The ESK blog
Melasma in pregnancy- is it safe to treat it?
19 August 2024
Dr Anne Thomson
Melasma in pregnancy- is it safe to treat it?
Hey there, mama-to-be!
So, you’re glowing with pregnancy, but that “glow” is also bringing along some unwelcome guests - those pesky dark patches of pigmentation known as melasma. First off, congrats on the baby, and secondly, let’s chat about how to handle this skin drama safely while you’re expecting.
Melasma: The Uninvited Guest
Melasma often pops up during pregnancy because of hormonal changes. Your body is pumping out oestrogen which in turn turbo charges your skin’s production of pigment- known as melanin. Your body is basically having a hormone party, and sometimes the melanin decides to join the fun in all the wrong places. Dealing with it while you’re pregnant is a bit tricky because not all treatments are safe for the baby.
Retinoids: The Big Nope
Retinoids, including tretinoin and retinol, are off the table during pregnancy. They can potentially cause birth defects and other issues, so we avoid them completely until after the baby arrives. Save these for your post-pregnancy skincare routine.
Hydroquinone: Another No-Go Zone
Let’s start with hydroquinone. This is a common ingredient used to lighten dark spots, but it’s a no-go during pregnancy. Why? Studies show that a significant amount of hydroquinone can be absorbed through the skin, and we just don’t have enough info on how it might affect a developing baby. So, we play it safe and avoid it during pregnancy and breastfeeding.
The Good Guys: Safe and Gentle Options
Here are some friendly faces in the melasma treatment world that are considered safe during pregnancy:
4-N-Butylresorcinol: This fancy-sounding ingredient is a great alternative to hydroquinone. It’s effective at lightening those dark patches without the risk to your baby. It has very little absorption into the body through the skin.
Enlighten is specifically designed to help reduce the appearance of pigmentation. This lightweight cream helps to gently create a more even skin tone and hydrate and improve the barrier function of the skin. While rarely used, 4-n-butylresorcinol (4nB) has some of the best evidence in this arena. Enlighten combines 4nB and Niacinamide (Vitamin B3) to create a rare combination of gentle yet effective ingredients. Enlighten helps tackle a mottled or uneven skin tone and is suitable for long term daily use
Enlighten
Featuring:
L-Ascorbic Acid (Vitamin C): This powerhouse antioxidant helps brighten the skin and can fade those dark spots. Plus, it’s safe during pregnancy. So go ahead and get your vitamin C fix!
C Forte Morning Serum is packed with 16% L-ascorbic acid, the purest form of Vitamin C, combined with vitamin E and ferulic acid for maximum results. Vitamin C (Ascorbic Acid) is an anti-oxidant helping neutralise free radicals (associated with exposure to the sun). The result? A brighter, firmer, plumper looking skin with fewer fine lines apparent and a more even skin tone. Formulated at the ideal pH (2.5-3.5) and housed in airless, opaque packaging, C Forte ensures stability and effectiveness, delivering radiant skin with every use.
C Forte
Featuring;
- Evidence based ingredients and formulations for superior efficacy.
- Potent skin brightening ingredients
- A plumper, more hydrated and even toned skin.
Note: C Forte can exacerbate acne and may be too strong for irritable skin.
Niacinamide (Vitamin B3): Another safe and effective option. It helps lighten melasma and also has anti-inflammatory properties to soothe your skin.
B Calm is formulated to support irritable and blemish prone skin while maintaining a healthy skin barrier. Ceramides strengthen resilience, Salicylic Acid exfoliates and calms the skin, and Niacinamide helps regulate oil and reduce the appearance of blemished skin.
B Calm
Featuring:
- Ingredients to support an improved skin barrier
- Helps manage excess oil production
- Supports a clearer-looking skin
Hydroxy Acids (like glycolic acid and lactic acid): These are great for gently exfoliating your skin and can help with melasma. While not specifically studied in pregnancy, they’re thought to be safe for use.
Smooth Serum is a night treatment formulated with 3% Glycolic acid, 1% Lactic acid, and 1% Gluconolactone. This gentle AHA blend supports the appearance of skin texture and surface renewal, helping maintain the look of even skin tone. Caution: Not recommended for very sensitive skin or skin prone to rosacea.
Smooth Serum
Key features:
Lasers – good to go!
When it comes to lasers, we have some good evidence to draw from. Certain types of lasers and mild peels can be safely used during pregnancy, however some aestheticians, nurses and doctors prefer to err on the side of caution and wait until after delivery.
Chemical Peels: Proceed with Caution
In terms of chemical peels, glycolic and lactic acid peels are considered safe in pregnancy. But trichloroacetic acid (TCA) and salicylic acid peels are not considered pregnancy safe- delay these until after bub arrives!
So, What Should You Do?
Gentle Skincare Routine: Stick with the safe ingredients we talked about above - 4-n-butylresorcinol, vitamin C, niacinamide, and hydroxy acids.
Sun Protection: This is HUGE. Melasma can get worse with sun exposure, so make sure you’re using a broad-spectrum sunscreen every single day.
Zinc Shade is a lightweight matte day cream and primer. Its non-greasy, matte finish allows for smooth application and works well under makeup. We spent countless iterations perfecting this lightweight, non-greasy formula to avoid the typical white cast and thick feel of zinc products. The results? A matte finish that works beautifully under makeup. With well tolerated matte finish, it's also well suited to irritable and blemish and bump prone skin. With SPF 15 it also provides broad-spectrum sun protection against UVA and UVB rays. Key features: Lightweight, matte formula suitable for daily use Smooth application with minimal white cast Broad-spectrum UV protection Tested SPF 15 with enhanced UVA coverage Usage: Apply evenly to all exposed areas of skin before sun exposure. Reapply as needed throughout the day.
Zinc Shade
Remember, melasma often fades after pregnancy, so hang in there! You’ve got this, and you’re going to be a great mum with or without those pesky spots.
Take care and keep glowing!
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*While 4-n- Butylresorcinol has been found in studies to have very low systemic absorption, so is usually presumed to be pregnancy-safe, it has not been specifically trialled in pregnant women.
** Please check with your clinician before using any skincare products in pregnancy.