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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
Picosure Pro as adjunctive therapy for melasma
.
🔫Lasers vs Peels: lasers provide better remodelling of skin, leading to longer remission times as compared to novel peels such as Cosmelan. Additionally lasers (pico) have no downtime nor skin irritation as compared to superficial peeling systems. They do however take several sessions (2-5) for optimal results
.
👉Tip: tailor melasma treatment according to the patient. Understand the potential as well as the limitations of peels, skin care, medical therapy, injectables & energy devices for melasma to formulate a plan based upon the individual
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#picosure #picosuresurepro #picolaser #melasmatreatment #themelasmaclinic #sydneydermatologist #drdavinlim
Picosure Pro as adjunctive therapy for melasma
.
🔫Lasers vs Peels: lasers provide better remodelling of skin, leading to longer remission times as compared to novel peels such as Cosmelan. Additionally lasers (pico) have no downtime nor skin irritation as compared to superficial peeling systems. They do however take several sessions (2-5) for optimal results
.
👉Tip: tailor melasma treatment according to the patient. Understand the potential as well as the limitations of peels, skin care, medical therapy, injectables & energy devices for melasma to formulate a plan based upon the individual
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#picosure #picosuresurepro #picolaser #melasmatreatment #themelasmaclinic #sydneydermatologist #drdavinlim
Novel peels are useful for some cases of melasma. At the clinic we employ these peels for individuals who travel to our clinic from far. Peels have the advantage over lasers, namely less sessions to deliver similar outcomes (in actual fact, lasers are better with a ‘hit’ rate of 80-85% as compared to peels with 60-70% success)
.
🍌Peels: We have the Dermamelan, Cosmelan, novel Melanopro & Vi Precision peels as well as Jesser, TCA, salicylic acid, AHA, & retinoic acid peels. We perform focal phenol peels, but not segmental phenol peels for melasma as the risks are too high for our mode of practice
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, Australia🇦🇺
.
#melasmaclinic #melasma #melasmatips #dermamelan #cosmelan #cosmelanpeel #drdavinlim #sydneydermatologist #melanopropeel
.
Disclaimer: lighting slightly different in exposure settings as different camera systems are employed.
Novel peels are useful for some cases of melasma. At the clinic we employ these peels for individuals who travel to our clinic from far. Peels have the advantage over lasers, namely less sessions to deliver similar outcomes (in actual fact, lasers are better with a ‘hit’ rate of 80-85% as compared to peels with 60-70% success)
.
🍌Peels: We have the Dermamelan, Cosmelan, novel Melanopro & Vi Precision peels as well as Jesser, TCA, salicylic acid, AHA, & retinoic acid peels. We perform focal phenol peels, but not segmental phenol peels for melasma as the risks are too high for our mode of practice
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, Australia🇦🇺
.
#melasmaclinic #melasma #melasmatips #dermamelan #cosmelan #cosmelanpeel #drdavinlim #sydneydermatologist #melanopropeel
.
Disclaimer: lighting slightly different in exposure settings as different camera systems are employed.
Picosure Pro can be useful in highly motivated & educated patients as adjunctive therapy for melasma pigmentation
.
👉Results can be seen in as little as 2 weeks, however a series of 3-5 sessions provides the best outcome
.
👉Success rate: 80-85%. Melasma can be significantly improved in most, but not all cases. Pico lasers are best combined with medical therapy for optimal outcomes
.
📅Remission: varies according to radiation exposure, hormonal influx, topical usage, maintenance treatments & adjunctive procedures💯
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, Australia🇦🇺
.
#melasmaclinic #melasma #melasmatips #picosure #picolaser #picosurepro #drdavinlim #sydneydermatologist
Disclaimer: lighting slightly different in exposure settings as different camera systems are employed.
Picosure Pro can be useful in highly motivated & educated patients as adjunctive therapy for melasma pigmentation
.
👉Results can be seen in as little as 2 weeks, however a series of 3-5 sessions provides the best outcome
.
👉Success rate: 80-85%. Melasma can be significantly improved in most, but not all cases. Pico lasers are best combined with medical therapy for optimal outcomes
.
📅Remission: varies according to radiation exposure, hormonal influx, topical usage, maintenance treatments & adjunctive procedures💯
.
😎Dr Davin Lim
Dermatologist
Brisbane | Sydney, Australia🇦🇺
.
#melasmaclinic #melasma #melasmatips #picosure #picolaser #picosurepro #drdavinlim #sydneydermatologist
Disclaimer: lighting slightly different in exposure settings as different camera systems are employed.
Melasma can be effectively treated in most cases with a combination of medical therapy as well as energy based devices & novel peels
.
👉This case: Lutronic Q switch nano short pulse (5ns) laser. 5 sessions, spaced 2 weeks apart
.
🔫Laser concepts: low fluence 1064 nm q switching reduces melanin transfer to cells, reduces melanin production, vaporises the stratum corneum allowing better penetration of topicals, shrinks down the dendritic arms of the melanocyte & has limited shattering of pigment particles. Flares are uncommon, results are seen in over 80% of cases
.
👍🏻Laser: Lutronic Hollywood Spectra: is the gold standard in QSL nano laser technology, it has an excellent beam profile with a short pulse duration with super accurate & steady state fluence.
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#lutronic #hollywoodspectra #dermaltoning #toninglaser #melasma #melasmaclinic #drdavinlim #melasmatreatment
Melasma can be effectively treated in most cases with a combination of medical therapy as well as energy based devices & novel peels
.
👉This case: Lutronic Q switch nano short pulse (5ns) laser. 5 sessions, spaced 2 weeks apart
.
🔫Laser concepts: low fluence 1064 nm q switching reduces melanin transfer to cells, reduces melanin production, vaporises the stratum corneum allowing better penetration of topicals, shrinks down the dendritic arms of the melanocyte & has limited shattering of pigment particles. Flares are uncommon, results are seen in over 80% of cases
.
👍🏻Laser: Lutronic Hollywood Spectra: is the gold standard in QSL nano laser technology, it has an excellent beam profile with a short pulse duration with super accurate & steady state fluence.
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#lutronic #hollywoodspectra #dermaltoning #toninglaser #melasma #melasmaclinic #drdavinlim #melasmatreatment
This is generally what happens, hence why it takes a few weeks before best outcomes are achieved following pico laser (providing the diagnosis & settings are accurate)
.
👉Exceptions: if pigment production is not halted, e.g. melasma or PIH, this may result in more (paradoxical) pigment production. For dermal pigment, the rate limiting factor is pigment removal via the immune system, or if the particles are broken down to much smaller pieces that reflect light
.
👉Concept: in some cases, pigment worsens before improving. This momentary increase in pigment lasts 2-4 weeks. Our clinicians will discuss this with you if we employ these settings💯
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#picosure #picosuresurepro #picolaser #melasmatreatment #themelasmaclinic #sydneydermatologist #drdavinlim
This is generally what happens, hence why it takes a few weeks before best outcomes are achieved following pico laser (providing the diagnosis & settings are accurate)
.
👉Exceptions: if pigment production is not halted, e.g. melasma or PIH, this may result in more (paradoxical) pigment production. For dermal pigment, the rate limiting factor is pigment removal via the immune system, or if the particles are broken down to much smaller pieces that reflect light
.
👉Concept: in some cases, pigment worsens before improving. This momentary increase in pigment lasts 2-4 weeks. Our clinicians will discuss this with you if we employ these settings💯
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#picosure #picosuresurepro #picolaser #melasmatreatment #themelasmaclinic #sydneydermatologist #drdavinlim
Retinoids such as #tretinoin & retinol can be useful in addressing melasma as they address cellular aging, increasing turnover of cells, & reduce pigment production (extremely weak action compared to other pigment correctors) 💯
.
👉In some cases our clinicians may titrate retinoids into your melasma routine, along with other pigment correcting ingredients
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#retinol #tretinoin #retinylaldehyde #melasmaclinic #davinlim #melasmatreatment #themelasmaclinic #sydneydermatologist
Retinoids such as #tretinoin & retinol can be useful in addressing melasma as they address cellular aging, increasing turnover of cells, & reduce pigment production (extremely weak action compared to other pigment correctors) 💯
.
👉In some cases our clinicians may titrate retinoids into your melasma routine, along with other pigment correcting ingredients
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#retinol #tretinoin #retinylaldehyde #melasmaclinic #davinlim #melasmatreatment #themelasmaclinic #sydneydermatologist
Retinoids such as #tretinoin & retinol can be useful in addressing melasma pigmentation. Best applied at night due to photosensitivity
.
👉Vitamin C: can be used as an antioxidant or as a pigment corrector. Personally I prefer patients to apply in the am, under sunscreen
.
👉Azelaic acid: can be applied twice daily
.
👉Glycolic acid: can be potentially photosensitising (in theory, however practically not too much of an issue)
.
👉Pigment correctors: generally applied in the PM, with exceptions such as #thiamidol, azelaic acid, HQ that can be applied twice daily depending on other skincare actives
.
👉Sunscreen: at least twice daily, AM & midday application
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #melasmatips #skincaretips #melasmaclinic #davinlim #melasmatreatment #themelasmaclinic #sydneydermatologist
Retinoids such as #tretinoin & retinol can be useful in addressing melasma pigmentation. Best applied at night due to photosensitivity
.
👉Vitamin C: can be used as an antioxidant or as a pigment corrector. Personally I prefer patients to apply in the am, under sunscreen
.
👉Azelaic acid: can be applied twice daily
.
👉Glycolic acid: can be potentially photosensitising (in theory, however practically not too much of an issue)
.
👉Pigment correctors: generally applied in the PM, with exceptions such as #thiamidol, azelaic acid, HQ that can be applied twice daily depending on other skincare actives
.
👉Sunscreen: at least twice daily, AM & midday application
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #melasmatips #skincaretips #melasmaclinic #davinlim #melasmatreatment #themelasmaclinic #sydneydermatologist
Vitamin C is useful in most cases of melasma, however formulations matter. Low pH formulations offer better bioavailability with the downside of higher rates of skin irritation
.
👉How to use: Apply under sunscreen as an antioxidant, or at night as a pigment corrector, or, in some cases twice daily. We prefer a combination vitamin C & ferulic acid plus #tocopherol or vitamin E in a stabilized low pH formulation. The most well known tiple combination is patented at a fixed percentage of 15% L-ascorbic acid with a distinctive metallic smell that stains whites. Several drops go a long way
.
👍🏻Tips: Spend the most amount of time & money on photoprotection. Over 90% of melasma patients do not get this correct, but rather spend efforts on skin care products & procedures. You will get the biggest traction out of understanding how to photoprotect your pigment as well as identifying triggers (beyond the usual ‘it’s hormonal’, think IR heat, additional sources of radiation, frictional components, including cosmetic (self induced) skin irritation). Skin care is always adjunctive to UV & visible light protection💯
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #melasmatips #vitaminC #ascorbicacid #melasmaclinic #davinlim #melasmatreatment #themelasmaclinic #sydneydermatologist #ceferulicacid #vitamincskincare
Vitamin C is useful in most cases of melasma, however formulations matter. Low pH formulations offer better bioavailability with the downside of higher rates of skin irritation
.
👉How to use: Apply under sunscreen as an antioxidant, or at night as a pigment corrector, or, in some cases twice daily. We prefer a combination vitamin C & ferulic acid plus #tocopherol or vitamin E in a stabilized low pH formulation. The most well known tiple combination is patented at a fixed percentage of 15% L-ascorbic acid with a distinctive metallic smell that stains whites. Several drops go a long way
.
👍🏻Tips: Spend the most amount of time & money on photoprotection. Over 90% of melasma patients do not get this correct, but rather spend efforts on skin care products & procedures. You will get the biggest traction out of understanding how to photoprotect your pigment as well as identifying triggers (beyond the usual ‘it’s hormonal’, think IR heat, additional sources of radiation, frictional components, including cosmetic (self induced) skin irritation). Skin care is always adjunctive to UV & visible light protection💯
.
😎Dr Davin Lim
Dermatologist
The Melasma Clinic
Sydney, Australia🇦🇺
.
#melasma #melasmatips #vitaminC #ascorbicacid #melasmaclinic #davinlim #melasmatreatment #themelasmaclinic #sydneydermatologist #ceferulicacid #vitamincskincare
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.
