Women commonly experience changes in the appearance of the skin during pregnancy, including dark spots on the breasts, nipples and inner thighs, melasma, linea nigra, stretch marks, acne, spider veins and varicose veins. Many of these conditions are considered normal and are due to hormonal changes.
This article will examine some of the skin changes associated with pregnancy.
- Dark spots and patches can develop due to increase in levels of melanin.
- Melasma, a form of hyperpigmentation, is also known as "the mask of pregnancy."
- Stretch marks may appear by the third trimester, and some never fade from the skin.
- Even those with clear skin can develop acne during pregnancy, but some forms of acne medication must be avoided.
- Varicose veins can develop, but they often resolve after delivery.
A range of skin conditions can result from pregnancy.
Hyperpigmentation is the appearance of dark spots or patches on the skin. It is caused by an increase in naturally occurring melanin. Typically, this will resolve after delivery, but it can persist for several years.
An example of hyperpigmentation in pregnancy is melasma, known as "the mask of pregnancy," which is characterized by brown patches on the face, cheeks, nose, and forehead.
Speak with a dermatologist about the treatment of melasma during pregnancy. Consider taking some steps to stop the condition deteriorating by limiting sun exposure between 10 am and 2 pm, using a factor 30 sunscreen or above, and wearing a wide-brimmed hat when outside.
Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a condition in which pale red bumps appear on the skin of a pregnant woman and cause significant itching, burning, or stinging. These bumps vary in size, ranging from very small areas to larger areas that form a plaque.
Most commonly, these lesions are present on the abdomen, legs, arms, breasts or buttocks. PUPPP typically resolves after delivery.
Your doctor might give you an antihistamine or topical corticosteroid for inflammation and itch relief, although self-care steps can be taken to minimize the symptoms of PUPPP. These steps include using lukewarm water when washing, applying cool compresses, wearing loose or lightweight clothing and avoiding soap on skin affected with PUPPP.
Pregnant women are all too familiar with the presence of stretch marks. Often, women will develop stretch marks across the abdomen, buttocks, breasts or thighs. Stretch marks initially appear reddish-purple and fade to a silver or white appearance.
Although they often fade, stretch marks never completely resolve. Postpartum treatment of stretch marks is frequently ineffective, although laser and prescription creams can be considered. There are many old folks' tales of effective ways to prevent or treat stretch marks. It does make sense to keep the skin well hydrated with moisturizers during pregnancy.
The development of skin tags during pregnancy is common, and these lesions typically appear on the neck, chest, back, groin, and under the breasts. Skin tags are generally nothing to worry about and are not malignant. If they are in a place where they are being irritated with clothing or motion, your doctor can remove them.
Pregnancy causes hormonal changes that can lead to acne.
Acne may develop or worsen during pregnancy. There are many ways to treat acne, including prescription and non-prescription options that should be discussed with your healthcare provider before use.
It is important to remember general hygiene practices, such as washing your face with lukewarm water and a mild cleanser twice daily, keeping hair from touching your face, shampooing daily, avoiding picking at pimples and using oil-free cosmetics.
During pregnancy, it is safe to use over-the-counter (OTC) products that include topical benzoyl peroxide or salicylic acid, azelaic acid or glycolic acid.
Not all medications are safe during pregnancy, however, and some of the unsafe products include:
- hormonal therapy, due to an increased risk of congenital abnormalities
- isotretinoin, a form of vitamin A, also called retinol, can lead to the risk of severe congenital abnormalities, intellectual deficits, life-threatening heart and brain conditions, and other physical deformities. Do not use medications that contain retinol while pregnant.
- oral tetracyclines, a type of antibiotic that enhances the risk of tooth discoloration in the infant when taken after the fourth month of pregnancy. This medication can also have negative effects on fetal bone growth
- topical retinoids, a form of vitamin A that can be found in both prescription and nonprescription products.
Varicose veins can occur during pregnancy.
Spider veins are small, red veins that most commonly appear on the face, neck, and arms.
These unsightly skin changes are caused by pregnancy-induced hormone changes and increased blood volume.
Varicose veins are painful, enlarged veins caused by increased weight and uterine pressure during pregnancy. This leads to a decreased blood flow to the legs. Varicose veins can present on the legs, vulva, vagina, and rectum. These typically resolve after delivery. Point these out to your doctor or midwife.
To keep the effects of varicose veins to a minimum and relieve symptoms, take the following precautions:
- Limit periods of sitting and standing.
- Uncross the legs when sitting for long periods.
- Elevate your legs when possible.
- Exercise often.
- Use support hose.
- Avoid constipation with exercise and fluids.
Other less common skin conditions during pregnancy include prurigo of pregnancy, pemphigoid gestationis, and intrahepatic cholestasis of pregnancy (ICP).
Prurigo of pregnancy
Symptoms of prurigo of pregnancy include tiny, itchy bumps resembling insect bites and are typically caused by pregnancy-induced changes to the immune system. Prurigo of pregnancy can affect women throughout their pregnancy, with symptoms often getting worse day by day.
This condition can take several months to resolve, even extending beyond the delivery date.
Pemphigoid gestationis is an autoimmune disorder that typically appears during the second or third trimester, or, in some cases, in the time immediately following childbirth.
Symptoms of this condition include blisters on the abdomen or other parts of the body. This condition slightly increases the risk for preterm birth or a small baby.
Intrahepatic cholestasis of pregnancy
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-induced liver condition that appears in the third trimester. It is characterized by severe itching without the presence of a rash. Itching is typically present on the palms of the hands, soles of the feet, or trunk of the body.
Symptoms of ICP generally resolve within the first few after birth. However, ICP also increases the risk of preterm labor and fetal death.
Speak with your healthcare provider if you are experiencing any unusual, concerning, or worsening skin conditions. Seek advice before starting treatment.