Facial Pigmentation Changes during Pregnancy

Archived Q&A and Reviews

Mask of Pregnancy

August 2004

I have had fairly bad facial pigmentation, mask of pregnancy, since i was about 6 months pregnant, my baby is now four and a half months old. Although it has faded a little, it still is quite pronounced and i'm sick of it!!! A MD who specializes in cosmetics told me that if it has not faded by now, it likely won't, and she reccomended a facial peel, the ''blue peel'', which is quite pricey. Any and all info on wheather there is still time for my body to fad on it's own, or remedies that work, including results from any one who had a blue peel, is greatly appreciated. thanks! ruth

I had a lot of melasma (mask of pregnancy) during my first pregnancy. It was awful! However in the next two and a half years after my daughter was born, it faded completely. I did not do any sort of treatment, other than sunscreen. I don't know if it made a difference that I nursed my daughter for two years. Also, it is interesting that it did not return with my second pregnancy. I wouldn't give up yet! - Gen

Facial hyperpigmentation occuring during pregnancy is called melasma. Unfortunately, it may not resolve completely, or at all after the birth of the baby. But it is treatable, and I have had great success in my practice with the Obagi NuDerm system. The Blue Peel which has been recommended to you is part of Obagi, but is an additional, much more aggressive procedure that I reserve for patients who have persistant pigmentation after Nuderm skun care treatment. This is rarely needed when treating melasma. Also, the Blue Peel requires pretreatment for 8 weeks with the Nuderm, prior to the peel and this pretreatment uses Retin A. Retin A should not be used during pregnancy or when breast feeding. The Nuderm works well to correct pigmentation even without the use of Retin A, so is safe to do while nursing. The Blue Peel could actually cause more pigmentation if the skin is not prepped properly. Elizabeth Lee, M.D.

I have dealt with pregnancy mask for years, even when just on the pill. I wouldn't consider my case severe, but definitely more than I could live with. I was able to get a presciption for a skin lightener called Neostrata. You apply it twice a day until the pigment lightens. I've had good luck with this. Hope this helps. Amy

I had a similar problem though I had only a few darkish spots that weren't too large. They didn't fade on their own. I went to see Dr. Christine B. in Berkeley (cosmetic dermatologist) and she really pushed for the obagi blue peel to see results, which sounds really invasive. I didn't like that she was pushing something so hard because I came in not wanting anything really invasive done and it's a fairly expensive procedure with a few weeks downtime. She seemed sort of put out that I didn't want to do it, then I asked if I could try the microdermabrasion and have been very happy with the results/value.

Also, as I was leaving the office I met a woman who had done the blue peel a month or so ago. She said her skin broke out after having the peel done and to be honest, her skin didn't look that great (could just be her skin, but I guess I was expecting perfection). anon

Hyperpigmentation on my face

May 2004

I am in my second pregnancy, and as happened in my first, I have what I believe is referred to as ''hyperpigmentation'' on my face. Basically, I have dark, mottled patches on the sides of my face, a little on my forehead, and lighter patches on my chin. I feel like Dax, the Bejoran character on Deep Space Nine. This first started years ago, long before any pregnancies, when I was using Retin A for its intended purpose (adult acne) and also using birth control pills. Even though I used daily moisterizer with sunscreen, I developed these dark patches, which I believe were the result of the Retin A reacting to the hormones I was taking. Ugh. I later used both over-the-counter and prescription bleaching creams, with limited success. Then, when I had my first pregnancy, it got worse again; then better after the birth; and now worse again with my second pregnancy. Other than using sunscreen, does anyone have any advice on what I can do to get rid of these patches, either now while I'm still pregnant or later after the baby arrives. Is there anything you can buy without a prescription that actually works? Or should I not waste my money? Is it better to go to a dermatologist and get some prescription cream? Or would it be more effective to go get a facial that addresses ''hyperpigmentation''? Do those facials really work for this? Or do they just make you think you are doing something? And if they do work, how many treatments would I need? Any advice, either from those who have had the same issue, or from those who know skin care, would be appreciated. Feeling Bejoran

I was just wondering, are you by any chance taking prenatal vitamins with large doses of Vitamin A? If so, you should stop taking them. First, recent research has concluded that you should take only the USRDA of vitamin A while pregnant. Second, Retin A is a form of vitamin A. It could be that the pigmentation has to do with the vitamins and not the pregnancy. I am certainly no expert on the subject, but the idea popped into my head and I thought I'd share it. Good luck! susan

I could have written your posting...retin A, hormones, sunspots on face, bleaching creams, facials, worse during pregnancies etc.

I am 38 years old and grew up in a VERY sunny and beautiful place which took it's toll on my skin. I have been seeing Dr. Kathie Rodan - the Proactive doctor - in Oakland for the past two months. First she started me on proactive for some minor adult acne(to prevent further scaring), then on her product line, Radiant, and now I'm into my second session of micro-derma abrasion(skin resurfacing). The results are AMAZING. My skin is smooth, almost feels luxurious and my hyper-pigmentation is almost gone.

I was tired of the the pat responses of my Berkeley dermatoligists - '' Oh, a few sun spots are not life threatening'', ''well, that's what the sun does...'', ''If Retin A doesn't help, not sure anything else will.'' I finally bucked up for a ''cosmetic'' dermatoligist who UNDERSTOOD what I really wanted. By the way, Rodan's line of skin care products can be ordered on-line without seeing her. I do have to say, the micro- derma work has done wonders for me. Good luck! No more spots!

I have had great success with foto facials. It is a pulsated high-specturm light treatment. You can do I higher power one with a dermatologist, but this can cost a lot. I want to a wonderful spa in Walnut Creek called Miracullum and after only about two treatments, so a fantastic improvement! It is recommended that you do about four. You might want to think about doing this after the summer though, as it is hard to stay out of the sun and even a little bit of sunlight can bring it right back. SPF 30 is always recommended but even so, I found it hard to maintain and always have better luck in the fall.

Dermabrasion is another option but that can be uncomfortable. The fotofacial doesn't hurt a bit at the spa but can with a dermatologist. Drama Mama