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Pregnancy Skin Problems: Melasma vs. Rosacea

Pregnancy Skin Problems: Melasma vs. Rosacea

By Amalah

Dear Amy,

I am trying to have a second child, but am a bit nervous because the first pregnancy wreaked havoc on my face. (I feel like I am ready to handle the heartburn, tiredness, 7 months of throwing up, and preeclampsia again.) I developed the dreaded “mask of pregnancy”, which in my case was not a dark discoloration but fire engine red and bumpy which by the end of the pregnancy covered half of my forehead, my nose, under my eyes and some of my chin. It was so bad that before I started wearing heavy concealer, people asked me if I had burned my face (with boiling water, not the sun). I had originally thought it was a just a red rash that I would be able to treat with medicine after I gave birth, but one of the hospital nurses took one look at me and said “Oh, you have the mask of pregnancy. Mine was red too.” Not helpful. Is there any way to head off the mask of pregnancy burn that looks like I should be in the ER?

Also, while most of it faded I still have a large, really dark area smack in the middle of my forehead. People who don’t see me very often, i.e. family members who remember what I looked like, ask if it is a bruise. Any OTC products I have looked at use bleach to fade dark spots and you have to be really careful where you put the stuff so that you don’t bleach out an area of skin that doesn’t need it. I am not willing to use bleach on my face. Is there any way other than bleach to fade the current dark area? If it works, hopefully if this happens again with the second pregnancy I will have some knowledge of what to do about it.

Other information you might find useful: my child is 2 yrs old and I quit breastfeeding a year ago (therefore I have given up hope that once the hormones level out it will go away), I will turn 30 this year, I have oily, sensitive skin and don’t use much makeup. I don’t use makeup because I have yet to find an overall face product that doesn’t take much time to use and doesn’t make my face break out. Any advice would be greatly appreciated.

Dreading Pregnancy Skin

Okay, so I am not a dermatologist, but despite what that nurse said to you,  most of your symptoms are not really jibbing with melasma, aka the “mask of pregnancy.” Melasma is a general darkening of the pigment of your skin. Brown, not red. It’s brought on by sun exposure, and pregnancy hormones tend to exacerbate the symptoms. Keeping your face out of the sun and wearing a good sunblock every day, no matter what, are the best preventative bets. It typically goes away on its own, but it’s also common for a couple spots to stick around. I recommend either Murad’s Rapid Age Spot & Lightening Serum or Clinique’s Even Better Clinical Dark Spot Corrector.  A dermatologist can also treat stubborn dark spots by freezing or lasering them, or with a prescription compound cream.

But. You, OP, should probably ignore everything I just said.

What you’re describing — an all-over red and bumpy rash — was probably not melasma. That sounds more like a really severe rosacea flare-up, which (YAY OF COURSE) is also a common pregnancy skin problem. Google it and look at some pictures and see if what you had looked similar. I highly, highly recommend you make an appointment with a dermatologist to discuss this, because it’s important to know 100% what you’re dealing with.

It’s entirely possible you suffered from both (oh God, you poor thing), since the remaining darkish spot on your forehead could be melasma. Or it could still be something stemming from the rosacea (if it’s still slightly red). Either way, definitely see a dermatologist before trying to treat it with anything OTC. Rosacea is typically best treated via prescription products, and even if it IS melasma, since it’s been present for a couple years I suspect OTC dark spot products will have little effect on it anyway. And while you’re there, ask him/her your questions about possible treatment options during pregnancy if the redness/bumpiness does flare up again.

Which: Who knows. It might. It might not. I personally had a few common symptoms throughout all three pregnancies, but there were plenty of things that happened only once, or presented slightly differently each time, in terms of severeness. But hopefully a dermatologist will be able to offer you some options this time, since you’ll be prepared and at least sort of know what to expect, the next time you’re expecting.


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About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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