In his book, Total Skin , Dr. Leffell says current theory suggests that hormonal changes stimulate skin darkening. This hyperpigmentation is usually in areas that are already heavily colored, including the nipples and areola, armpits, and genitals. It usually affects the cheeks but can also darken the upper lip, chin, and forehead. Hormones and ultraviolet rays together cause the facial darkening. Debra Jaliman, MD, clinical instructor of dermatology at Mount Sinai School of Medicine, urges women to faithfully use a broad-spectrum sunscreen.
Many dermatologists suggest avoiding bleaching creams during pregnancy.
If melasma lingers after delivery, visit your dermatologist. The good news is that it almost always disappears after delivery. But after the third month, she says, the skin tends to clear. Some prescription creams and lotions are also safe. Discuss all prescription creams with your doctor before using them.