Melasma in Pregnancy: What to Expect, When It Starts, and How Long It Lasts

Pregnancy melasma, often called the "mask of pregnancy" or chloasma, is a specific type of melasma triggered by the dramatic hormonal shifts that occur during gestation. Estrogen and progesterone levels rise steadily through pregnancy, and these hormones stimulate melanocytes, the pigment-producing cells in the skin, to produce more melanin. When combined with UV exposure, the result is the characteristic brown to gray-brown patches that appear on the face.

The condition is remarkably common - somewhere between half and three-quarters of pregnant women will develop some degree of melasma. It's more common in women with darker skin tones who naturally have more active melanocytes, though it can affect anyone. The onset is almost never immediate. Most women notice the pigmentation starting in the second trimester, around weeks 13 to 26, when hormone levels are at their peak.

The reassuring news is that pregnancy melasma is usually temporary. For most women, the patches begin to fade within a few months of giving birth as hormone levels return to normal. However, complete resolution isn't universal - some women find that residual pigmentation remains, and the condition can recur with subsequent pregnancies, oral contraceptives, or even significant sun exposure.