Prevalence of melasma in pregnant women and its relationship with body perception: a cross-sectional study in Türkiye
Keywords:
Pregnancy, Melanosis, Chloasma, Body image, Perception, Prevalence, Risk factors, Melasma, Body perception, NursingAbstract
BACKGROUND: Melasma is one of the most common physiological hyperpigmentation disorders observed during pregnancy, and its clinical characteristics and risk factors have been extensively investigated. However, evidence regarding the relationship between pregnancy-related melasma and body perception remains limited.
OBJECTIVE: This descriptive cross-sectional study aimed to determine the prevalence of melasma among pregnant women and to examine its association with body perception.
METHODS: This study included 450 pregnant women in the central city center of the Central Anatolia Region of Türkiye who met the inclusion criteria. Data were collected using the Introductory Information Form, the Melasma and Skin Type Characteristics Assessment Form, and the Body Perception Scale (BPS) and analyzed using descriptive statistics, comparative analyses, and logistic regression.
RESULTS: Melasma was identified in 37.8% of the participants, and the centrofacial pattern was the most common presentation (56.5%). A statistically significant association was found between pregnancy-related melasma and total BPS scores (p < 0.05). Pregnant women without melasma had significantly higher mean BPS scores than those with melasma (150.83 ± 17.18 vs. 146.15 ± 15.16; p = 0.004). Logistic regression analysis demonstrated that low educational and income levels, a personal or family history of melasma, and Fitzpatrick skin type IV were significant predictors of pregnancy-related melasma (p < 0.05), accounting for 61% of the variance.
CONCLUSION: The findings indicate the need for a holistic assessment of physiological skin changes and body perception during pregnancy, as well as the integration of counseling, education, and nursing care interventions targeting risk factors into routine prenatal care.
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References
1. Rigopoulos D, Gregoriou S, Katsambas A. Hyperpigmentation and melasma. J Cosmet Dermatol. 2007 Sep;6(3):195–202. PMID: 17760699; https://doi.org/10.1111/j.1473-2165.2007.00321.x.
2. Handel AC, Miot LDB, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014 Sep;89(5):771–82. PMID: 25184917; https://doi.org/10.1590/abd1806-4841.20143063.
3. Zhao L, Fu X, Cheng H. Prevention of Melasma During Pregnancy: Risk Factors and Photoprotection-Focused Strategies. Clin Cosmet Investig Dermatol. 2024 Oct 15;17:2301–10. https://doi.org/10.2147/CCID.S488663. Erratum in: Clin Cosmet Investig Dermatol. 2024 Nov 02;17:2445–6. PMID: 39430643; https://doi.org/10.2147/CCID.S503955.
4. Lopes CCC. Prevention of Melasma in Pregnant Women: Aspects of Approach in Aesthetic Treatment. EIJ. 2022;6(3):1–9. https://doi.org/10.23880/eij-16000245.
5. Kartal B, Kızılırmak A, Zedelenmez A, Erdem E. The effect of physical changes in pregnancy on women’s body image. Journal of Contemporary Medicine. 2018 Dec 26. https://doi.org/10.16899/gopctd.447159.
6. Sohrabi Z, Kazemi A, Farajzadegan Z, Janighorban M. Body perception in pregnant women: a qualitative study. BMC Pregnancy Childbirth. 2023 Mar 11;23(1):165. https://doi.org/10.1186/s12884-023-05467-y.
7. Kale M, Köksal Akyol A, Karagöz S. Beden algısı: tanımı, tarihçesi ve beden algısıyla ilgili kavramlar. In: Kale M, editor. Beden Algısı. Ankara: Nobel Akademik Yayıncılık; 2023.
8. Linde K, Lehnig F, Nagl M, Stepan H, Kersting A. Course and prediction of body image dissatisfaction during pregnancy: a prospective study. BMC Pregnancy Childbirth. 2022 Sep 20;22(1):719. PMID: 36127633; https://doi.org/10.1186/s12884-022-05050-x.
9. Desai K, Poojari DP, Shwetha TS, Upadhyaya R, Ramachandra P. Understanding the body image perception of pregnant women during their third trimester in a tertiary care setting in Southern India. BMC Pregnancy Childbirth. 2024 Oct 14;24(1):671. PMID: 39402515; https://doi.org/10.1186/s12884-024-06864-7.
10. Kazemi F, Nahidi F, Kariman N. Disorders Affecting Quality of Life During Pregnancy: A Qualitative Study. J Clin Diagn Res. 2017 Apr;11(4):QC06–QC10. PMID: 28571212; https://doi.org/10.7860/JCDR/2017/23703.9560.
11. Chandra M, Paray AA. Natural Physiological Changes During Pregnancy. Yale J Biol Med. 2024 Mar 29;97(1):85–92. PMID: 38559455; https://doi.org/10.59249/JTIV4138.
12. Türkmen H, Yörük S. Risk factors of striae gravidarum and chloasma melasma and their effects on quality of life. J of Cosmetic Dermatology. 2023 Feb;22(2):603–12. https://doi.org/10.1111/jocd.14783.
13. Sümbüloğlu K, Sümbüloğlu V. Biyoistatistik. 15. baskı. Ankara: Hatiboglu Yayıncılık; 2012.
14. Kaplan Ö, Bülbül T, Şahi̇N MG, Çinar SL, Müderri̇S İ. Kadınlarda Stria Gravidarum Oluşumu ile İlişkili Faktörler ve Vücut Algısı. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2021 Sep 8;4(2):163–71. https://doi.org/10.38108/ouhcd.868766.
15. Moin A, Jabery Z, Fallah N. Prevalence and awareness of melasma during pregnancy. Int J Dermatology. 2006 Mar;45(3):285–8. PMID: 16533230; https://doi.org/10.1111/j.1365-4632.2004.02470.x.
16. Fitzpatrick TB. The Validity and Practicality of Sun-Reactive Skin Types I Through VI. Arch Dermatol. 1988 Jun 1;124(6):869. PMID: 3377516; https://doi.org/10.1001/archderm.1988.01670060015008.
17. Hovardaoğlu S. Vücut algısı ölçeği’nin geliştirilmesi. Psikiyatri, Psikoloji, Psikofarmakoloji (3P) Dergisi.1993;1(Özel sayı 2):21–7.
18. Hexsel D, Rodrigues TC, Dal'Forno T, Zechmeister-Prado D, Lima MM. Melasma and pregnancy in southern Brazil. J Eur Acad Dermatol Venereol. 2009 Mar;23(3):367–8. PMID: 18631207; https://doi.org/10.1111/j.1468-3083.2008.02885.x.
19. Rathore S, Gupta S, Gupta V. Pattern and prevalence of physiological cutaneous changes in pregnancy: A study of 2000 antenatal women. Indian J Dermatol Venereol Leprol. 2011;77(3):402. PMID: 21508591; https://doi.org/10.4103/0378-6323.79741.
20. Ikram S, Malik A, Suhail M. Physiological skin changes during pregnancy. J Pakistan Assoc Dermatologists. 2018;28(2):219–23. https://doi.org/https://www.jpad.com.pk/index.php/jpad/article/view/1167.
21. Özdemir S, Özdemir M. Gebelikte melazma. Turkderm-Turkish Arch Dermatology Venereol. 2006;40(3):98–100.
22. Ünlü E, Demirci Saadet E. Evaluation of Epidemiological and Clinical Features of Melasma Patients. atfm. 2023 Oct 24;76(3):220–6. https://doi.org/10.4274/atfm.galenos.2023.24196.
23. Tamega AA, Miot LDB, Bonfietti C et al. Clinical patterns and epidemiological characteristics of facial melasma in Brazilian women. Acad Dermatol Venereol. 2013 Feb;27(2):151–6. PMID: 22212073; https://doi.org/10.1111/j.1468-3083.2011.04430.x.
24. Platsidaki E, Markantoni V, Nicolaidou E et al. A Clinical and Epidemiological Single-Group Observational Study in the Greek Population. Dermatol Ther (Heidelb). 2024 Nov;14(11):3183–92. PMID: 39485595; https://doi.org/10.1007/s13555-024-01297-8.
25. Aladwan S, Issa R, Al. Safadi W, Alnsour L, Al‐Halaseh LK. Perceptions and Management of Pregnancy‐Related Skin Changes: A Cross‐Sectional Study on Knowledge, Practices, and Use of Skincare Product. J Cosmetic Dermatology. 2025 Apr;24(4):e70132. PMID: 40145230; https://doi.org/10.1111/jocd.70132.
26. Pollo CF, Miot LDB, Meneguin S, Miot HA. Factors associated with quality of life in facial melasma: a cross-sectional study. Int J Cosmet Sci. 2018 May 7. PMID: 29734511; https://doi.org/10.1111/ics.12464.
27. Ullman LE, Nasir-Moin M, Hoffman V et al. Sunscreen use and affordability attitudes based on ethnicity, socioeconomic status, and Fitzpatrick skin type. Arch Dermatol Res. 2024 May 25;316(6):266. PMID: 38795207; https://doi.org/10.1007/s00403-024-02997-z.
28. Ortonne JP, Arellano I, Berneburg M et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol. 2009 Nov;23(11):1254–62. PMID: 19486232; https://doi.org/10.1111/j.1468-3083.2009.03295.x.
29. Alifa D, Hamzah RA, E. Ladi J. Influencing Factors of Melasma. SCIRJ. 2021 Oct 25;9(10):26–8. https://doi.org/10.31364/SCIRJ/v9.i10.2021.P1021884.
30. KrupaShankar DS, Somani VK, Kohli M at al. A cross-sectional, multicentric clinico-epidemiological study of melasma in India. Dermatol Ther (Heidelb). 2014 Jun;4(1):71–81. PMID: 24643868; https://doi.org/10.1007/s13555-014-0046-1.
31. Majid I, Aleem S. Melasma: Update on Epidemiology, Clinical Presentation, Assessment, and Scoring. J Skin Stem Cell. 2022 Jan 25;8(4). https://doi.org/10.5812/jssc.120283.
32. Guinot C, Cheffai S, Latreille J et al. Aggravating factors for melasma: a prospective study in 197 Tunisian patients. Acad Dermatol Venereol. 2010 Sep;24(9):1060–9. PMID: 20202051; https://doi.org/10.1111/j.1468-3083.2010.03592.x.
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