If I have melasma, which products are effective and also safe during pregnancy?

Dear Dr. Irvin, I am 35 years old and I developed melasma during my pregnancy 5 years ago. It seemed like it was going away afterwards, but then over the years it worsened a lot. Now I think that might have been done by my IUD. I know that a lot of doctors say the IUD does not cause melasma, however, I have read plenty of articles that stated that other women had the same experience while having an IUD. Anyways, the IUD is out and I'm on a strict regimen of skin care products...thanks for all your awesome advice. I use the SkinCeuticals Phloretin CF Gel, SkinMedica Lytera and SkinMedica Retinol complex 0.5 as well as plenty of sunscreen in 3 layers (Elta MD, Dermaquest Zinclear and Colorescience sunforgettable). Every single one of these products as well as wearing a hat has made the look of my skin so much better. So here is my question: I am planning to become pregnant again and am a little scared of what is going to happen with my skin. Can you tell me if I need to stop using some of these products right away before even getting pregnant and what would be a safe regimen for my skin then. Also, I should mention that we are about to move to sunny Georgia which is not going to help:( Thanks so much in advance and for all your great tips! Best Regards, Stefanie

You’re sooooooo welcome!  I’m glad the skincare products are helpful.   You’re right, of course, your melasma may get a little worse with another pregnancy, but with attention and care for your skin, you can prevent most of that. More on prevention.

The following are considered to be safe during pregnancy:

  • Skinceuticals Phloretin CF –  an excellent antioxidant that also helps reduce pigment
  • SkinMedica Lytera –  all plant based lighteners/brighteners – it is hydroquinone free
  • SkinMedica Retinol –  this is very gentle but stop this during pregnancy . Current recommendations are to avoid Vitamin A related products during at least the first 3-4 months just to be perfectly safe, even these gentle non prescription ones.  Why take any chances?
  • The Elta, Dermaquest and Colorescience sunscreens are fine.   I love that Colorescience sunscreen but put it on outside.  No one knows if breathing this type of powder over time is okay.  Again, just use it in a well ventilated area. 

And hats are, of course, always safe!!   🙂

Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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