The Mark of Melasma

What pregnant women need to know about this unsettling skin disease.

With all the various changes your body goes through during your pregnancy, it seems a bit unfair that Mother Nature would see fit to throw something else into the mix. Often called “the mask of pregnancy,” a condition known as melasma affects the pigmentation of the skin, causing it to have a brownish, splotchy look. While not necessarily harmful to the skin itself, it can be a source of discontent for the person suffering from it.

Janet Kiosk of Houston, TX, says, “I loved to go out in the sun when I was pregnant, but as I advanced along the timeline of my pregnancy, my skin started to get more and more discolored. I’d have one area near my chin where it was lighter than the area around my mouth, and my nose was lighter than my cheeks. It looked terrible.”

At first, Kiosk thought that the discoloration was a result of simply not effectively applying sunscreen.

“I had a terrible case of ‘Mommy Brain,’ she says, and I figured maybe that had something to do with it since I hadn’t been putting on sunscreen each time I went to the park or lake near my home,” she recalls.

“Having melasma was a terrible and embarrassing experience,” Kiosk says. “It’s difficult enough being pregnant with an enormous belly and sore back, but to have to deal with brown splotches on my face was too much.”

As time went on, Kiosk’s condition got worse. So much worse, in fact, that she not only became embarrassed by the changes in her skin pigmentation, but also severely worried about what the discoloration meant.

“I felt fine, but my skin looked worse and worse every time I’d look in the mirror. It really had me concerned if my baby’s health was being put at risk.”

When Kiosk asked her OB/GYN about it, he basically told her it wasn’t a big deal and to not get too concerned about it. “I tried, but I couldn’t help it. This huge wave of despair would come over me every time I’d look in the mirror. Even my husband started to notice I wasn’t my usual happy-go-lucky self.”

That’s when she decided to seek out the expertise of Dr. Paul Friedman, medical director of DermSurgery Associates in Houston, one of the nation’s leading centers for dermatology.

Trained in dermatologic laser surgery and Mohs micrographic surgery at the Laser & Skin Surgery Center of New York, Friedman says, “We see it [melasma] a great deal in our practice. Our patients are well aware of the inherent dangers of too much sun, but with melasma, it is really more of a cosmetic concern.”

Friedman adds: “Historically, we’ve treated the condition with an array of different lasers that target the discoloration in the pigment of the skin, and they worked fairly well. But just within the last year we’ve been able to address the issue of melasma with a new type of laser.”

“Just this past July, a laser made by Reliant Technologies called the Fraxel® was put on the market that does an amazing job of treating the brown splotchy areas by getting them back to where they were in terms of color.”

The cheeks, upper lip, chin and forehead are the most frequently affected areas; however, melasma can occasionally occur in other sun-exposed locations as well. Women in tropical climates seem to be more affected than others. Although melasma may develop in any individual, Asian and Hispanic females are most commonly affected. Because pregnant women are particularly susceptible to developing melasma, it is often referred to as “the mask of pregnancy.” Birth control pills have also been linked to the onset and often worsening condition of this disease.

“Historically, women who suffered from melasma were told to stay out of the sun, as it appears to be a very strong contributing factor,” explains Dr. Friedman. “Now we know that while the sun can exacerbate the condition, heredity also has a known casual link to the condition.”

So, how many treatments does it typically take for the patient to see real results? “The number of treatments may vary from patient to patient, but typically we find that after three or four treatments, the brown patches of melasma are greatly diminished,” says Friedman. “The treatment allows the melanocytes in the skin to slow pigment production, which, over time, returns the skin to normal pigmentation.”

Kiosk comments, “I am very satisfied with my treatment, and this time around, I don’t have to worry about everyone looking at the pictures of our family and wondering what’s wrong with my skin. My advice to moms-to-be that are suffering from melasma is to go have it taken care of as soon as possible. You’ll save yourself a lot of sleep and stress.”