What is the mask of pregnancy? Your guide to pigmentation in pregnancy

“The mask of pregnancy”can negatively affect your confidence. Chereen Streydom considers your solutions.


It’s estimated that melasma affects up to 70% of pregnant women, largely thanks to the hormonal changes that take place during this time. “Melasma (sometimes called chloasma) occurs primarily as a result of the increase in the female sex hormones, oestrogen and progesterone. These stimulate the production of excess melanin in the skin, resulting in dark patches,” explains Anisa Ramdass, brand manager for Eucerin South Africa. “Melanin is the pigment responsible for causing changes in skin tone. When melanin production goes into overdrive, dark spots in various shapes and sizes will appear on the skin.” Although melasma can affect anyone of any race or gender, it most commonly affects pregnant women, which is why it’s often referred to as the “mask of pregnancy”.
Most people confuse melasma with hyperpigmentation and may use these terms interchangeably, but there is a subtle difference between the two.

ALSO SEE: 8 ways your body changes during pregnancy

Hyperpigmentation refers to any skin condition that may result in dark spots, including dark scars and blemishes left behind by acne, boils, eczema, or sun spots. Melasma is triggered by fluctuating hormones and exposure to UV light, and is often harder to treat than traditional hyperpigmentation, as it goes deeper into the dermis.

What’s happening to my skin?

There are a number of physiological changes in pigmentation that take place during pregnancy, along with melasma. These include a darkening of the areolae and nipples, as well as changes in colour around the vagina and perineum. You may also notice a dark line down the centre of your abdomen, called the linea nigra, which usually appears during the second trimester and occurs on the skin where your abdominal muscles stretch and separate to accommodate your growing baby. It usually fades a few weeks after delivery.

What to look out for

The mask of pregnancy usually appears in three patterns:

  • Centrofacial – dark spots and patches on your nose, forehead, and above your lips. This is the most common.
  • Malar – discolouration on your cheeks.
  • Mandibular – pigmentation along your chin and jaw line. This occurs in 50 to 80% of all cases.

The good news

You’ll be pleased to know discolouration should fade naturally within a few months of giving birth. That said, frequent sun exposure during and after pregnancy may cause pigmentation to darken further, which is why using a broad-spectrum sunscreen with antioxidants is essential during pregnancy.  “Hyperactive melanosomes respond to even low-level UV light, so it’s vital for those prone to dark spots and pigmentation to use a high SPF sunscreen 365 days a year – not just on sunny days,” adds Dr Stefanie Conzelmann, head of product development dermo cosmetics at Eucerin. “Many people underestimate the sun, because they can’t always feel its warmth during the cooler months, but even ‘cold light’ can activate melanin production, so we have to be disciplined when it comes to applying sunscreen on a daily basis.”

ALSO SEE: Post-pregnancy body changes you can expect

Prevention is better than cure

Dark spots and pigmentation are notoriously difficult to treat, so protect your skin as far as possible. In addition to sunscreen, Anisa says, “Limiting the time you spend in the sun, wearing protective clothing, as well as using a broad-spectrum sunscreen with a high SPF every day will help prevent existing dark spots from getting worse”. You may also want to invest in skincare products formulated specifically to treat dark spots and pigmentation, but you need to be careful and do your research when doing so. There are many skincare products and treatments that are highly effective when it comes to treating pigmentation, but many of these aren’t safe to use during pregnancy or breastfeeding.

As the ingredients in many topical creams and lotions are absorbed by the skin and can potentially enter the bloodstream, it’s best to avoid products containing retinoids or retinol, which have been linked to major birth defects. Some studies suggest it’s best to avoid salicylic and glycolic acids during pregnancy, and skin-brightening creams containing hydroquinone are a no-no.

Most suncare products are safe to use during pregnancy, but keep an eye out for a sunscreen with minimal chemical filters,” advises Charize Neill, marketing manager for Eau Thermale Avène in South Africa. “Make sure you apply sunscreen every morning, about 20 minutes before you leave the house – and don’t forget to reapply after swimming or sweating, and every two hours.”
Research suggests a deficiency in folic acid may increase your chances of experiencing skin discolouration, so ensure you’re taking a good folic acid supplement and eat as many leafy green vegetables as possible.

7 products you should have in your beauty bag

Oh-Lief Natural Sunscreen for Face SPF20 (R220) is a mineral sunscreen that also contains antioxidants to help reverse damage caused by the sun’s rays.


Eucerin’s Even Brighter range (priced from R185.95) is an anti-pigmentation range that doesn’t contain any retinol or retinoids, so it’s perfect for use during pregnancy and when breastfeeding.

Eucerin night cream

Eau Thermale Avene Thermal Spring Water (R159.95 for 150ml) is great for spritzing over your face and décolletage when you’re feeling hot and bothered. It’s great for soothing tired and swollen feet, too!

Eau Thermale Spring Water

Nivea Sun UV Face BB Cream SPF50+ (R124.99) adapts to every skin tone and contains pigments that help to disguise dark spots and blemishes. No need for a moisturiser, sunscreen, and foundation – this one does it all!

Nivea Sun BB Cream
Labello Sun Protect Caring Lip Balm SPF30 (R27.99) contains nourishing beeswax to help keep your lips soft and supple, while protecting them from the sun’s UV rays at the same time.


Bioderma Photoderm Spot Cream SPF50+ (R279.95) is specifically formulated to help protect damaged skin and scars from UV rays. It’s suitable for use on both the face and body.


Neutrogena Norwegian Formula Anti-Ageing Hand Cream SPF25 (R99.99 for 50ml) was developed by dermatologists.

Neutrogena hand cream
Eezy Sun Sunscreen Sachets SPF30 (R10.99 per sachet) is a convenient, single-use application of sunscreen.

Eezy Sun sachets

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