From acne and hyperpigmentation to stretch marks and laxity, pregnancy can have a pretty significant impact on the skin. On one end of the spectrum, women tend to enjoy thicker fuller hair during gestation, while increased blood flow helps promote that flushed, pregnancy ‘glow.’ But not all changes are quite so positive. “There are massive changes in the skin in the first trimester and there may be hypersensitivities in the skin,” says skin and wellness expert Marie Reynolds of Marie Reynolds London. Here, we asked the experts what exactly happens to the skin and hair during pregnancy and how to address those shifts.
Not just a teenage concern, acne is common in pregnancy. “Many women who are on oral contraceptive pills have clear skin because the pill regulates the hormones and oil production,” Joshua Zeichner, MD, a board certified dermatologist in New York City. “Going off of the oral contraceptive pill means there is no longer that control.” Additionally, the normal hormonal shifts that women experience during pregnancy stimulate oil glands, pushing them to overdrive, and, often, causing acne, he adds.
But that’s not all. “Pregnancy may mean cravings for food you don’t normally eat and sugary and starchy foods,” Dr. Zeichner says. This increases inflammation in the skin and activates oil production. Reynolds agrees that certain cravings can impact the health of the skin. Sugar cravings, for instance, can create imbalances in the skin and affect the microbiome. “The growing fetus will put pressure on the digestive system, as well,” Reynolds adds. “Be well hydrated and make sure the baby isn’t dictating what you crave.” She recommends eating flaxseeds and chia seeds during pregnancy.
Connecticut-based board certified dermatologist Mona Gohara, MD, says that acne is a wildcard in pregnancy. If you have it, it can get worse or better. If you never had it, you can get it. The tricky part is treatment. As we’ve outlined in our guide to skincare during pregnancy, many common ingredients are off limits for pregnant women. “Even over-the-counter products like benzoyl peroxide shouldn’t technically be used in pregnancy,” Dr. Gohara says.
When fine-tuning your pregnancy skincare regimen, simplicity is key. “I found the brightening, firming and nourishing performance of our Active Botanical Serum indispensable when I was pregnant and even more so once I was raising babies,” says April Gargiulo, founder and CEO of Vintner's Daughter. Time becomes your most precious commodity, so finding a regimen that can give your skin what it needs in as few steps as possible is important, she says.
Pigmentation is another common skin condition during pregnancy, says New York City-based board certified dermatologist Rosemarie Ingleton, MD. Known as the “mask of pregnancy,” Ames Melasma affects many women. Dr. Zeichner notes that the reason for unwanted pigmentation is unclear, but melanocytes (i.e. pigment-producing cells) are sensitive to hormones like estrogen. “During high-estrogen states, pigment-producing cells are pushed to produce more melanin, our skin’s natural pigment,” he explains. To treat it or, at the very least, prevent it from getting worse, Dr. Ingleton suggests using mineral sunscreen and skin brighteners, like her ROSE MD Complexion Brightening Booster Serum. She says to avoid hydroquinone during pregnancy but recommends glycolic acid peels, microdermabrasion, and Clear + Brilliant® laser treatments to address pigmentation in-office.
3. Stretch Marks
Stretch marks are essentially scars that develop when the skin is stretched faster than it can adjust. During pregnancy, the growth of the child can exceed the ability of the dermis to compensate, explains Christopher Funderburk, MD, an associate plastic surgeon at Neinstein Plastic Surgery. The growth is so rapid, in fact, that some areas of the skin are not able to receive the proper amount of nutrient-rich blood, and the collagen and elastin fibers physically break from the strain. This leads to areas of ‘dead’ skin that is devoid of its natural, adaptive properties. “This skin no longer has elastic properties, and the skin has a change in coloration,” he says.
Once the child is born and the skin deflates, you see those areas as stretch marks. They most often show up in the lower abdomen, below the navel, but they can impact the breasts, thighs, and arms as well. “Many patients tell us that they have spent a small fortune on various treatments and have seen little to no effect,” says Dr. Funderburk says. “And, since stretch marks are ‘dead’ skin, no amount of cream or lotion will bring these areas back to life.” Instead, in-office treatments are required.
“During our modern mommy makeover, we are able to remove this area with a simple skin incision,” Dr. Funderburk says. “The incision is often the size of a C-section scar, and we can often place this in an even lower position. Since the incision mimics that of a C-section scar, no one needs to know that the mom ever required a tummy tuck.” Non-surgical treatments for stretch marks include microneedling and Fraxel® laser treatments. It should be noted that white stretch marks are often the most difficult to treat, but Dr. Ingleton says they can be improved a bit by employing one of these options.
4. Abdominal Skin Laxity
Needless to say, the same growth that leads to stretch marks can cause abdominal skin laxity. Dr. Funderburk says that with new, energy-based technologies, skin contraction is possible. “This allows us to combat skin laxity and thereby minimize the length of the incision needed to recreate a taut abdomen,” he notes. Previously, women looking to recreate their pre-pregnancy contour required a lengthy incision. “This is no longer the case, as we employ energy-assisted liposuction devices and treatments such as J-Plasma to contract the collagen fibers and physically shrink and tighten the skin,” Dr. Funderburk shares.
5. Facial Changes
During pregnancy, women commonly gain weight and retain fluid, and this may mean puffiness of the face. In some cases, hormonal changes may cause women to develop dark hair on the chin or sideburns, where they previously did not have it. After delivery, with relatively rapid weight loss after relatively rapid weight gain, the face may appear sunken or hollow. “In some cases this will improve on its own, while, in others, cosmetic procedures like injectables might be needed to restore lost volume,” Dr. Zeichner says.
“When the baby grows, it creates pressure on your venous system and, poof, varicose veins,” Dr. Gohara says. She generally advises leg elevation and, if needed, mild compression stockings. “If they persist, wait until you are done having kids to fix them cosmetically,” she shares. When you’re ready for treatment, check our guide to varicose and spider veins.
Many women experience changes in hair texture and growth during pregnancy. Hormones can make hair grow even faster and fall out less. But it’s important to keep in mind that these changes aren’t permanent. Typically, women shed that hair postpartum or after breastfeeding.
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