Can skin changes in pregnancy be harmful?
Whilst common pregnancy skin changes pose no health problems, you should always talk to your GP if your skin is inflamed, blistered, or you have a rash, irritation or itchiness that lasts more than a couple of days.
Because other conditions, unrelated to pregnancy, could bring about skin discoloration, you should always check with your doctor or midwife if you notice any changes, such as a change in the color or size of a mole, or if pigmentation changes are accompanied by pain, tenderness or redness.
Your doctor will be able to diagnose the condition, and make sure that you are given the appropriate treatment, should it be necessary.
Chloasma (pigmentation changes on your face and neck)
Also known as the “mask of pregnancy”, chloasma has the appearance of brown patches of pigmentation on the forehead, cheeks, and neck. On darker-skinned women, they appear as lighter patches. It’s caused by the increased production of melanin, the tanning hormone, which protects the skin against ultraviolet light.
Exposure to sunlight will darken the patches, making them more obvious, so protect your skin with a high factor sunscreen (SPF15 or more) and/or hat whenever you go out. If you feel the patches look unsightly, try blending in the color with a tinted foundation. They will begin to fade within three months of your baby’s birth.
Linea nigra (dark line running up your tummy)
This is a dark, vertical line, up to a centimeter wide that appears down the middle of your stomach, often crossing the navel. It tends to appear around the second trimester. It is caused by pigmentation in the skin where your abdominal muscles stretch and slightly separate, to accommodate your baby as it grows.
This line of pigmentation will fade within a few weeks of delivery, although you may need to give it a gentle rub to remove any dry skin. You will notice that other areas with pigmentation – such as your nipples, moles and freckles – may darken too, but this will also fade with time.
The “bloom” or “glow” of pregnancy is not just a saying. Your skin retains more moisture during pregnancy, which plumps it up, smoothing out any fine lines and wrinkles that you may have. The pinkish glow that makes you look radiant is due to increased levels of blood circulating round your body. This may also make you feel slightly flushed sometimes.
The downside of this effect is that you may look puffy from water retention and that any red patches that you already have on your face may become more visible.
Don’t try to cut down on drinking water – your body needs fluids – but rest as much as you can. Any red patches will eventually calm down once you’ve given birth, but if you want to hide them, try using a moisturizing foundation.
These tiny clusters of broken capillaries (small blood vessels), or spider naevi as they are sometimes known, most often appear on the cheeks. They are common in pregnancy, particularly if you are already prone to them. They are caused by the increased volume of circulating blood putting extra pressure on the capillaries, which are also more sensitive during pregnancy.
To reduce the chances of spider naevi appearing, protect your face from extremes of cold or heat, as exposure to either can encourage the problem. The veins will fade once your hormone levels have settled down after delivery.
Spots and acne
Pregnancy can sometimes trigger acne, which many of us have not experienced since adolescence. Higher levels of hormones can encourage the production of sebum – the oil that keeps our skin supple – and too much sebum causes pores to become blocked, resulting in greasy skin and spots.
Cleanse regularly with a gentle cleanser and use an oil-free moisturizer. If you prefer to avoid skin products, keep your skin fresh and clean by patting it dry rather than rubbing, so that you minimize the irritation to the acne.
Don’t use acne creams or treatments unless your GP advises you to do so – some of them cannot be used when you are pregnant. A few weeks after your baby is born, your skin should return to its pre-pregnancy condition.
The thin reddish or brownish (depending on your skin color) lines of stretch marks usually appear on the abdomen, breasts and thighs. They affect between 75 and 90 per cent of pregnant women and may appear as you put on more weight during pregnancy, causing the skin to stretch.
Higher levels of hormones also disrupt your skin’s protein balance, making it thinner than usual. After pregnancy, the reddish or brown pigmentation in the stretch marks gradually fades, and the streaks become lighter than the surrounding skin. It can take some time for them to fade.
Some lucky women have more elastic skin than others, meaning they won’t get stretch marks, but for most of us they are simply a fact of pregnancy. You can try to minimize them by avoiding putting on weight too quickly, rubbing oil or cream rich in vitamin E over your abdomen to keep it supple, eating a healthy diet rich in vitamins E and C, and in zinc and silica to help to keep your skin healthy.
A research review of creams for preventing stretch marks found only one study, based in Spain, which showed creams to be of benefit. This was by massaging with a cream called Trofolastin, containing the active ingredients Centella asiatica extract, alpha tocopherol (vitamin E) and collagen-elastin hydrolysates. This cream is currently unavailable in the UK.
As you put on weight, chafing can take place between your thighs or under your breasts, resulting in red, moist skin. Your skin may then become inflamed and blistered and you may notice an odor. This is a condition known as intertrigo.
Keep the affected area as dry as possible and use talc to help absorb any moisture. Keep your skin cool by wearing cotton clothes and avoid wearing tights.
See your GP about this chafing, especially if you are sweating a lot, as it may cause a fungal infection called thrush to develop. It is important to clear this up before your baby is born or it can be passed on to your baby.
Sensitive, irritated skin
Skin tends to become more sensitive during pregnancy, not only due to higher hormone levels, but because it has become more stretched and delicate. Soaps and detergents may suddenly cause irritation, or conditions such as eczema may become worse. Your skin may become more prickly than usual when exposed to sunlight.
Try to identify what could be causing your irritation – could it be your washing powder or a perfume that you use? Also, choose loose, cotton clothes and keep your body well-moisturized. Long soaks in a warm bath will dry out your skin so keep these to a minimum, or add bath oil that will help keep your skin supple. (But make sure you don’t slip when you’re getting in and out of the bath).
Finally, always protect your skin from the sun with a high-factor sunscreen (SPF15 or more).
Rashes and itchiness
It is common for temporary rashes and itchiness to come and go during pregnancy, without any obvious cause. Increased hormone levels make you more sensitive to contact with substances that would not normally affect you. For instance, you may find you become sensitive to chlorine in the local swimming pool.
Thrush, which causes vaginal itching, and piles, which can cause itching around the anus, also occur more often in pregnancy. Wear light, loose-fitting cotton clothes to keep your body cool. Talk to your GP about safe treatments to use for thrush and piles – you may be given advice on increasing the fiber in your diet as a first line attack for piles.
For other areas, dabbing on calamine lotion should reduce the itching. If your rash or irritation lasts longer than a couple of days, get advice from your GP.
Intense itching all over, particularly at night and on the palms of your hands and the soles of your feet, can be a sign of a rare liver disorder, obstetric cholestasis, that only occurs in pregnancy. It tends to appear in the third trimester, from about 28 weeks pregnancy, and usually clears up within three weeks of delivery.
Although the exact cause is unknown, it is thought that high levels of oestrogen in pregnancy can prevent the liver from functioning properly resulting in increased levels of bile salts. The itching can be intense and sometimes intolerable and it can be worrying to find out that your liver is not working properly, but obstetric cholestasis will not damage your health.
The risks for your baby are less clear. Early research in the 1970s linked the condition to stillbirth but new evidence suggests that the risk of stillbirth is no higher than that for the rest of the population. There is no evidence that obstetric cholestastis affects your baby’s growth or causes disability. Further research is needed.
For more information see the Royal College of Obstetricians & Gynaecologists leaflet on obstetric cholestasis at www.rcog.org.uk.
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