Pregnancy and the Skin

Pregnancy is the start of the journey of a lifetime for many women. While your body is preparing to nurture and welcome a newborn, you may experience a variety of skin changes that are induced by your fluctuating hormones. In this article we will try and sum up what are the normal skin changes that you may see during pregnancy and how to deal with them. 


1-    Pigmentary changes that occur in pregnancy:
Many women may notice that their skin colour is changing during pregnancy, specifically, they may get dark spots over the cheeks and forehead. This condition is called melasma or mask of pregnancy and is seen very frequently in pregnant women. Melasma may regress after pregnancy but in most cases this pigmentation will persist and you should seek a medical opinion concerning treatment. Beware of excessive sun and heat exposure during your pregnancy as it may worsen the darkening. Treatment of melasma includes sun protection, bleaching creams as well as peelings and laser treatment. Please make sure not to use a bleaching cream during pregnancy without your dermatologist’s advice as some creams may contain ingredients that are not safe during pregnancy.  
Other changes in skin color include the development of a dark line over the midline of your abdomen that will get darker as the pregnancy advances. This is called a linea nigra and it typically slowly disappears after you give birth. You may also notice a darkening of preexisting nevi or sunspots. If this should occur do not get alarmed however it would be better to show these spots to your dermatologist in order to make sure that they don’t require surgical removal. 


2-    Hair changes during pregnancy
Many women report that their hair gets fuller and thicker during pregnancy and this is because the normal hair cycle halts momentarily during pregnancy and hair stops shedding. A few months after birth (depending on whether or not you are breastfeeding) you may notice that you’ll start shedding hair more intensely. This is a normal phase called post-partum telogen effluvium, and although it may be alarming, rest assured that your hair will grow back to their original fullness unless you have a familial predisposition for hair thinning. You may ask your dermatologist for advice concerning vitamins that can help boost your hair regrowth or other treatment options such as PRP (Platelet Rich Plasma) injection that can help stimulate hair growth. 
Hirsutism (excessive body and facial hair) can also be seen during pregnancy because of the hormonal changes that accompany pregnancy and this tends to regress after giving birth. There aren’t enough safety studies on laser hair removal during pregnancy, however seeing as the laser beam doesn’t penetrate past the skin, we generally recommend laser hair removal for small areas, if needed. Alternative hair removal options such as mechanical depilation or electrolysis can also be used.


3-    Stretch marks during pregnancy  
This is one of the most common skin changes during pregnancy. The areas that are the most at risk are the abdomen, hips, buttocks, and breasts. Genetic factors seem to be the main risk factors for the development of stretch marks, however weight gain during pregnancy may also contribute. There are very few satisfactory treatment options for stretch marks and care should be taken not to use anti stretch marks creams containing retinoids during pregnancy as they may theoretically be risky to the fetus. Weight control is the best and safest way to prevent excessive stretch marks. 


4-    Vascular changes during pregnancy 
You may notice that your hands are unusually red. This finding is called palmar erythema and it’s a very common, benign and reversible skin change during pregnancy. Tiny blood vessels called spider angiomas may become more apparent. These may be treated after your delivery with a vascular laser.


5-    What are the skin changes that you should look out for
Your skin will experience a number of benign changes during your pregnancy, most of which are benign and some of which are reversible. However should you experience any of the following skin changes you should notify your obstetrician or dermatologist and seek medical treatment:

  • Severe itching 
  • Itching and a change of skin color to a yellowish hue (jaundice)
  • Red blotches over the abdomen and extremities
  • Blisters over the body 
  • Pustules over the body 
  • Worsening of a preexisting skin condition such as psoriasis or eczema