EVERYTHING YOU NEED TO KNOW ABOUT THE MASK OF PREGNANCY
Published January 22, 2024
The mask of pregnancy is a major concern for pregnant women, but what is it? Are there effective ways to prevent it, or maybe even make it go away? In this article, FILORGA's experts delve into the origins of the mask of pregnancy and suggest solutions for protecting facial skin from these blemishes.
WHAT EXACTLY IS THE MASK OF PREGNANCY?
The mask of pregnancy, or melasma or chloasma to use its scientific names, is a condition in which irregular, asymmetrical blemishes gradually form on the skin, mainly on the cheeks, forehead, nose, and upper lip. It is often called the “mask of pregnancy” because it frequently affects pregnant women. In fact, it can affect up to 30% of pregnant women in certain population groups.
But this form of hyperpigmentation doesn't only occur during pregnancy. 10% of cases occur in postmenopausal women, and sometimes men are also affected.
VARIATIONS OF THE MASK OF PREGNANCY
The mask of pregnancy can assume three different forms, depending on the part of the skin where it develops and the color it has.
- Epidermal melasma. This is a superficial variant of the condition defined by increased pigmentation (melanin) in the epidermis, the outermost layer of the skin. The blemishes are brown and of varying degrees of darkness, with clearly defined edges.
- Dermal melasma. This appears as grayish-blue patches within the dermis, the second layer of the skin.
- Combined melasma. This variant blends the characteristics of epidermal and dermal melasma and has a brownish-gray color.
HOW THE MASK OF PREGNANCY CHANGES OVER TIME
The appearance of the mask of pregnancy in pregnant women usually occurs during the second trimester and disappears a few months after giving birth. The skin then returns to a more uniform appearance. It's important to note that women who already developed melasma during a previous pregnancy are much more likely to experience a recurrence of the condition during a subsequent pregnancy.
In other cases (those for which the term “mask of pregnancy” would not be appropriate), the causes of melasma need to be examined in greater detail to determine how it can be avoided.
CAUSES OF THE MASK OF PREGNANCY
There are several possible causes for the development of the mask of pregnancy. Let's take a look at them.
THE COMMON THREAD: OVERPRODUCTION OF MELANIN
Melanin is the pigment responsible for the color of your skin. It plays a vital role as a natural UV filter, shielding the skin from the harmful effects of the sun's rays. It's synthesized in the deep layers of the epidermis by specialized cells called melanocytes.
Melanin production is chiefly triggered by exposure to the sun, which results in a tan. With melasma, melanin is excessively secreted as a result of major hormonal variations or excessive exposure to UV radiation. This leads to the development of clusters that then cause blemishes.
HORMONAL FLUCTUATIONS
This is the most conspicuous and most often cited cause.
As mentioned above, almost one in three pregnant women develops the mask of pregnancy. During pregnancy, hormones (specifically estrogen) produced naturally in the body stimulate melanocytes, resulting in an overproduction of melanin.
This phenomenon is also seen in women who take oral contraceptives (10 to 25% of cases) or in people undergoing hormone therapy.
Unlike liver spots, melasma can disappear spontaneously when estrogen levels fall.
EXPOSURE TO THE SUN
The mask of pregnancy shares similar characteristics with photoaged skin. Researchers have identified a number of similarities:
- Solar elastosis. This refers to an abnormal accumulation of elastic tissue in the dermis due to prolonged exposure to the sun. Some 90% of people with melasma present varying degrees of solar elastosis.
- A compromised basement membrane. This membrane links the epidermis and dermis, and it is damaged in over 83% of people with melasma. The basement membrane is mainly made up of collagen, and chronic UV exposure increases levels of the enzymes that break down type IV and VI collagen in the skin. This means that a compromised basement membrane enables melanin to spread throughout the dermis, leading to dermal melasma.
- Inflammation. An increased number of mast cells (a kind of white blood cell found in the skin's connective tissue) has been more frequently observed in skin affected by melasma. How mast cells contribute to the development of melasma is not yet fully understood. However, the release of histamine (a molecule secreted during allergic reactions) by mast cells in response to exposure to UV radiation has been observed; this histamine then stimulates melanin secretion.
- Sebaceous glands are also likely to play a role in the development of the mask of pregnancy, but it is not yet clear how, and more research is needed.
ARE SKIN BLEMISHES AND THE MASK OF PREGNANCY THE SAME THING?
The mask of pregnancy is not the only kind of blemish that can appear on the skin. There are two other types:
LIVER SPOTS
Also known as solar lentigo or age spots, these are also the result of excessive exposure to the sun. They generally occur in areas that tend to be less protected by clothing, such as the face, neck, forearms, etc. These clusters of melanin form over time and usually become visible after the age of 40, and are one of the main signs of skin aging.
ACNE
This condition can leave lasting marks on the skin, even after pimples have cleared. These can have a reddish or brownish color. One of the causes of acne, as an inflammatory disorder, is the excessive production of melanin, which accumulates in the areas where pimples form. Once the pimples have cleared up, the clusters of melanin remain, leaving long-lasting blemishes.
HOW CAN THE MASK OF PREGNANCY BE AVOIDED?
INFLUENCING THE PRODUCTION OF MELANIN
Because melasma results from a localized excess of melanin, the key to tackling the mask of pregnancy is to block its secretion by melanocytes.
Active ingredients like vitamin C and glabridin, a polyphenol extracted from liquorice root, can be used to inhibit melanin synthesis, while the extract of the brown seaweed “rainbow wrack” (Cystoseira tamariscifolia) prevents the delivery of melanin to epidermal cells, thereby preventing the formation of blemishes.
SUN PROTECTION IS A MUST
Just like for liver spots, protection against UV radiation is crucial.
Try to avoid exposure to the sun during the summer months, especially between midday and 4pm. Also make sure to use a quality sunscreen on your face. It should ideally have a high sun protection factor (SPF 50), and needs to be reapplied regularly. You should also wear a hat and sunglasses to protect your face.