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Chloasma: the pregnancy mask

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What is chloasma?

Chloasma is a skin discolouration that is common during pregnancy, and is also known as the “mask of pregnancy”, affecting 70% of pregnant women.

Blotches may appear on your cheeks, forehead and nose, and may merge into a mask a few shades darker than your natural skin tone – tan to deep brown. While hormonal fluctuations are a contributing cause, chloasma is still a mysterious condition.

Research and studies have found that these pregnancy hormones overstimulate the pigment generating cells (melanocytes), hence the discolouration.

When does chloasma clear up?

Typically, chloasma disappears about 3 months after your baby is born but in some extreme cases it can penetrate cells in the skin’s deeper layers. And if you’re experiencing a summer pregnancy be warned: chloasma could be more intense due to sun exposure and could return with subsequent pregnancies.

Research says that chloasma seems to be more common in dark than fair skin, where it appears as lighter patches.

Treatment

Stay out of the sun

The first course of action to combat chloasma is to stay out of the sun to avoid more damage to your skin. If you are forced into the sunlight, use a strong sunblock.

The effects of the sun on chloasma is not to be underestimated as doctors believe that even strong indoor lights can trigger and exacerbate the chloasma.

Avoid facial cleansers, skin creams and make-up

In most cases, chloasma disappears a few months after you have given birth. Help the matter by avoiding facial cleansers, skin creams or make-up that could irritate your skin.

If the dark patches are persistent and haven’t faded after pregnancy, ask your pharmacist for an over-the-counter cream that will restore your natural colour.

Beware high doses of hydroquinone

Beware of products that have high doses of hydroquinone. Creams with this mineral initially make the skin lighter, but they also bleach it by breaking down melanin, destroying the skin’s protective layer in the process, and your skin is reduced to paper-thin consistency.

You may need something stronger

Sometimes, however, the chloasma extends into deeper layers and can “settle in”. Your dermatologist may recommend a stronger skin cream, bleach or a chemical peel, dermabrasion, or even laser treatment.

  • Chemical peel entails a solution being applied to the skin, which causes it to peel off over a few days. New skin grows in to replace the blistered areas.
  • Dermabrasion will remove the surface skin cells with a rapidly rotating brush. This procedure will leave skin red and sensitive and you will need to stay out of the sun for a few months.
  • Laser treatment uses a narrow laser beam to target skin cells.

Fast facts on chloasma

YP chatted to Dr Bradley Wagemaker, medical director at Lamelle Research Laboratories for the need-to-know facts on chloasma.

What products are safe to use during pregnancy?

Although the trigger or cause of the melasma is believed to be largely hormonal, exposure to ultraviolet radiation (sun) can make the pigmentation much darker. So, the first place to start is to avoid the sun and use a good quality broad-spectrum sunscreen (preferrably with an SPF rating of more than 20).

Using topical antioxidants and oral pycnogenol (ovelle) has been shown in studies to reduce the extent of the pigmentation. Prescription medications and topical Vitamin A are not recommended during pregnancy or breastfeeding so wait until baby has been born and weaned.

Can the problem persist?

The pigmentation areas often lighten after pregnancy. In many cases however, the condition does not disappear and requires treatment and might reappear during a second or third pregnancy.

Is there anything you can do before pregnancy to avoid chloasma?

Unfortunately not. The best prevention is to avoid sun exposure and use sun protection.

Can you wear make-up if you have chloasma?

Most certainly. As long as your make-up doesn’t exacerbate the problem, you can still use it. If it does, go natural for the rest of your pregnancy.

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