Pregnancy mask (melasma) in men, is that possible?

Melasma, or popularly called pregnancy mask, is a pigment disorder. It is accompanied by erratic dark spots on the face, such as forehead, cheeks, upper lip. The condition is commonly seen in women, but it also occurs in men. More often than you think, according to research.

Who does it occur in?

In women with melasma, this varies by population group and geographical location between 1.5% and 33.3%. And in pregnant women, the estimated prevalence of melasma is around 70%. In men it occurs between 5-10%, with an average age of 30.7 years, just like in women.

It is more common in people with dark skin (Fitzpatrick skin types IV to VI) such as Hispanics, Asians and African Americans than in white populations.

Melasma is caused by a combination of external factors and genetic predisposition. The exact cause of melasma is not known. Some of the most common factors include sun exposure, hormonal influences, and genetic predisposition. Other, less common causes include cosmetics (highly perfumed products, aftershave), photosensitizing medications ( for more information: medications and photosensitivity), diet, thyroid disorders, liver diseases, ovarian tumors, parasites and stressful events.

What does ‘pregnancy mask’ look like in men?

Actually not much different than in women, the discolorations are on the cheekbones and forehead. Melasma in the neck and forearms in men has also been described.

The causative factors in men are probably the same as in women, with the exception of pregnancy and contraceptive use. An Indian study suggests excessive sun exposure and genetic predisposition as the main causes of melasma in men. 48% of the Indian men spent a lot of time outside due to work or hobby and 37% of the men also had a family history of melasma. A South American research group found chronic sun exposure as a causative factor in 81.4% of men with melasma. And 70.4% of men have a family history of melasma.

What happens in the skin?

With melasma there is an “overstimulated” pigment system. As a result, the pigment cells produce too much pigment, making the skin too dark in that area. The aforementioned causal factors can lead to an increased activity of the pigment cells, resulting in increased pigment production. Because not all pigment cells in the skin react equally strongly, a blotchy brown to dark brown discoloration of the skin occurs. However, in some patients there are no clear triggers.

Successfully treating melasma is a multilevel approach

To successfully treat melasma there are basic processes to keep in mind. Melasma is caused by overstimulation (for example by sunlight) and enzymatic stimulation at the level of pigment cells. This can result in excessive pigmentation on multiple levels, superficially and/or deep in the skin. The multi-level approach ensures that the pigment spots reduce or disappear.

It is a misconception that men are not bothered by a blotchy face. Read more about: pigmentation spots more than just a cosmetic problem

There are differences in the approach to melasma in men versus women. Men prefer an uncomplicated, non-time-consuming ‘quick-fix’ solution. Men also prefer a serum rather than a cream or ointment when it comes to facial care. Good and clear explanation is the first step.

A mix of different melasma treatments

First of all is sun protection! A sunscreen with at least an SPF30 factor. We prefer a mineral sunscreen (containing titanium dioxide AND zinc oxide). The main reasons are: direct sun protection effect after application, safe, no absorption in the body and does not cause skin irritation. Mineral sun protection is also recommended in the literature.

Read more about mineral sunscreen

Camouflage treatment, most treatments take at least 4-8 weeks before you see a visible effect. Camouflage is a simple and safe way to even out your skin in the meantime. Men are generally less open than women. The cosmetic industry has seen this well and nowadays, they have the tinted moisturizer for men.

Whitening pigment (ingredients) creams can help to some extent to reduce the dark spots. Pigment reduction can be tackled in 3 different steps (see image below).

Step 1. There are ingredients such as hydroquinone, botanical: arbutin / deoxyarbutin (found in berries, cranberry, pears), kojic acid, azelaic acid, aloesin (Aloe Vera), vitamin C (L-Ascorbic Acid) & E (Tocopherol) that enzymatically metabolize the amino acid tyrosine (tyrosinase) inhibition.

Step 2. Another possibility is to prevent the transport (pigment packets) from melanosomes to keratinocytes, vitamin B3 (Niacinamide) being a well-known example. More about effects of niacinamide

Finally, step 3. By accelerating your epidermal turnover or renewing your superficial horny layer faster, the dark tint is reduced. Ingredients that support this are vitamin A (Tretinoin), α-hydroxyacids (AHA fruit acid) and a plant hormone salicylic acid.

Pigment formation in steps

Did you know that?

Iconic Elements Targeted Pigment Serum is designed to effectively reduce pigment spots and promote an even skin tone. Here is an explanation of the main ingredients in the serum:

  1. Arbutin: This is a natural ingredient derived from plants such as bearberry and pears. It is known for its ability to reduce hyperpigmentation. Arbutin acts as a tyrosinase inhibitor, meaning it reduces the activity of the enzyme tyrosinase. Tyrosinase is involved in the production of melanin, the pigment in the skin responsible for dark spots. By inhibiting the activity of tyrosinase, arbutin helps even out skin tone and reduce dark spots.
  2. Niacinamide (Vitamin B3): Niacinamide is a powerful ingredient known for its skin brightening properties. It regulates the production of melanin in the skin, resulting in gradual fading of pigment spots. In addition, niacinamide has anti-inflammatory properties and can even out skin tone.
  3. Malic Acid: Also known as malic acid, it is an acidic substance found in various fruits, such as apples. In the Targeted Pigment Serum it has mild exfoliating properties. This means it can help remove dead skin cells and improve the skin’s texture. By gently exfoliating the top layer of the skin, malic acid can help reduce the appearance of pigment spots and make the skin look fresher and more radiant.

What can a skin specialist do for you?

Chemical peeling is used to superficially renew the epidermis and the superficial dermis (dermis) with a chemical agent. Suitable for treating fine wrinkles, but also unwanted dark pigment spots. Substances used are trichloroacetic acid (TCA), phenol and glycolic acid (AHA, alpha hydroxy acids). The skin is first degreased and then TCA, AHA or phenol is applied to the skin using a cotton swab or gauze. A disadvantage is the risk of pigment shift in the skin, often this is temporary.

Pigment laser therapy aims to specifically remove unwanted and excessive pigment in the skin. The laser works very superficially and does not go deeper than 0.5-1 mm. The laser sends a targeted energy pulse that is specifically absorbed by the pigment in the skin and perishes. Other structures in the skin remain intact.

The multilevel approach is therefore an approach in which the overstimulated pigment often caused by sunlight and pigment in different depths of the skin is treated. This approach is suitable for both men and women. It is a combination of sun protection, peeling or laser treatment and post-treatment with a pigment-reducing skin care.

The result of these treatments depends on the depth of the pigment. Superficial pigment can generally be treated well. The deeper pigment in melasma can only be removed with laser therapy.

About Francis Wu

‘In my dermatology practice, I often encounter people who suffer from itching. I see what they struggle with and unfortunately too often notice that certain care products help someone out of the rain.
Because I want you as a user to be able to rely on the product you are applying, I have developed my own skincare line: Iconic-Elements. A complete skin care line that stands out because it works (evidence-based)!


Sarkar R, Puri P, Jain RK, Singh A, Desai A. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol. 2010 Jul;24(7):768-72.

Sarkar R, Ailawadi P, Garg S. Melasma in Men: A Review of Clinical, Etiological, and Management Issues. J Clin Aesthet Dermatol. 2018;11(2):53-59.

Vazquez M, Maldonado H, Benmaman C, Sanchez JL. Melasma in men. A clinical and histologic study. Int J Dermatol 1988; 27: 25–27.

Vachiramon V, Suchonwanit P, Thadanipon K. Melasma in men. J Cosmet Dermatol. 2012 Jun;11(2):151-7.

Shankar K, Godse K, Aurangabadkar S, et al. Evidence-based treatment for melasma: expert opinion and a review. Dermatol Ther (Heidelb). 2014;4(2):165-186.

While you are here

Nitrogen dioxide causes pigmentation

The newspapers are full of it and we hear it in the news: at the moment there is a nitrogen crisis. According to the government, emissions must be reduced to ensure human health. We know that by now. But what many people in the beauty industry don’t know is that nitrogen dioxide, the gas that cars and trucks emit, causes pigmentation.. Francis Wu, dermatologist at the Dermatological Center Utrecht, explains it to youit. He bases this on various scientific studies. More here: NITROGEN DIOXIDE CAUSES PIGMENTATION

Dr. Francis Wu

Dr. Francis Wu

Dr. Francis Wu, een vooraanstaande dermatoloog, is de drijvende kracht achter Iconic Elements. Hij heeft sinds 2004 zijn expertise ingezet om een veilige en effectieve huidverzorgingslijn te creëren, geschikt voor zowel gezonde huid als huidproblemen. Iconic Elements, opgericht in 2016, is de eerste brede skincare lijn in Nederland ontwikkeld door een dermatoloog. Als medisch specialist streeft Dr. Wu naar het bevorderen van het welzijn van mensen door hoogwaardige en effectieve huidverzorgingsproducten te bieden. De proefdiervrije en vegan producten vermijden schadelijke chemicaliën en bevatten natuurlijke ingrediënten.
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