Skin Changes During Pregnancy and the Best Ways to Treat Them

When a woman is pregnant, their skin changes along with so many of things. Sometimes it’s more than having a healthy glow. Many soon-to-be moms might not be so happy about things like stretch marks, dark spots, acne, or rashes. They can ask if these changes normal? Are they permanent?

Bryce Desmond, MD, dermatologist for Intermountain Healthcare, explains why there are skin changes during pregnancy, the proper care for skin, what’s changes are normal during pregnancy, and when to consult a doctor or dermatologist.

“There are many changes that occur in the skin during pregnancy,” said Dr. Desmond. “Most are considered normal and do not affect the health of the mother or the baby.”

Some skin changes are due to changes in hormone levels that occur during pregnancy. There’s a shift in the predominant hormones, progesterone, during pregnancy. For most skin changes, health care professionals are not sure of the exact cause.

The most common skin change is hyperpigmentation, or a darkening of the skin in certain areas. Dark spots and patches are caused by an increase in the body’s melanin—a natural substance that gives color to the skin and hair.

The body can also begin to produce increased pigmentation due to the hormonal shift during pregnancy. This can involve the face causing chloasma or melasma, also known as the “mask of pregnancy.” It can be very distressing to women as it can cause significant discoloration and is most common on the face. It can remain throughout life.

“If dark spots, or sunspots are developed, be sure to protect yourself from the sun as it can prevent it from worsening,” said Dr. Desmond. “Use a sunblock with a high SPF and that contains ferric (iron) oxide protects skin from visible light to help with melasma.”

After childbirth, dark patches of skin typically return to their normal pigment after a period of months. However, some dark patches may never fade.

Another type of hyperpigmentation is the linea nigra. It is a line that appears on the abdomen from the pubic bone all the way up to the navel or even the breastbone. It can seem unsightly but tends to fade after birth.

Darkening of the armpits can also appear, and moles can darken or change. Hormones are to blame in these cases. Know the ABCDs of skin cancer and see a dermatologist if you notice one of the types of changes.

Acne

Many women have acne during pregnancy. Some already have acne and notice that it gets worse or better during pregnancy. Other women who have always had clear skin may develop acne while they are pregnant.

Some tips to treat acne:

• Wash your face twice a day with a benzoyl peroxide cleanser and lukewarm water.
• If you have oily hair, shampoo every day and try to keep your hair off your face.
• Avoid picking or squeezing acne sores to lessen possible scarring.
• Choose oil-free cosmetics.
• Prescription therapy may be needed. See your doctor or consult with a dermatologist to see what is safe. Many topical acne treatments are safe during pregnancy.

Pregnant women should not take the oral acne medication Accutane or the generic isotretinoin as it can cause severe fetal defects. Topical versions with Retin A should also not be used during pregnancy, according to Dr. Desmond.

Before or after pregnancy, birth control pills can cause acne.

The most important ingredient to avoid in skin care while pregnant are retinoids. This family of medications, often seen in anti-aging creams or serums are considered “Category X”. This means they are well known to cause birth defects. There are many over-the-counter retinoids available and even these should be avoided during pregnancy.

Stretch marks

Stretch marks are indented streaks that often appear on the abdomen, breasts, hips, buttocks and thighs. They’re caused by the stretching of the skin and are common during the second and third trimesters.

Stretch marks are more likely to happen with rapid weight gain, with twin pregnancies, or in women who are already obese. These often occur later in pregnancy as the fetus develops and grows. Stretch marks are a form of scar tissue from rapidly expanding skin.

Typically, they’re unsightly scars. Using a heavy moisturizer may help keep your skin soft, and aggressive moisturizing of the abdomen can help offset the risk of stretch marks.

Coconut oil or bio oil, Palmers cocoa butter, and vitamin E oil can hydrate the skin to minimize the risk for stretch mark development.

Most stretch marks fade after the baby is born, but they may never disappear completely.

“If you develop a rash near the stretch marks, you may want to see a dermatologist,” noted Dr. Desmond. “This is called PUPPP (pruritic urticarial papules and plaques of pregnancy). It’s a rash that starts in the stria or stretch marks in the third trimester and is more common in twin pregnancies. It is horrifically itchy. It can be so intrusive that an early delivery may even be recommended.”

While there may be some changes that many pregnant women don’t love, there is the healthy glow that many rave over.

The healthy glow may not be physiologic, but it could be due to increased blood volume during pregnancy. Increased circulation can make skin look healthier and brighter. Hormones can make oil production more prominent – and skin can shine or glimmer. Additionally, some skin conditions, like rosacea, acne, or eczema can clear up during pregnancy.

When to see a dermatologist about a skin condition when you’re pregnant

When you are pregnant, there are really two patients: mom and baby. The needs of the baby may be more pertinent.

Some skin changes are considered pathologic or abnormal and could affect the health of the mom or baby. Some rashes can affect the health of the mother and even more concerning, some rashes can impact the health of the baby.

It’s important to be seen by a board-certified dermatologist if you have one of these conditions:

• Blistering around the belly button. This can impact morbidity or mortality of baby.

• A rash with a large oval or circular patch on the chest, back or torso – Pityriasis Rosea. Usually, this starts as one large patch and then after 3-7 days, smaller versions develop in a Christmas tree pattern. It may be related to a viral infection. It is usually asymptomatic.

• Severe itching of the palms of the hand or soles of the feet can be due to cholestasis of pregnancy – a liver condition where bile acids in the liver are getting obstructed. It causes severe itching on palms of hands or soles of feet and can spread to the trunk. It occurs in the third trimester but goes away after childbirth. It can lead to preterm birth, or other problems.

For more information, go to https://intermountainhealthcare.org/services/dermatology/conditions/ or find a doctor in the Intermountain region at https://intermountainhealthcare.org/services/dermatology/.

About Intermountain Healthcare

Headquartered in Utah with locations in eight states and additional operations across the western U.S., Intermountain Healthcare is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called SelectHealth with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information and updates, click here