Oh Baby! Skin Changes You May Expect When You're Expecting

This month, we are excited to introduce our guest blog contributor, Dr. Rose Chang-Jackson. She is a board certified Obstetrician/Gynecologist, and is currently an Associate Professor at the University of Texas at Houston Medical Branch.

As any woman who has been pregnant in the past or those who are pregnant now knows, your body undergoes extreme changes during those nine months. From the pregnancy weight gain to the increase in shoe size, pregnancy is the only time that a multitude of changes occur in a woman’s body that usually are reversible after the pregnancy has ended (yes, ladies, we can lose that pregnancy weight!). The skin is also an area that undergoes a metamorphosis. Due to the increased amounts of pregnancy related hormones that course through a woman’s body, the skin, hair and blood vessels may change either subtly or quite dramatically. We will be discussing some of these normal physiologic changes today.

Hyperpigmentation: Approximately 90% women will be experiencing some degree of skin darkening from melanin deposits, especially in brunettes and those with darker complexions. If the pigmentation occurs in the face, it is referred to as chloasma or melasma. This condition may worsen with UV light exposure, which can be prevented by use of sunscreen and avoiding direct sun exposure. The majority of hyperpigmentation resolves after pregnancy, but 1/3 of patients can experience lingering effects up to 10 years later. Oral contraceptives can aggravate melasma, as can continued sun exposure. Speak to your dermatologist regarding treatment and continue wearing sunscreen daily.

Freckles: Most people have some form of freckling on their skin. During pregnancy, these freckles may enlarge or darken. Although this may be a sign of malignant transformation in those who are not pregnant, studies have shown this is usually normal in pregnancy. You may also grow skin tags during your pregnancy, and these are easily removed if needed.

Changes in hair growth: Have you ever noticed how a woman glows during her pregnancy? Part of this has to do with her healthy, lustrous hair. During pregnancy, the growing hair phase is increased relative to the resting hair phase, which means that women will grow more hair and shed less. Unfortunately, this lasts only as long as the pregnancy. During the first four months after the pregnancy ends, most women will experience rapid shedding of this hair, usually associated with brushing or washing. Fortunately, this process is self-limited and most normal hair growth is restored in the first 6-12 months. Some woman also experience mild excess hair growth over the rest of their body, referred to as hirsutism. This may be more noticeable on the face, especially in those women who are genetically predisposed to course hair growth. Again, fortunately, this will resolve in the first few months after delivery. If the hair growth seems excessive, you may need to be evaluated by a dermatologist to determine if this is caused by another condition other than pregnancy.

Pregnancy Glow: About that glow...it is caused by and increase in blood flow, which means more blood is circulating in your body. Your body is also producing more oil, leaving your face more shiny than usual.

Changes in blood vessels: Our blood vessels near our skin surfaces also change in pregnancy. Here’s a fun fact: for those women who notice that they are icing their partners out of bed at night, the reason is that our blood vessels near the surface of our skin increase the rate of blood flowing through them. They do so to release the heat generated by increased metabolism during the pregnancy. Other changes to your vessels include the appearance of spider angiomas – 2/3 of white women and 10% of black women will experience this during their pregnancy, most of which resolve after delivery. A condition called palmar erythema may also occur in 2/3 of white women and 1/3 of black women, where the palms become reddish in color. Approximately 5% of women will see small blood vessels appear along their head and neck, known as capillary hemangiomas. The growth of blood vessels may also affect a pregnant woman’s gums, where they bleed more, known as pregnancy gingivitis. This is why it is emphasized during pregnancy to visit your dentist and practice proper dental hygiene.

Stretch Marks: Stretch marks are one of the most talked about skin changes that can occur during pregnancy. Many pregnant women will experience stretch marks. Stretch marks appear as pinkish or reddish streaks running down your abdomen and/or breasts. Exercising and applying lotions that contain vitamin E and alpha hydroxy acids have been said to help in the prevention of stretch marks. These remedies have not been medically proven to have a direct effect on stretch marks, but it never hurts to try. You can also try creams with retinoids (after you deliver and finish breast feeding because retinoids are not safe during pregnancy) and lasers to help treat them. If you find that nothing is working for you, take comfort in knowing that these streaks will fade to silvery faint lines after delivery.

Linea nigra: This is a dark brown vertical line that runs from your navel to your pubic bone. Linea nigra is due to an increased pigment producing hormone made by the placenta. There is not much you can do about the line, but rest assure after you deliver, the line will fade with time.

Acne: Sorry ladies, not all women get that pregnancy glow. Acne is caused by many reasons, and during pregnancy, it is typically caused by your changing and increasing hormones. The higher level increases the skin's production of natural oils. It is hard to predict who will develop pregnancy acne. You have a higher risk if you have a history of acne or have acne flares at the start of your menstrual cycle. Managing acne when you're pregnant can be tricky. That's because many prescription and over-the-counter treatments come with a high risk of birth defects. Make sure you consult your doctor before starting any medications while your pregnant and breast feeding.

Dr. Cindy N. Berthelot, M.D. is a board certified dermatologist treating patients in the greater Houston community, including the Clear Lake, Webster, Friendswood, Deer Park, Pasadena, and Pearland areas. To make an appointment with Dr. Berthelot, please contact us at (281) 480-7272.