Skin Changes During Pregnancy

During pregnancy and postpartum, your body and your skin go through significant and complex changes. While a shift in hormonal, metabolic, and immunologic processes accommodate and nourish the brand new person that you are creating, you may notice some abnormalities appear on your skin. 

Skin changes associated with pregnancy often have complicated names and might sound scary. But in reality, most of them are a series of pigmentary variations and mucous membranes that fade with time. Other more severe, but mostly temporary issues, may include the appearance of new lumps, blood vessel changes and pruritic lesions. 

Below, we’re taking you through each trimester and the skin conditions you might notice. With most, they’ll pass with time. But if you notice something severe, long-lasting or painful, please consult your doctor. 

THE 1ST TRIMESTER

The Skin “Glow” or Glandular changes are the result of high levels of estrogen and progesterone that stimulate the function of sweat and sebaceous glands. Ever wonder where the proverbial ‘pregnancy glow’ comes from? This is it. This process will cause excessive sweating and a higher production of oil (sebum) on the face. Sebum makes the skin look shinier than usual, giving you a glow. Excess oil can clog pores and retain dirt, increasing the risk for acne and pruritic folliculitis of pregnancy. Don’t fret though, these changes are temporary.

Red Spots or Vascular spiders (spider angiomas) occur during the hyperestrogenic phase of the first or second trimester in up to 67% of pregnancies. Angiomas (or an abnormal growth produced by the dilatation of or new formation of blood vessels) have a central red spot and are surrounded by small blood vessels that fade towards the margins, resembling a spider's body and legs. Angiomas appear on the face and chest as a result of an increase in the mothers' blood volume of up to 50% to supply nutrients and build a new cardiovascular system in the growing baby. These vascular issues disappear after delivery and rarely require specialized treatment. 

Palmar erythema refers to a reddening of both palms and appears in up to 66% of pregnancies. Erythema is also a result of high estrogen levels and goes away after birth. 

THE 2D TRIMESTER

“Mask of pregnancy” or Melasma (Chloasma) is a dark discoloration of the skin that appears on cheeks, bridge of the nose, forehead, chin and upper lip. This condition occurs in up to 75% of pregnancies during the second or third trimester. Melasma is caused by a high level of estrogen, progesterone, and melanocyte-stimulating hormone that stimulate melanin secretion. Melanin is a pigment responsible for the color of the skin, hair and iris of the eyes. Melasma fades away on its own in a few months after giving birth, and in some cases, may require specialized dermatology treatments.

Stretch marks usually occur between the second and third trimester and are associated with partial tears in skin structures produced by weight gain and a growing belly. Stretch marks have a reddish color, with a slightly depressed streak and appear predominantly on the lower abdomen, thighs and breasts. These stretches are among the most feared skin changes, as they tend to be permanent. On the bright side, these marks are a symbol of the miracles your body is capable of and you are definitely not alone in this as almost 90% of pregnant women get a form of stretch marks. In time, these marks become atrophied and less evident. 

Itchy Skin (Pruritus gravidarum PG) is induced by a disturbance in hepatic (from the liver) bile flow and increased circulating bile acids causing the skin to itch. The rates of PG vary from 1% to even 28% of pregnancies. Women with PG experience an intense generalized itching sensation, often involving the face. Skin lesions are usually induced with extreme scratching. This situation may be dangerous for both you and your baby and you should inform your obstetrician about any weird itchy feeling you might experience. 

Pyogenic granuloma or pregnancy tumor (PT) – can occur during the second or third trimester in up to 5% of pregnancies. PT is defined as a small red-colored growth that often appears on the gingiva and sometimes on the lips. This type of granuloma is related to the increased hormones or growth factors that stimulate the formation of new blood vessels. PT goes away after delivery. 

THE 3RD TRIMESTER

Pimples on Stretch marks or Polymorphic Eruption of Pregnancy (PEP) is an itching disorder that can occur in 0.6% of first or multiple (twins, triplets) pregnancies. In some cases, PEP can also appear after giving birth. This condition does not affect face skin, but unfortunately, if you experience PEP, this is when things can get a little rough. Lesions appear as red bumps and swellings of the skin on the abdomen, buttocks and thighs overlapping the stretch marks. The pruritic sensation can be very pronounced and interferes with sleep. PEP is believed to appear as a consequence of rapid or excessive weight gain, and a secondary inflammatory reaction caused by severe damage to the connective tissue or the glue that holds skin cells together. Don`t worry! PEP will pass in a few weeks after onset. 

THE 4TH TRIMESTER

Lightning and resolution of most skin problems occur during the first to second month after bringing your baby into the world. Patience and a little bit of extra skincare might be required. The disappearance of skin issues that lasted for almost nine months is gradual and it might seem like it's taking a long time to get back to normal. Relax, enjoy the new life you brought into the world and everything will be fine.

Here are a few things that you can do to protect your skin during and after pregnancy:

High SPF sunscreen can prevent sunburns and aggravation of any dermal lesions. Women with melasma, in particular, should wear 30SPF regardless of the season. Areas that need protection include the face, cleavage, arms and other skin areas exposed to direct sunlight. 

Use a gentle soap-free and alcohol-free cleanser even if you might be tempted to use products that dry your skin to get rid of the greasy feel. Don`t! These products will only dehydrate your skin and worsen oil production. 

Moisturize daily as the skin can get very dehydrated. Even women with oily skin are prone to dehydration from attempting to remove excess oil. Keep your skin moisturized with a gentle, unfragranced and minimally formulated moisturizer.

Eat a balanced diet rich in antioxidants, essential fatty acids and vitamins. Keep away from processed or sugary foods that can spur inflammatory processes and worsen any of the existing dermal problems. Also, don`t forget to drink enough water to stay well hydrated. 

There’s no doubt that pregnancy skin changes can be scary and confusing, especially if you’re a first-time mom. If you’re feeling this way, know that this is completely natural. It is important to remember that these skin problems are temporary and everything will go back to normal after you’ve brought your beautiful baby into the world. If you have questions about minimizing your skincare routine and the products you use during your pregnancy don't hesitate to contact us by email or by Instagram DM.

References:

Barankin, Benjamin, et al. “The Skin in Pregnancy.” Journal of Cutaneous Med and Surg: Incorporating Medical and Surgical Dermatology, vol. 6, no. 3, 2002, pp. 236–240., DOI:10.1007/s10227-001-0045-6.

Bergman, Hagit, et al. “Pruritus in pregnancy: treatment of dermatoses unique to pregnancy.” Canadian family physician Medecin de famille canadien vol. 59, no. 12, 2013, pp. 1290-1294., PMCID: PMC3860924

Gondivkar, Shaileshm, et al. “Oral Pregnancy Tumor.” Contemporary Clinical Dentistry, vol. 1, no. 3, 2010, p. 190., DOI:10.4103/0976-237x.72792.

Sachdeva, Silonie. “The Dermatoses of Pregnancy.” Indian Journal of Dermatology, vol. 53, no. 3, 2008, p. 103., DOI:10.4103/0019-5154.43203.

Thappa, Devindermohan, et al. “A Clinical Study of Skin Changes in Pregnancy.” Indian Journal of Dermatology, Venereology and Leprology, vol. 73, no. 2, 2007, p. 141., DOI:10.4103/0378-6323.31910.

Vora, Ritav, et al. “Pregnancy and Skin.” Journal of Family Medicine and Primary Care, vol. 3, no. 4, 2014, p. 318., DOI:10.4103/2249-4863.148099.