Treating melasma during pregnancy.
Pregnancy comes with many physical demands, given the changes that the female form endures. Some can go unnoticed, while others pose more of a challenge. A common belief is that skin is at its best during this time, namely that famous pregnancy ‘glow’. But for many, this is not the case. Women more often have problematic skin due to increased hormone levels, lack of sleep and stress.
Melasma is common, and among the most stubborn skin complaint during pregnancy, affecting one in four women. Believed to be due to hormone surges, hyperpigmentation appears mostly in sun-exposed areas of the face, like the cheekbones, nose or forehead and can be large in size and hard to disguise. There are some other factors that are thought to contribute to the development of melasma.
For example, darker skin types, intense sun exposure, oral contraceptives and a family history can make melasma more likely. One of the difficulties in treating the condition during pregnancy is that it’s best to avoid potentially harmful chemicals, acids and lasers, which is what the condition usually calls for. We tend to be quick in treating pigmentation with anything off the pharmacy shelf that claims to resolve uneven skin tones, promising brightness overnight, sometimes with a hefty price tag.
Lasers have become another popular for pigmented skin, which can be effective in removing the unwanted top layer but consequently cause the skin to become stressed. Melasma can be complicated and certain laser treatments can actually worsen the condition while some topical agents are a waste of time and money.
Dr Carmen Lam, specialist in dermatology and venereology, from Skin Central says, “The treatment of melasma is challenging, and prevention definitely better than a cure. Sun protection is particularly important especially during pregnancy, and making sure to include a broad-spectrum sunblock of at least SPF 30 in your everyday skincare routine is paramount.
On top of that, wearing sunglasses and a sun hat is necessary.” What makes melasma treatment complex is that there is is no one-sizefits- all solution. Dr Lam says, “There are combinations of different treatments used together to treat the condition effectively. Hydroquinone, azelaic acid, mequinol, kojic acid and topical retinoid are found to be very effective topical treatments for the condition, but all of these agents can be irritating to the skin so a careful skin examination for each client is important.”
Chemical peels and microdermabrasion are commonly used in conjunction with topical agents for a more specific and aggressive approach. This may not be suitable for expectant mothers as Dr Lam explains that topical retinoids can be teratogenic and should not be used during pregnancy. She says, “They both exfoliate the top layer of skin, but multiple treatment sessions are often required to see good results and treatment response depends on different skin type.
For refractory cases, laser and light-based therapies can be used, but with caution. The risks and benefits must be carefully assessed as there is a risk of making the condition worse. It really does depend on the case which is why it is so important to see a trusted dermatologist.” Angela Li, lead dermatologist at Skin Laundry agrees that lasers are best avoided while pregnant, but says that melasma treatment can begin immediately postpartum, even while breastfeeding.
She says, “Lasers tend to have an aggressive reputation, however ours have been designed to gently lift the top layers of skin over a longer period of time. We expect that for a bad case of melasma you may find yourself coming in once a week over a period of a couple of months to see a real change in pigmentation – the slower the process, the better.”
“Making sure to include a broad-spectrum sunblock of at least SPF 30 in your everyday skincare routine is paramount” ~ Dr Carmen Lam.
Pregnant woman in bathroom mirror/thinkstock; Skin Care. Face Beauty Treatment. IPL. Photo Facial Therapy. Ant/thinkstock.