Pregnancy not only causes changes in your body, but also affects your skin. These are some of the most common skin conditions that occur during pregnancy. In this feature, let us walk you through the causes, symptoms and treatments of these skin problems.

Skin conditions that occur during pregnancy are very common and are generally caused by hormonal shifts in the body. “During pregnancy, your body undergoes several changes, and so does your skin,” says New York-based skincare specialist, Mario Badescu. “Due to fluctuating hormone levels, your skin’s tone and texture can drastically change during the nine months and for some time afterward.”

Good news is, most of them will usually clear up after the baby is born. But if these conditions still bother you and you would like to get them under control, there are treatments and products available just for pregnant women. As a precautionary measure however, it is advisable to seek your doctor’s opinion before using any medication or treatment while you are pregnant.

“It is important to be mindful of your skin and the products used in your regimen,” advises Badescu. “If your skin type has changed, be sure to re-evaluate your skincare regimen, and consult your skincare specialists to adjust your products accordingly.”

01. Hyperpigmentation

What causes it: This condition is caused by an excess production of melanin – a substance in the body responsible for pigmentation (skin colour). “Hyperpigmentation is the result of either of two occurrences: (1) an abnormally high concentration of melanocytes which produce melanin or (2) when melanocytes are hyperactive,” says Badescu. “For instance, sun exposure stimulates the production of melanin. Although it can affect anyone, this condition is more prevalent among certain ethnicities such as Asian, Mediterranean, African, or Latin.”

Symptoms: Dark spots on the skin, which may occur anywhere on the body, but usually appears on the face, hands or neck.

Treatments: According to Badescu, there is no cure for hyperpigmentation and treatments for hyperpigmentation can only lighten the appearance of the spots, but not completely remove them. For pregnant women, he advises to use sunscreen with a minimum value of SPF15 and skincare products that contain alpha hydroxy acids (AHAs). “Glycolic and lactic acid are examples of AHAs,” he says. “AHAs help remove the buildup of dead surface cells that are already stained with pigment, thus lessening discolouration.”

02. Melasma (also known as “mask of pregnancy”)

What causes it: Melasma is usually caused by hormones and sun exposure. According to Badescu, this condition, which is similar to hyperpigmentation, occurs due to hormonal changes that affect the pigmentation in the skin, making it more susceptible to discolouration when exposed to sunlight.

Symptoms: Tan or brown patches, which usually appear on the face and develops particularly along the cheekbones and upper lip. “Melasma is more commonly referred to as “pregnancy mask”. It appears as brown pigmentation around the eye and cheek area and, at times, above the lip,” says Badescu. “Pregnant women with fair complexions are particularly susceptible to melasma, as is Asian skin.”

Treatments: Melasma usually fades three to six months after pregnancy, but the patches may reappear if you spend time outdoors without applying sunscreen. Try limiting your skin to sunlight exposure, especially between 10am and 2pm. You can also use a sunscreen with at least SPF30 when outdoors. It is also recommended to use a sunscreen with zinc oxide, which provides a broad spectrum of UVA and UVB protection. Again, always check if your sunscreen is safe for you during pregnancy. According to Livestrong, most sunscreens contain between 5 and 10 percent zinc oxide. Using topical zinc oxide in normal amounts is probably safe for pregnant women, although if you’re using it on large areas of your body, talk with your doctor first, eMed TV advises.

03. Pruritic urticarial papules and plaques of pregnancy (PUPP)

What causes it: There is no known cause of PUPP. PUPP usually occurs during the first pregnancy, or if you are carrying male babies or multiple babies, such as twins or triplets. If you have a history of hypertension, you are also more prone to getting PUPP.

“PUPPP is the most common pregnancy-specific dermatosis, occurring in one out of 130 to 300 pregnancies,” says Marc Tunzi M.D., and Gary R. Gray, D.O in their article that was published by the American Academy of Family Physicians. “The disorder is more common with first pregnancies and multiple gestations, and familial occurrences have been reported.”

Symptoms: PUPP is an outbreak of pale red bumps on the skin. “A PUPPP- associated rash, characterized by intense pruritus, develops in the third trimester and generally first appears on the abdomen, often along the striae,” says Tunzi and Gray. When formed together in a large patch, these bumps are referred to as plaques. During pregnancy, these bumps may develop on the arms, abdomen, buttocks, and legs.

Treatments: According to Tunzi and Gray, “There is no specific treatment for PUPPP, and it is not associated with adverse pregnancy outcomes. Antihistamines and topical steroids may be used to treat pruritus, and systemic corticosteroids may be used for extreme pruritus. The rash typically resolves one to two weeks after delivery.”

To relief the itching, burning or stinging sensations, it is advised to wash your affected skin with lukewarm water and apply cool compresses or wet cloths to the affected areas. Do not use soap on the affected skin, as it will cause more dryness and itching. Also wear loose, lightweight clothing.

04. Stretchmarks

What causes it: Stretchmarks are a form of scarring, which is also known as striae. Rapid growth caused by pregnancy, weight gain, or extreme weight loss, makes the skin stretch, and when the skin is unable to revert back to its pure state, stretchmarks appear. “The skin is like a rubber band: as the pregnancy progresses, it pulls and stretches to accommodate the growth,” says Badescu. “However, if the skin stretches too quickly, and not enough collagen is present, the skin can tear and leave permanent stretchmarks.”

Symptoms: In pregnant women, stretchmarks usually occur on the abdomen, breasts, upper arms, buttocks, and thighs. “Stretchmarks occur in the dermis, the middle layer of the skin that contains Elastin, the component that gives the skin its elasticity,” says Badescu. “These marks may appear as red or purple lines on the lower abdomen, breasts, buttocks, lower back and thighs. Stretchmarks are more likely to appear if you gain more weight than recommended during your pregnancy or weight is gained or lost rapidly. You are more likely to get stretchmarks if your mother or sister had them. African American women are less likely to get stretchmarks than Caucasian or Asian women. If you have stretchmarks from a previous pregnancy, you can also expect a darkening or an extension of the old marks.”

Treatments: Laser or prescription creams can be used to rid of stretchmarks. However, these treatments for stretchmarks can only be used after your baby is born. There are also creams and lotions that you can apply to reduce the appearance of the stretchmarks.

“Like all skin problems, prevention is the most effective means of avoiding stretchmarks,” advises Badescu. “Keep your body well hydrated. Healthy, hydrated skin stretches better. Avoid caffeine because it can increase the likelihood of getting stretchmarks. Consume foods that promote good skin health like fruits and vegetables for Vitamins A and C, nuts for zinc and lean meats and fish for protein. Using a body brush or cloth to gently exfoliate the areas of possible stretching improves circulation which may help the condition. Keeping the skin moisturized at all times will make the stretching more comfortable and less itchy. Age, skin tone and diet all factor into whether or not you will get stretchmarks and to what degree.”

05. Acne

What causes it: During pregnancy, the primary cause of acne is the increase of hormone levels in the first trimester. High levels of hormones increase the skin’s production of natural oils. “The extra hormones in your body cause your oil glands to secrete more oil, which can cause breakouts,” reports American Pregnancy Association.

Should you have a history of acne or are prone to acne breakouts at the start of your menstrual cycle, you have a higher risk of developing acne while you are pregnant. However, it is unlikely that you will have unusual acne breakouts during the second and third trimesters if you do not develop acne in the first trimester.

Symptoms: Whiteheads, blackheads, papules, pustules, nobules and cysts.

Treatments: “The good news is that acne that occurs during pregnancy can be safely treated with a number of effective acne treatments – from over-the-counter products to topical or oral medications depending on acne severity. The key is to consult a board-certified dermatologist to find the acne treatments best suited for each woman’s specific type of acne,” advises the American Academy of Dermatology (AAD).

A daily regime is also important. “Wash skin with lukewarm water and mild cleansers or foams. Avoid cleansers that contain beads that scrub the skin; they are too inflammatory for skin that is already inflamed by acne,” advises board-certified dermatologist Dr. Jonette Elizabeth Keri, MD, PhD, FAAD, associate professor of dermatology and cutaneous surgery at the University of Miami Leonard M. Miller School of Medicine and chief of dermatology at the Miami Veterans Administration (VA) Hospital, both in Miami, Fla.

Always use mild, fragrance-free cleanser and hydrating cleansers. If you have oily hair, shampoo daily and keep hair off your face. Avoid scratching, picking, popping, or squeezing acne spots as these habits can cause scarring. Apart from self-care, you may consider medication as a treatment for pregnancy acne. However, any medication that is applied to your skin or swallowed can enter your bloodstream and can harm your baby. Some acne medications also have high risks of birth defects. Hence, it is important to exercise caution during pregnancy, even with over-the-counter products. Do consult your doctor before using any medications to treat pregnancy acne.

“Acne is not a condition that should be dismissed because a woman is pregnant because it’s important for women to feel good about themselves during pregnancy and particularly post-partum, when ‘baby blues’ or post-partum depression could become an issue,” says Dr. Keri. “It’s really a personalized decision to seek treatment for acne while pregnant, and women should consult their dermatologist to understand the options available to them.”

06. Linea nigra (also known as pregnancy line)

What causes it: Linea nigra is caused by pigmentation due to hormonal changes. It is a natural part of pregnancy, believed to be created by the melanocyte-stimulating hormone, which is produced by the placenta.

Symptoms: A vertical brownish, dark line that develops on the middle of the belly, running from your navel to the pubic bone. It can grow up to 1cm wide. The pregnancy line usually appears during the fifth month of pregnancy and grows darker as the pregnancy develops.

Treatments: There is no treatment to prevent this condition. The linea nigra should fade on its own a few weeks after giving birth.

07. Spider Veins and Varicose Veins

What causes it: Varicose veins and/or spider veins usually develop or worsen during pregnancy. “There are three types of abnormal veins, which are frequently seen in combination,” says The Australasian College of Phlebology. “‘Spider veins’ (telangiectasias) are the fine red capillary veins. The larger blue veins are called ‘reticular veins’, and are slightly deeper below the skin’s surface. Varicose veins are the largest of the abnormal veins, and may bulge above the skin’s surface.”

These abnormal veins develop during pregnancy due to the growing uterus putting pressure on the large vein located on the right side of your body. “Pregnancy results in elevated hormone levels and blood volume, which in turn cause veins to enlarge,” says The Australasian College of Phlebology. “In addition, the enlarging uterus causes increased pressure on the leg veins. Varicose veins occurring in pregnancy will often improve significantly within three months after delivery. However, with successive pregnancies, abnormal veins are likely to get worse. Other predisposing factors include ageing, standing occupations, obesity, lack of mobility, previous venous thrombosis and leg injury.”

Symptoms: Spider veins are small, red, purple, and blue blood vessels that twist and turn. These are easily noticeable on the skin and usually develop on the face and legs. Varicose veins are swollen veins that may protrude near to the skin surface. These blue or purple, and sometimes wavy veins tend to appear on your legs. You may also get them in your vulva or elsewhere. There is little to no discomfort caused, but in some cases, the varicose veins may make your legs feel heavy and sore. The skin around a varicose vein may itch, throb, or have a burning sensation. The symptoms tend to be worse at the end of the day, particularly if you have been on your feet a lot.

Treatments: It is a good measure to not wear tight clothes, exercise regularly, avoid prolonged sitting or standing, and elevating your legs whenever possible. These would ease the pain and prevent your varicose veins from getting worse. You may also wear compression stockings. However, if your varicose veins persist even after self-care, become too uncomfortable to live with, or even if you are unhappy with how they look, there are a variety of treatment options available. Do ask your doctor to refer you to a specialist to have those varicose veins removed.

“Early treatment of varicose veins may reverse the symptoms of venous congestion and minimise the risk of varicose vein-related complications and further progression of the disease,” says The Australasian College of Phlebology.

“Treatment becomes more urgent if there are coexisting complications such as bleeding, inflammation (phlebitis), clots (thrombosis), dermatitis or ulcers. In general, it is much easier to treat varicose veins when they are smaller, as early treatment tends to be less complicated and less involved. It is recommended that varicose veins be treated before pregnancy, since complications such as clotting and bleeding can develop during pregnancy. Varicose veins that have worsened during pregnancy may not fully recover after pregnancy, requiring more involved and complicated treatment than would have been required before pregnancy. Spider veins should be treated only after the varicose veins have been successfully treated.”

08. Skin tags

What causes it: A skin tag is a small fold of tissue that suspends from the skin by a linking stem. Skin tags are usually benign (non-cancerous).

Symptoms: Typically found on the neck, chest, under the breasts, back, and in the groin. They are common in pregnant women and usually painless except if something rubs against them.

Treatments: Skin tags usually disappear after giving birth. Your doctor can professionally remove skin tags if they bother you, by having them cut off with a scalpel or scissors, or with electrosurgery (burning with an electric current).

REMINDER:

While pregnancy-related skin conditions are usually benign, should these skin conditions hurt, irritate or become worse, seek medical attention immediately.