Skin Changes During Pregnancy: What to Expect

(Photo Credit: Our Adventuring Souls Photography)

It’s no secret that pregnancy takes a massive toll on one’s body, but did you know pregnancy can affect your skin, as well? These changes are normal and happen to many pregnant women, occurring as early as the first trimester. While most skin conditions that appear during pregnancy will clear up after delivery, some issues can last longer or even be permanent. In this post, we will explore common skin conditions that arise during pregnancy, as well as give advice on how to prevent them and when to seek the opinion of a dermatologist.

Common Skin Changes During Pregnancy

Understanding skin changes during pregnancy and knowing how to manage them can help you embrace this unique phase of life. While most of these issues will happen regardless of preventive measures, there are some things you can do to reduce your risk. The most common skin changes you might experience during pregnancy are:

Stretch marks (striae gravidarum)

Stretch marks are among the most well-known skin changes during pregnancy. They can appear on the abdomen, breasts, hips, and thighs as your skin stretches to accommodate a growing belly. These marks, often reddish or purple at first, may eventually fade to a lighter color postpartum. There have been no topical agents that have been proven to prevent or reduce stretch marks, as there lacks high-quality evidence on the efficacy of the products being used. Interestingly, perhaps the benefits of massage alone may be helpful to help reduce the development of stretch marks. Centella asiatica extract is thought to be a helpful ingredient for collagen production and can be found in some stretch mark creams marketed to women in pregnancy.

Spider angiomas

Spider angiomas, those small “red dots” or “red bumps” that pop up on your body, can be a common occurrence for men and women, but they particularly affect women during pregnancy. The good news is that many of them may resolve after delivery. These tiny blood vessels, called capillaries, become more visible due to hormonal changes. Postpartum, if persistent, these can be treated cosmetically with various in office treatments.

Hair growth

Pregnancy hormones can lead to increased hair growth, and not just on your scalp. Many women experience thicker and faster-growing body hair during pregnancy, as well. Enjoy those luscious strands while they last, as hair shedding (telogen effluvium) can occur up to 15 months postpartum.

Melasma (mask of pregnancy)

Melasma, often referred to as the “mask of pregnancy,” manifests as dark patches on the face. Hormones and sunlight trigger this condition, making sun protection crucial. Wearing sunscreen and sun-protective clothing can help reduce the risk of developing melasma, and while it usually fades following delivery, it can persist, especially in individuals with darker skin types. Keep melasma from getting worse by practicing strict sun protection. Wear SPF 30 or more, choose a physical (mineral) sunscreen that contains zinc oxide and/or titanium dioxide and wide-brimmed hats. Ingredients like topical vitamin C and azelaic acid can be used to combat pigmentation in pregnancy and breastfeeding women.

Linea nigra

Some pregnant women develop a vertical dark line on their bellies, known as linea nigra. This pigmentation usually lightens postpartum as hormonal levels return to normal.

Skin tags

Skin tags, small flaps of skin, can appear during pregnancy, often in areas like the neck and underarms. Although some resolve postpartum, others may persist and, while there is no certain way to prevent skin tags, they are easy for a dermatologist to safely remove.

Acne

Pregnancy can bring about changes in skin texture, including acne. Establish a good skincare routine, including gentle cleansing, moisturizing, and sunscreen. If needed, consult a dermatologist for pregnancy-safe acne treatment options.

Pregnancy glow

The “pregnancy glow” is not just a myth. Increased blood volume and hormonal changes boost blood circulation, giving your face a brighter appearance. Enjoy this radiant look while it lasts, as it typically dissipates after childbirth.

Varicose veins

Varicose veins, bulging blueish veins that appear on the legs during pregnancy, occur due to increased blood flow demands to support the baby. To minimize their development, elevate your legs, wear compression stockings, and stay physically active. Treatment options such as laser therapy, sclerotherapy, and vein removal surgery can be considered postpartum for any remaining varicose veins.

Spider veins

Like varicose veins, spider veins are small reddish veins with numerous “branches” that spread outwards. The steps to minimize their development are the same as for varicose veins. Postpartum, you can explore treatment options to address spider veins as well.

Skin darkening

Changes in hormones can lead to pigmentation changes in areas like freckles, moles, nipples, and the labia. While there is no way to prevent or limit these changes, it is essential to have your dermatologist screen your moles for any irregular changes in shape or appearance.

When Do These Changes Occur?

Skin changes during pregnancy can occur at various times throughout the gestational period. These changes are primarily driven by hormonal fluctuations, increased blood circulation, and the physical stretching of the skin to accommodate a growing belly. While the timeline for when these changes occur can vary greatly from person to person, they are all very common and most—if not all—women will experience at least a couple of the conditions during their pregnancy.

First Trimester (Weeks 1-14):

• As hormonal changes start to take effect, some women may notice mild skin changes, such as a subtle pregnancy glow or acne.
• Hair growth changes, including increased hair thickness, may also begin in the first trimester.

Second Trimester (Weeks 15-27):

• Many skin changes become more noticeable during the second trimester.
• Stretch marks may start to appear as the skin begins to stretch to accommodate a growing uterus.
• Skin darkening, including the development of melasma or linea nigra, may become more prominent.
• Increased oil production can lead to acne breakouts in some women.
• Spider angiomas and skin tags may begin to appear.

Third Trimester (Weeks 28-40+):

• Stretch marks may continue to develop and become more visible.
• Varicose veins and spider veins may become more pronounced due to increased blood volume and circulation and pressure on the veins.
• Skin darkening and hyperpigmentation may persist and become more noticeable.
• Hair growth changes, including thicker hair, may continue.

What Causes These Changes?

Skin changes during pregnancy are primarily driven by hormonal fluctuations and the body’s adaptation to the demands of pregnancy. Elevated hormone levels can lead to increased sebum oil production, potentially causing acne breakouts, and can also trigger pigmentation changes in various areas of the skin. The increased need for blood flow to support the developing baby may lead to the formation of unwanted veins, such as varicose veins and spider veins. Additionally, the natural expansion of the tummy, breasts, and hips to accommodate the growing baby can result in the development of stretch marks. It is important to understand that these skin changes are entirely normal and are part of the remarkable journey of pregnancy.

When to See a Dermatologist

Most of the skin changes experienced by pregnant women are entirely normal and naturally revert after childbirth without requiring any intervention. However, for women who find themselves still grappling with unwelcome skin changes following delivery, it is advisable to seek guidance from a Board Certified Dermatologist. They can assess the situation and discuss suitable treatment options to address any persistent concerns and help restore your skin’s health and appearance.

Dr. Kellie Reed specializes in aesthetic skin care, general medical dermatology, pediatric, and rheumatologic dermatology. She is passionate about her patient care and attention to detail, and her positive attitude provides a sense of comfort for her patients. Dr. Reed is a member of the Travis County Medical Society, Texas Medical Association, Texas Dermatological Society, Austin Dermatological Society, Women’s Dermatologic Society, Rheumatologic Dermatology Society, and the American Academy of Dermatology.