal changes that occur during pregnancy, laser settings are lower, as compared to post-partum. This means patients require 40 to 80% more sessions to get the same results.
Can Cosmelan peels or Dermamelan peels be used in pregnancy?
Dermamelan or Cosmelan peels are not recommended in pregnancy as the level of skin irritation is epic with healing times of 7-14 days. Better chemical peel options include glycolic, lactic or salicylic acid chemical peels. These peels are safe in pregnancy.
Are sunscreens safe in pregnancy?
Super safe. If you are pregnant it is recommended to use a high factor SPF of 50 or greater, ie. 50+. Chemical & physical blocker are recommended, as well as a make up base high in iron oxide (tinted).
Iron oxides attenuate viable light, which is a wavelength not protected by sunscreen.
How do I use sunscreen?
Wearing a good SPF 50+ is key. Look for products that contain zinc oxide, titanium dioxide & iron oxides. Physical blocking sunscreens tend to offer broader protection and may be less irritating to the skin.
The two rule of sunscreens are-
- Two finger lengths of sunscreen
- Apply twice daily, regardless of sun exposure
The Melasma Clinic difference
Our specialist clinic can effectively treat pigmentation in all skin types, employing bespoke treatment protocols that consist of skin care actives, picosecond lasers, clinical peels & in some cases prescriptive medication. With 20 years of dermatology behind us, we can manage all forms of pigmentation, from melasma, through to post inflammatory pigment.
Dr Davin Lim
650K subscribersHow to treat PIGMENTATION
If I can identify the cause of pigmentation, chances are I can treat it. This can only be achieved with careful real time examination…
More of our mostFrequently asked questions
Does pregnancy induced melasma differ from normal melasma?
What are other causes of pigmentation that may occur in pregnancy?
Will melasma affect my pregnancy?
Can LED lights be used to treat melasma in pregnancy?
Can microneedling be used in pregnancy?
What is the best laser for melasma?
How do I treat melasma at home (DIY tips)?
How do I get an appointment with our specialists at The Melasma Clinic?
A SummaryMelasma treatments in pregnancy
Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney
Coined the mask of pregnancy, melasma can affect up to 70% of pregnancies. Darker skin types are more susceptible to pigmentation. Additionally genetics play an important role. Though the majority of cases resolve spontaneously within 12 months of delivery, 10-30% of cases persist.
Management is three fold, namely prevention prior to pregnancy (especially important if you suffered from it prior), treatment during pregnancy, & management postpartum.
Pre-pregnancy: the usual mitigation measures apply, most importantly the use of hats, sunglasses ,high factor SPF & iron oxide mineral makeup.
During pregnancy: is a compromise between safety & efficacy. The management strategy here is to marginally improve melasma using skincare products that are compatible with pregnancy. They include azelaic acid, vitamin C & alpha hydroxy acids. Treatments can be stepped up during the second and third trimester, a period when pigment intensifies.
Postpartum: is when treatments are taken up to the next level. Prescription medication & pico lasers can effectively manage melasma in over 80% of cases.
