Monday, 20 May 2019 23:36

Melasma: Treating Clients During Pregnancy

Written by   Jessica Slorah

As if our pregnant clients don’t have enough changes happening during pregnancy – it is unlikely their skin is going to let them sail through the next several months without any surprises. Many women notice their freckles and moles may look darker, as well as odd shaped gray-brown, tan, or dark brown patches appearing on places like the forehead, upper lip, cheeks, chin, and bridge of nose. Pigmentation can also occur on the forearms and neck, if exposed to the sun.


Rather than the desired pregnancy glow, many experience “pregnancy mask,” more commonly known as melasma. While this is a common problem during pregnancy, it can be embarrassing and frustrating.



During pregnancy, melasma is referred to as chloasma – a female skin disorder connected to hormone changes. Extensive hormonal changes are flooding a woman’s body in preparation for a baby. Cholasma is connected to the elevation of progesterone and estrogen hormones, which in turn causes increased melanin production.


Affecting a whopping 50% to 70% of women, the exact cause is not clear. Many factors have been cited in scientific literature, including excessive sunlight (ultraviolet rays), genetics, stress, thyroid disease, and certain drugs. And, as mentioned, progesterone and estrogen are also associated with the condition, which means oral contraceptives, hormone therapy, and, of course, pregnancy can trigger melasma.



So, how can professionals help pregnant clients during this exciting but vulnerable time? Arm them with knowledge about prevention.


Mid to high SPF sunscreen needs to be worn religiously, even while in the car. The ingredients oxybenzone and avobenzone should be avoided because of possible hormone disruption.1,2 Zinc and titanium dioxide-based sunscreens should be suggested instead. To prevent against melasma, a sunscreen that blocks not only the sun’s rays, but also its light and heat is needed. Choosing a non-chemical, blocking sunscreen stops different wavelengths and light from coming through.


Wearing sunglasses with polarized protection should also be recommended. Ultraviolet rays stimulate the pituitary gland through the retina of the eyes, simulating more melanocytes.3 All wavelengths of sunlight can jumpstart melasma, explains Dr. Lance Setterfield in The Concise Guide to Microneedling.


Use natural tyrosinase inhibitors and lighteners to help prevent and correct hyperpigmentation. These ingredients will also help post-pregnancy to speed up lightening. Look for hydroquinone-free alternatives like:

  • licorice root
  • kojic acid
  • ascorbic acid
  • bearberry
  • arbutin
  • magnesium ascorbyl phosphate
  • niacinamide
  • vitamin C
  • glycolic acid
  • mandelic acid
  • azelaic acid


It is best to avoid salicylic acid, hydroquinone, and retinoids during pregnancy and while breastfeeding because there has not been substantial studies on their effects during pregnancy.


Facial waxing should be approached with caution on pregnant clients. This can increase the risk of pigmentation in general. There is especially increased risk with sun exposure.


Pregnant clients should also take precautions from overheating. It has been found that temperature regulates how much melanin our bodies produce. Heat from the sun, cooking, saunas, hot flashes, and even blow dryers can trigger pigmentation.



Don’t let pregnancy scare you away from treating this group of well deserving clients. Instead, get creative with your backbar full of skin lightening ingredients listed above and give them a treatment that is going to give them the pregnancy glow they deserve.


 For these treatments to be successful, it is crucial for clients to follow your suggested homecare and tips on how to keep their melanocytes calm and happy. Here are a few facial ideas for pregnant clients.


Deep Cleansing: For problematic skin, try a deep cleansing treatment. This generally includes exfoliation, extraction of blemishes, and massage, followed by a healing clay or charcoal mask. Have a hydra-infusion machine? This would be a great add-on to this service.


Oxygen Facials: This facial introduces ingredients into the skin through a pressurized stream of steam. Incorporate hyaluronic acid for skin-plumping vitamins, botanical extracts, and antioxidants. This treatment is great for expecting moms with dull or dry skin.


Exfoliating Facial: Our expecting clients can tend to be more sensitive during this time. Take this into consideration and bypass exfoliation with microdermabrasion. Instead, get those cells turned over with gentle facial scrubs and pregnancy-safe alpha hydroxy acids like glycolic, mandelic, or lactic acids.


With melasma being one of the most difficult conditions to treat, be careful not to make any promises to your client about being able to completely eliminate it. Still, reassure them that the majority of cases lighten or resolve themselves within six to 12 months after giving birth.


“Hormones continuously trigger these dark spots,” explains Amy Takken with Masterpiece Skin Restoration.5 So, your client will get the best results if you delay treatment until after pregnancy and breastfeeding. Those prone to melasma and hyperpigmentation will always be more likely to have recurrences throughout their life. Because of this, melanin suppressants must be used daily, all year-round, during and after pregnancy. These recommendations along with treatments from you, their aesthetician, will make a huge difference.



1 Shanehsaz, Siavash M. “Efficacy of licorice extracts in the treatment of melasma: Randomized, double-blinded and placebocontrolled clinical trial.” Journal of Cosmetology & Trichology.

2 Yang, Changwon, Whasun Lim, Fuller W. Bazer, and Gwonhwa Song. “Avobenzone suppresses proliferative activity of human trophoblast cells and induces apoptosis mediated by mitochondrial disruption.” Reproductive Toxicology 81 (2018): 50-57.

3 Lanning, Cassandra. “The Story of the Melanocyte.” The Renegade Esthetician. 2016.

4 Setterfield, Lance. The Concise Guide to Dermal Needling. Expanded Medical Edition. Victoria, BC: Acacia Dermacare, 2013.

5 Takken, Amy. “Melasma Treatment | 11 Things That Really Work!” Masterpiece Skin Restoration. 2019.

6 “Melasma.” American Academy of Dermatology Association.

7 “Unmasking the causes and treatments of melasma.” Harvard Health Publishing. 2018.

8 Draelos, Z., A. Dahl, M. Yatskayer, N. Chen, Y. Krol, C. Oresajo. “Dyspigmentation, skin physiology, and a novel approach to skin lightening.” Journal of Cosmetic Dermatology 12, 4 (2013): 247-53.

9 Lyford, Willis Hughes. “Melasma Treatment & Management.” Medscape. 2018.


2019 Jessica SlorahJessica White Slorah is a licensed master aesthetician who practices solo and is the owner of illume Skin Care in Holladay, Utah. She was voted Favorite Licensed Master Aesthetician in DERMASCOPE’s 2019 Aestheticians’ Choice Awards.

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