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Pregnancy and your skin

February 8, 2020 / Duncan Fisher
What to expect when you’re expecting

Congratulations, if you’ve got baby news at your house!

If this is your first, you’re in for a world of changes, and we wish you all the very best!

Some of the possible changes, which you may not know about, concern your skin. Pregnancy is a big, complicated event, biochemically speaking, and for a lot of women with babies on the way, there are dermatological features that come along. By and large, they are not signs of trouble, they’re very common, and for the most part they go away. Some of them can be a little startling, though, and so we want to let you know what they are, if only to reassure you. You'll have plenty of other things to think about besides your skin.

Common skin changes in pregnancy

Skin darkening

For reasons that aren’t clear, it’s not uncommon for pregnant women to develop patches of skin with extra melanin, the pigment protein that makes you tan. It’s spoken of as ‘hyperpigmentation.’

It’s never all-over. It’s only in patches. A typical presentation is on the cheeks, nose, and forehead, where it’s spoken of as ‘melasma’, or the ‘mask of pregnancy’.

Another common one is the ‘linea nigra,’ the dark line that sometimes appears on the tummy, very narrow, and running vertically, sometimes all the way from sternum to pubis.

Whatever form it takes, hyperpigmentation during pregnancy usually resolves after the baby comes, though sometimes it takes a few years.

It is absolutely harmless, and your dermatologist does have a few ways to help. You can help, too, chiefly by making sure you stay out of the sun.

Itchy little bumps

You can get something very like hives. It’s pale-red bumps, that itch or burn or sting. Sometimes they clump together and make an itchy plaque.

Technically, they’re called ‘pruritic urticarial papules of pregnancy.’ They generally appear on your tummy, torso, arms, or bottom.

They always go away after delivery.

Your doctor can give you antihistamines or corticosteroid cream. You’d do well to keep your skin cool, and go easy on soaps.

Stretch marks

Stretched-out skin sometimes scars. These stretch marks are purplish-red, as a rule, and like scars in general, they fade eventually.

They may not vanish completely. There isn’t a really proven way to treat them, but it has been observed that well moisturized skin tends to develop them less.

Skin tags

It’s not unheard of to get little skin growths, usually on the torso, or the neck or groin. They almost never cause any problems. They won’t go away by themselves, but they are easy for your doctor to remove.

Acne

You may get acne.

Do keep your face clean, use lukewarm water and mild cleanser, do go lightly on cosmetics, and do try not to pick at your zits.

Also feel free to put on the over-the-counter topical remedies that you used with you were a pimply teenager – products with benzoyl peroxide, glycolic acid, or azelaic acid.

DO NOT TAKE ANY ORAL ACNE MEDICATION WITHOUT TALKING TO YOUR DOCTOR.

  • Isotretinoin, known commercially sometimes as ‘Roaccutane,’ increases the risk of serious birth defects.
  • Hormone therapy, which is to say, ‘the pill,’ is also risky for unborn babies.
  • Tetracycline, an antibiotic, is associated with developmental problems in the unborn too.

Suddenly visible veins

Hormonal changes during pregnancy, and the fact that your blood volume increases hugely, can put your circulatory system under quite a strain.

You may see bulgy ‘varicose’ veins, on your legs, or in your groin, or smaller ‘spider’ veins, in your face, neck, or arms.

Generally speaking, these resolve after delivery. Point them out during checkups. Around the house, you might get off your feet when you can, keep your legs elevated, wear support tights, and make sure you’re getting a little exercise.

See your doctor if …

There are other skin conditions associated with pregnancy that aren’t so trivial, and do warrant a call to the doctor.

Prurigo of pregnancy

This looks a lot like hives, but it’s immune-modulated. It can be pretty uncomfortable, and it may take some months to clear, even after delivery.

Pemphigoid gestationis

This is a blistering autoimmune syndrome late in pregnancy. It’s associated with pre-term, underweight babies.

Intrahepatic cholestasis

This is a late-term liver condition, usually transitory, but associated with early labor, and sometimes fetal death. Its signs are itchy, widespread rash.

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