Skin changes during pregnancy are common—even expected—and although they may be initially concerning, they generally pose no danger to the health of the parent or the baby. These changes can be divided up into three categories: hormone-related, pre-existing (like atopic dermatitis and psoriasis), and pregnancy-specific.

Read on for an overview of the most frequent hormonal skin conditions that can occur during pregnancy.

Hormonal Skin Changes During Pregnancy

Acne

Hormonal shifts are the usual culprit behind pregnancy breakouts. In most instances, progesterone pushes oil glands into overdrive, resulting in clogged up pores, bacteria buildup, and pimples. In general, gentle cleansers, moisturizers, and minimal manipulation—that means no picking or popping—is the best therapeutic approach. There are medications and topical treatments that can be used for blemishes during pregnancy; however, this is something that should always be checked with a Dermatologist or Obstetrician, as even some products sold over the counter may not be advisable.

Note also that those who struggle with acne prior to conception may get a welcome reprieve during this time.

Melasma

Melasma, also dubbed the "mask of pregnancy," is characterized by patchy brown discoloration on the face. Melasma usually occurs on the upper cheeks, upper lip, and forehead, but it may appear on any facial skin. People with melanin-rich skin, such as Latinx, Asian, Black, and Middle Eastern individuals, have higher incidences of this condition. Melasma is thought to occur most commonly as a result of hormonal shifts and exposure to ultraviolet, blue light, heat, or pollution. Those taking oral contraceptives may also experience melasma.

Treatment usually focuses on very judicious sun protection, including the daily use of a broad-spectrum sunscreen with SPF 30+ year-round, with reapplication every two hours when outside or sweating. And yes, sunscreen is safe to use while pregnant. Broad-brimmed hats and sunglasses are part of the plan as well, as is seeking shade when the sun is strongest. What's more, computer screens, cell phones, and indoor light bulbs are also potential sources that may induce melasma, so using sunscreen indoors is important. After pregnancy, if the skin changes persist, there are topical creams and medications that can be prescribed.

Pregnancy can also bring about hyperpigmentation in other areas of the body. This commonly results from spikes in estrogen and melanocyte-stimulating hormones. This darkening is most often seen on the abdomen, areola, genitals, underarms, and inner thighs. No treatment is necessary, seeing as complete resolution generally occurs after delivery.

Striae Gravidarum

Striae Gravidarum is the full scientific name for one of the most common effects of pregnancy: stretch marks. These marks can appear as pink-purple lines or bands on the abdomen, buttocks, thighs, breasts, or arms. Those with a family history of striae, those carrying larger babies, and generally younger individuals are all predisposed to striae. This results from the skin being stretched and a hormonal relaxation of the elastic fibers. Although many creams claim to prevent and treat striae, there is little scientific evidence they truly work.

Postpartum treatment with retinoids and in-office devices, such as a laser treatment, may provide some benefit. It's always wise to consult with a Dermatologist if you are looking for any treatment.

Vascular Lesions

Estrogen in pregnancy can cause dilatation, instability, multiplication, or congestion in blood vessels. When capillaries in the skin widen or dilate, spider angiomas can result. As the name suggests, these can resemble little threads of a spider web. Reddening of the palms and hemorrhoids are additional examples that result from hormonal effects on blood vessels.

If lesions persist after childbirth, there are multiple procedural options for treatment.

Pre-Existing Conditions and Pregnancy-Specific Dermatosis

Falling in the category of pre-existing skin conditions, eczema and psoriasis may get worse or improve during pregnancy. It is best to consult with a board-certified Dermatologist to come up with a treatment plan that is safe and effective, should it be necessary.

As far as pregnancy-specific conditions, there are a host of rashes that only those who are pregnant will experience. These are separate from the other two categories noted above. If at any point, a pregnant individual sees changes in their skin, consultation with a board-certified Dermatologist is strongly advised, given that the experience varies so much.

Remember: Your Derm Is Your Best Friend

Pregnancy treats everyone differently, so a trained medical professional is the best person to show you the way forward when it comes to your pregnancy-related skin concerns. It's a good rule of thumb to check in with your Dermatologist when you observe any skin changes at all, pregnant or not.

Again, the conditions discussed here are not a cause for any medical concern, but understandably, many will want to know what's going on with their skin. As a parent, it's more important than ever to be diligent in forming good health habits, so take care of your skin, keep your eyes open for changes, and consider giving your Derm a call today.

Author

  • Dr. Mona Gohara is a Connecticut-based Dermatologist and associate professor of Dermatology at Yale School of Medicine. She has a particular interest in skin cancer prevention and treatment for skin of color. Dr. Gohara spends a lot of time outdoors with her husband, son, and two dogs, Coco and Cleo. They all wear sunscreen.