Changes are par for the course when it comes to nine months of pregnancy. You gain weight, your feet swell, your eating habits change and you may have morning sickness or chronic heartburn. Skin changes are also common – that's where the term "pregnancy glow" comes from. Nobody minds a bit of glow, but what happens when the skin changes aren't so attractive?

Kim Ford, a mother of two from Columbia, S.C., got melasma, or "pregnancy mask" as it's also called, during both of her pregnancies. "I noticed it both times at during the 5th month," says Ford. "I'm sure it appeared earlier, probably in the 4th, but by the 5th it was very noticeable, and that's when it caught my eye. After my second child, I was left with a dark patch of melasma under my left eye. It's not very large, and it didn't become noticeable until my postpartum. I thought it would disappear but it never did."

Melasma is an increase in the pigmentation of the skin. Many women experience it, and while it also can occur in women who take birth control pills, it is more common in pregnancy. It's thought to be, in these instances, caused by the dysregulation of the progesterone to estrogen ratio. However, the medical community is torn on this because it isn't seen in postmenopausal women.

Barbara Dehn, a women's health nurse practitioner and the author of Your Personal Guide to Pregnancy (Blue Orchid Press, 2004), says melasma is pretty easy to detect. "It occurs in areas of the face that have been exposed to sunlight and is more common in women who tend toward darker complexions," says Dehn. "The areas of the face affected can be the cheeks, the upper lip or the chin." Dehn says it will not be spots, but a darkened area of one-half to three to four inches in diameter. The borders are irregular and may cover the entire cheek area or upper lip or chin.

"Melasma can persist through the pregnancy and fade after delivery," says Dehn. "For most women the melasma will be faded and barely perceptible three to six months after delivery. However, there are women who have persistent darkened patches." The severity often decreases over time, provided that sunscreen is used and sun exposure is avoided, as prolonged exposure to the sun can make the dark areas worse.

Dr. Julia Hunter is the founder of Skin Fitness Plus, a skin care clinic in Beverly Hills, Calif. She is an advocate of beautiful skin starting on the inside, and her treatments reflect that. She says there is some evidence that candidiasis (an over abundance of yeast) may be the culprit. Dr. Hunter believes no matter what the original cause, the hyperpigmentation is caused by chronic inflammation deep in the dermis, which is ongoing until the cause of the chronic inflammation is cured.

"Chronic inflammation can be caused by certain chemicals in hair, skin, makeup products, environmental exposure via air, food, skin, medications, etc.," says Dr. Hunter. "It makes good common sense to me to avoid, as much as possible, all potentially harmful chemicals and to decrease or cure overpopulation of candida with dietary intervention. Try to moderate sugar, processed foods, carbohydrates, sodas and alcohol, and attempt to promote a healthy lifestyle and diet. I also suggest that you assist the body's physiological functions with the appropriate supplementation."

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