Pregnancy and the Skin

You know that fairytale about the pregnant woman with that ‘never looked better’, healthy and radiant looking skin. Well I, myself, appeared in a different story; I was that expectant mother with the blotchy, irritated and over sensitive skin. And to my greater frustration it wasn’t until months later, after the births of my children, that I could, once again, see a radiant glowing skin in the mirror. Pregnancy not only has a great effect on your body, but also on your skin. This is due to the major hormonal changes. People with problem skin can have lovely skin during their pregnancy, but, in reality, many people have irritated skin and a sudden outbreak of spots.

How your skin changes

A pregnant glow
During pregnancy the volume of blood increases in your skin. This results for some women in a healthy looking glow, but for others, with less fortunate blood vessels, in red blotches. To make matters worse, those women usually have small red stars on their face (spider naevi) and sometimes even broken capillaries (couperose). After the pregnancy, those visible blood vessels may not go away, but they can be removed with laser light treatment.

More pigment
The effect of hormones (oestrogen and progesterone) cause pigment cells to produce extra pigment. This will cause already present pigmentation spots and freckles to become darker. After the birth these will go away. Because some pigment cells produce more than others, you may be left with new pigmentation spots. You usually see them on the forehead, cheeks, under the eyes and around the mouth (some women acquire a moustache). This is also known as pregnancy mask or melasma. Women who take the contraceptive pill (notably the Diane-35) may be familiar with this. The only thing you can do about this is make sure that you are completely protected in the sun. If you are not pregnant, then there is a cream with Hydroquinone which you can use for pigmentation spots, but do not use this during pregnancy. Cosmetic ingredients which are safe for use during pregnancy and which can lighten surface pigmentation spots are Niacinamide, Vitamin C and liquorice root. Sadly many creams do not contain a high enough concentration of these to have an effect, so check the ingredients list before buying anything. These substances need to be displayed in the first part of the ingredients list.

Spots
Although, through increased sebum production, the lucky few gain a lovely glowing complexion, the less fortunate get blocked pores and spots. You were probably so relieved when you said goodbye to teenage acne, only to get landed with pregnancy acne. Even though you are limited in what you can use during pregnancy, there is still much that can be done to limit the damage. For one thing, use mild products. Skin with acne is, by definition, sensitive skin and you want to cause it as little damage as possible. Do not scrub either, this will only cause the problem to escalate. There are a number of ointments which can reduce acne. It is well known that Vitamin C, Niacinamide and liquorice root counteract acne and, more importantly, are safe to use during pregnancy. Exfoliating products with a low concentration of Glycolic Acid (under 10%) or Salicylic Acid (under 2%), or an anti-bacterial cream with 2.5% Benzoyl Peroxide also often help. Make sure you do not use Vitamin A Acid during pregnancy (and while breastfeeding) If you do have a severe problem then your Doctor may prescribe antibiotic creams such as Erythromycin, Clindamycin, Azelaic Acid and Metronidazole. Azelaic Acid also has another attribute in that it can improve pigmentation problems. If your acne does not improve through use of the above creams then an oral medication is a possibility. This is definitely not the most favoured treatment option for pregnant women, but there are three antibiotics which are found to be safe for use during pregnancy. These are Azithromycin, Cephalexin and Erythromycin.

Itching
Many pregnant women suffer from itching. This is due, partly, to the skin being stretched and sometimes being more dry, but also because the liver has to work harder to drain off bile acids. These bile acids, which end up in your blood, can make your nerve endings tingle. By keeping well hydrated and keeping your body supple you can keep the itching under control. You can use a neutral body lotion (un-perfumed) or pure jojoba oil. If the itching remains and you find it difficult to tolerate then seek advice from your Doctor. He can check to see if you are suffering from obstetric cholestasis.

Stretch marks
Another problem during pregnancy is stretch marks. The younger you are during pregnancy, the greater the risk is of this happening. By keeping your skin supple with a hydrating cream, you may be able to reduce the chances of stretch marks. If you do have them then, sadly, there is not much you can do about it.

Sun protection
Finally a quick word about sun protection. Bearing in mind the risk of irritating or stubborn skin blemishes during pregnancy, it is even more important that you protect your skin from the sun. This is possible by wearing hats, sun glasses, clothing and sun protection cream. During pregnancy, though, avoid sun protection products in the spray form and don’t buy products containing Oxybenzone (Benzophenon 3)! Products with Tinosorb or Zinc/Titanium Oxide are the safest for now… Make sure as well that you get enough Vitamin D. Take a vitamin supplement if necessary to avoid a deficiency (also advisable if you are not pregnant, for that matter). A deficiency in Vitamin D brings a higher risk of complications during pregnancy such as your baby having a low birth weight, pre- eclampsia or diabetes.

Regards Jetske

Research Physician Cosmetic Dermatology

You can also read the blogs:
‘Broken Capillaries’,
‘Different Types of Pigment”,
‘Hydroquinone’,
‘All about Spots, Pimples and Acne’,
‘The Removal of Dead Skin Cells. An Exfoliant or Scrub’,
‘Vitamin C’,
‘Niacinamide’,
‘Oxybenzone’ and
‘Vitamin D’.