What kinds of changes does your skin undergo when you're pregnant, and is there any way to prevent or repair pregnancy-related skincare concerns?
Your body undergoes many changes when you're pregnant, and your skin is no exception. Melasma, acne, varicose veins and stretch marks are the most common skin problems that pregnant women face. Each can be treated both during and after pregnancy, says Dr. Eric Bernstein, clinical associate professor of dermatology at the University of Pennsylvania. You can also take important preventative measures.
Melasma, more commonly known as "pregnancy mask," is brown pigmentation around the eyes, on the cheeks and sometimes above the lip. It is caused by the hormonal changes of pregnancy, which make your skin more likely to develop dark pigment when exposed to sunlight. Asian skin can be particularly susceptible to melasma.
Avoiding melasma begins during pregnancy. Always wear an ultra-broad-spectrum sunscreen that blocks both UVA and UVB rays. The best sunscreens contain titanium, zinc or Parsol 1789. You may not feel as if you spend a lot of time outside, but even incidental exposure (such as through your car window) can cause melasma.
If you do develop melasma during pregnancy, ask your dermatologist about a skincare regimen consisting of alpha-hydroxy acids or retinoids after you've given birth. Those products should help speed the exfoliation process and thus help shed the darker cells. For stubborn cases, your doctor may prescribe a low- to mid-potency topical steroid cream, sometimes combined with a series of glycolic-acid peels (anywhere from 3 to 10 depending on the severity of the condition.) Generally lasers are not an effective treatment for melasma; they often exacerbate the condition by making the affected area darker.
The hormonal changes of pregnancy can also exacerbate acne. Some (lucky) women find that their skin clears up during pregnancy, but those cases are relatively rare. More common are persistent outbreaks of whiteheads, blackheads and cystic acne. Treating acne while you're pregnant or nursing can be tricky, and you should be extremely cautious. Many commonly prescribed antibiotics, such as tetracycline and Accutane, are out of the question. However, the antibiotic erythromycin, in either a topical solution or a pill, is usually safe for pregnant women and should help clear up the acne. As for topical preparations, you can also try using AHAs during your pregnancy, but it's best to avoid beta-hydroxy-acid products, which are often used to treat acne. They are related to aspirin, which can be harmful for pregnant women. Before you take any course of action, consult with both your dermatologist and your obstetrician.
Varicose Veins, Spider Veins and Broken Blood Vessels
Varicose veins, spider veins and broken blood vessels are also common during pregnancy, because your blood volume increases when you're pregnant and the baby also puts pressure on your veins. Some will disappear after you give birth, but many can remain.
For broken blood vessels on the face, you might consider laser treatment, since it is safe and can be effective on the face in only one treatment. For the legs, sclerotherapy is also an option. This procedure injects a special chemical (sclerosant) into the varicose vein that causes it to close. It can be used alone or combined with laser treatment. In terms of prevention, support hose may help a little. But if you're predisposed to varicose and spider veins, pregnancy will definitely aggravate them.
Stretch marks are probably the most common skin problems pregnant women face. When the elastic fibers that help the skin stretch become damaged during pregnancy, they reorganize to form a mark. Inflammation also occurs, as evidenced by the redness of many stretch marks. They are not easy to eliminate because it's very difficult to stimulate your body to form new elastin.
An aggressive exfoliation program using AHAs, Retin-A or laser treatments is the best bet for fighting them, but even those treatments won't do a lot to improve the texture of stretch marks. It is easier to reduce the redness of the marks, though, using a pulse dye laser.
Stretch marks can't be prevented, according to Dr. Bernstein. Many women have found that applying vitamin E or very emollient oils to the skin during pregnancy helps, but overall there is no clinical information to support this. It doesn't do any harm, however, so it may be worth a try if you're willing to spend the time on daily application.