This site has limited support for your browser. We recommend switching to Edge, Chrome, Safari, or Firefox.

Melasma During Pregnancy: Is Hydroquinone Safe?

Melasma During Pregnancy: Is Hydroquinone Safe?

What is Melasma?

Melasma is one of the most common types of skin pigmentation disorder, and it occurs when the pigment cells in your skin are activated.

The pigment cells are the same ones that produce melanin, which gives your skin its natural color. When you have melasma, these pigment cells are activated too much, making your skin look darker than it should be. This can make your skin look red or brownish-looking, sometimes with a grayish cast to it as well.

Melasma can happen at any age, but it tends to occur most often in women between 30 and 50. It's thought that having too much sun exposure at an early age can cause this condition; however, other factors such as pregnancy or hormone changes may also contribute to its development.

Signs and Symptoms of Melasma in Pregnant Women

Melasma can be difficult to treat during pregnancy because it is caused by an increase in melanin production in your skin. Pregnant women with melasma often experience:

  • Pigmentation in their face and chest area (especially on the face)
  • Pigmentation on their upper arms and upper legs (especially on the legs)
  • Small dark spots that are often raised on the forehead or cheekbones

Medications to Treat Melasma


The best way to treat melasma is to use light therapy. Light therapy involves exposing your skin to bright lights for 30 minutes a day for six weeks. This can be done at home or in the doctor's office. It may take several weeks for the treatment to work, but it will usually clear up in six months or less.

Chemical facial peels

If light therapy isn't an option, you might consider chemical peels like acid and retinoic acid peel treatments to help fade melasma. These treatments are designed to remove excess pigment from the top layer of skin (epidermis) while leaving healthy skin cells intact underneath to continue producing collagen and elastin over time.


You can also try using microneedling treatments that contain alpha hydroxyl acids (AHAs). These are found in many skin care products, so there are lots of options out there. You can get the most out of these treatments by doing them regularly—every 3-4 weeks—and making sure that you clean out your pores after each session with a gentle cleanser.

Prescription medicated topical creams

There are several medications that can be used to treat melasma. First-line treatment usually involves topical creams, including hydroquinone, tretinoin, and retinoids.

The first option is hydroquinone, a bleaching agent that reduces the melanin production in the skin. It is effective at treating melasma but may irritate, so it should only be used temporarily and with caution.

Another option is tretinoin, another bleaching agent that works by reducing the amount of pigment-producing cells in your skin. This medication can also irritate and should only be used short-term.

The final option is tazarotene cream, which works by inhibiting the activity of tyrosinase, an enzyme responsible for producing melanin. This medication can also cause irritation and should only be used on a short-term basis, as it can have side effects such as dryness or redness of the skin.

Why is hydroquinone not a good option for pregnancy melasma?

As you know, hydroquinone is a skin bleaching agent that can be used to treat hyperpigmentation. It's FDA-approved for use in pregnant women, but it's been linked to birth defects and other serious health problems. It's also been known to cause Exogenous ochronosis (EO) if used chronically over long periods of time.

So why wouldn't it be a good option for preventing pregnancy melasma?

First: hydroquinone can affect fertility. You may be wondering if there are any other options out there that are safer and less likely to cause problems with your body during pregnancy. Well, the answer is no! Hydroquinone is the only approved option for treating melasma during pregnancy.

Second: hydroquinone doesn't work that well on its own. It might help reduce your hyperpigmentation, but it won't make it go away completely. This means that even if you use this product while pregnant, you will still have some residual marks left behind—and no one wants to see those marks!

Third: many people have reported negative side effects from using hydroquinone during pregnancy. Some of these include nausea and vomiting, fatigue, headaches, dizziness, insomnia, dry skin, and eyes (and more!).

Is there a better alternative to hydroquinone for treating pregnancy melasma?

Hydroquinone is a commonly used skin lightening agent. However, it has been known to cause several serious side effects, including hypothyroidism and photosensitivity reactions. Because of these side effects, some people have turned to alternatives to hydroquinone.

Azelaic acid

Azelaic acid is a naturally occurring skin-lightening substance found in the white sap of several plants. This ingredient has been shown to lighten skin and reduce the appearance of fine lines and wrinkles when applied topically. It also helps treat hyperpigmentation caused by inflammatory acne and rosacea, which can be treated with oral antibiotics and topical corticosteroids.

Azelaic acid works best when used with other topical treatments like retinoids or kojic acid, which can help increase efficacy while reducing irritation or side effects.

Kojic acid

Kojic acid is also an effective treatment for melasma, a compound that comes from fermentation processes, and it's produced by several different types of fungi. It has been used in skin care products since the early 2000s and has become one of the most popular skincare ingredients on the market in recent years.

Kojic acid can be used to treat melasma on its own (or in conjunction with other ingredients) or as a base ingredient for other skincare products such as sunscreens, moisturizers, toners, etc.


Retinoids work by reducing the size of existing pigmented cells, which allows them to slough off at a faster rate than normal pigment cells would. They can be used alone or in combination with other topical treatments like glycolic acid or mequinol.

Glycolic Acid

Glycolic acid is a natural alpha hydroxy acid that promotes collagen production and cell turnover, making it an excellent treatment for aging and sun-damaged skin. It also helps with fine lines and wrinkles, which is perfect for women going through pregnancy.

It has been used for decades to treat acne-prone skin, but it can also be used on the face to help reduce fine lines and wrinkles. The best part about using this product during pregnancy is that it will not contribute to stretch marks or other issues related to weight gain or hormonal changes in your body.


Arbutin, which is derived from bearberries and is used to treat hyperpigmentation, has been linked to photoprotection. It has been shown to reduce melanin production in human skin cells and inhibit tyrosinase activity, the enzyme responsible for melanin production. 

Arbutin may be more effective than hydroquinone at treating melasma because it can penetrate into the deeper layers of skin more easily than hydroquinone and because it has a longer half-life (which means that it stays in your system longer).


Mequinol has been used in Europe for over a decade as a treatment for melasma, but only recently has it been approved for use in the United States. It works by inhibiting tyrosinase (which helps produce melanin), which means that it will reduce the visibility of dark patches on your skin. It also has anti-inflammatory properties that can help reduce redness and swelling, which are both common problems with melasma.

However, there are some downsides to mequinol. The most significant one is that it can cause dryness and irritation if used too often or in high doses (so talk to your doctor before using this product).


Tetrahydrodiferuloylmethane is a derivative of turmeric that has been used as an alternative to hydroquinone for treating pregnancy melasma. It is believed to work by inhibiting tyrosinase, an enzyme that catalyzes the production of melanin. This can potentially help treat hyperpigmentation caused by pregnancy or other hormonal changes.

Managing Melasma During Pregnancy

Dealing with melasma during pregnancy can be a challenge, but it's not impossible. Here are some of the most important things to know about melasma and how you can manage it during pregnancy:

  • It's a good idea to minimize sun exposure during peak hours (10 am – 2 pm). This means wearing long sleeves, covering up with a hat and sunglasses, and staying out of the sun during those hours.
  • UV rays from the sun cause melasma, so it's important to protect your skin from this harmful light. Wear a hat with a broad brim and UV-blocking material on the crown or any clothing that covers your arms, legs, and neck.
  • Some skincare products are labeled as being suitable for pregnant or nursing mothers, but they may contain ingredients that could be harmful to the baby or mother. This includes retinyl palmitate (a form of vitamin A), which has been linked to birth defects when taken during pregnancy or breastfeeding.

You can also try using pregnancy-safe sunscreen daily to help prevent melasma. Check with your doctor too about using a cream instead if your skin is sensitive to sunscreens and/or chemicals.

  • Take any vitamins or medications that your doctor has recommended. If you are taking prescription medication, make sure that you take it as directed and not more often than prescribed. If you are taking over-the-counter products, make sure that you follow the directions on the label carefully.
  • Avoid skin irritants such as smoke, harsh chemicals, and soaps that strip oils from your skin. These can make your skin more prone to developing melasma because they cause more friction between your skin and the outer layer of your epidermis (the top layer of the skin).

Other Common Pregnancy-Related Skin Changes

Hormones, changes in your body's metabolism, and other factors can cause your skin to look different when you're pregnant.

Some common changes include:

  • Pregnancy acne: This acne is caused by hormonal changes that take place during pregnancy. The hormones estrogen and progesterone cause your sebaceous glands to overproduce oil, which can clog pores and cause blemishes.
  • Stretch marks: These are the result of your skin stretching as it grows larger during pregnancy. They can appear anywhere on the body but are most common on the stomach, hips, breasts, and thighs. They usually fade in the first few months after giving birth.
  • Fatigue lines: Sometimes called "mother lines," these lines form on your face as a result of stress or fatigue from carrying a baby inside you. They can happen around the eyes and mouth. They will disappear once your body returns to normal after delivery or after breastfeeding begins.


Knowing more about this condition will give you the right kind of information and help you make the right choices if you have it. Although melasma is not life-threatening, it can cause significant discomfort for women who suffer from it during pregnancy. Unfortunately, treatment options are limited and can often be complicated by side effects.

Hydroquinone has long been used as a first-line treatment for melasma; however, due to its potential side effects and lack of evidence that it works better than other treatments, many doctors now recommend avoiding hydroquinone during pregnancy altogether. 

If you don't want to deal with side effects (like dryness and redness), there are other alternatives that have been shown to effectively treat melasma without causing irritation or discoloration, which include light therapy, topical retinoids, and oral retinoids.