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The color of the skin is influenced by a number of pigments, including melanin, carotene, and hemoglobin. Recall that melanin is produced by cells called melanocytes, which are found scattered throughout the stratum basale of the epidermis. The melanin is transferred to the keratinocytes via melanosomes.
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Pigmentation and Pregnancy: Knowing What Is Normal.

Amy Kalowitz Bieber1, Kathryn J Martires, Jennifer A Stein

  • 1Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York; the Department of Dermatology, University of Connecticut, Farmington, Connecticut; and the Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland.

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Pregnancy does not significantly alter moles (melanocytic nevi). Any concerning mole changes during pregnancy require medical evaluation for potential melanoma, similar to non-pregnant individuals.

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Area of Science:

  • Dermatology
  • Obstetrics
  • Oncology

Background:

  • Hormonal changes during pregnancy are often incorrectly blamed for significant alterations in melanocytic nevi.
  • Delayed assessment of changing moles in pregnant patients may lead to advanced-stage melanoma diagnoses.

Purpose of the Study:

  • To evaluate the actual impact of pregnancy on melanocytic nevi.
  • To differentiate between concerning nevus changes and benign physiologic skin alterations during pregnancy.

Main Methods:

  • Review of recent studies and existing evidence on nevus changes during pregnancy.
  • Analysis of physiological pigmentary changes common in pregnancy.

Main Results:

  • Pregnancy does not induce significant changes in most nevi, except for growth on the abdomen/breasts due to skin expansion.
  • There is insufficient evidence that nevi darken during pregnancy.
  • Physiological pigmentary changes like melasma and linea nigra are common but benign.

Conclusions:

  • Changing nevi during pregnancy should be assessed for malignancy irrespective of pregnancy status.
  • Physicians must recognize benign pregnancy-related pigmentary changes to reassure patients and avoid unnecessary stress.