Skin during pregnancy

Many skin changes result from the altered levels of hormones which occur during pregnancy.The changes that occur in the skin during pregnancy are related to different aspects of the skin’s structure. We can group these into four types:

  1. changes in pigmentation (the colour of the skin);
  2. changes in the function of the skin’s glands;
  3. vascular changes (affecting the blood vessels beneath the skin); and
  4. changes in the connective tissue which holds skin together.

Many of these changes result from the altered levels of hormones which occur during pregnancy or from the physical stretch and strain on the skin. Fortunately, most are only temporary and subside or lessen shortly after delivery.

Skin changes during pregnancy

Pigmentation (colour changes)

Changes in skin pigmentation during pregnancy may involve an increase in pigment (skin darkening), or a loss of pigment (skin lightening).

Hyperpigmentation, or darkening of the skin, is extremely common; particularly during the first trimester of pregnancy. Up to 90% of pregnant women experience an increase in skin pigmentation on various parts of their bodies. It usually occurs on areas of skin which were darker to begin with, such as moles, freckles, nipples and genitals. Most experts attribute these changes to increased hormone levels (estrogen, progesterone and α-MSH) in the blood. It is thought that skin cells, called melanocytes, are stimulated by the hormones to produce more of the brown pigment (melanin) in the skin.

Melasma is common during pregnancy. Image: Jmh649 from Wikimedia commonsIt is well known that folic acid can reduce the risk of neural tube defects in babies, but studies have also shown a link between folic acid deficiency and hyperpigmentation. Ensuring you get enough folic acid, by taking supplements and eating plenty of folate-rich foods (leafy green vegetables, citrus fruits and legumes), can therefore help to minimise unwanted skin darkening.

Melasma, a type of facial skin darkening, and linea nigra, the formation of a dark line down the centre of the abdomen, are two common pigmentary changes to occur during pregnancy.

Glands

Most women will find that they sweat (perspire) more during pregnancy; in some cases this can be quite profuse. Once again, this is due to the increase in hormones affecting the operation of the sweat glands in the skin.

The influx of hormones during pregnancy can also stimulate the oil-producing (sebaceous) glands in your skin to secrete more oil (sebum). This can lead to worsening acne, particularly in women that had a preexisting problem or suffered from acne during adolescence.

Vascular

A pregnant woman’s body also produces much more blood (some studies suggest up to 50% more) than normal to adequately supply the growing fetus. As a result, the small blood vessels beneath the skin surface dilate and become more permeable, those penetrating the skin can also become more numerous and visible. These changes in blood and vessels can cause unwanted spider and various veins, however the increased circulation is also responsible for the phenomenon of radiant skin known as the ‘pregnancy glow’.

Connective tissue

Pregnancy places a huge strain on the body, and the skin is no exception. Often the tissue beneath the skin tears if the skin is overstretched. This can create stretch marks on the abdomen as the skin is pulled over the expanding uterus, or on the breasts as they enlarge. Another change to the structure of the skin which is relatively common is skin tags, small, soft growths (usually in folds of skin) made up of collagen fibres and blood vessels.

Changes to the skin on the breasts

In addition to darker skin on the nipples, the areolas, the circular area surrounding the nipple, often expands during the first trimester. The small bumps on the areolas are actually specialised oil glands, called Montgomery’s tubercles, these may protrude more during pregnancy and lactation.

As well as stretch marks on your breasts, you may notice the veins beneath the skin become more obvious. Early in the pregnancy, your body begins to make colostrum, a thick, yellow liquid which the baby is first fed on. Small quantities of colostrum may leak from yours breasts towards the end of the pregnancy.

Skin care during pregnancy

  • Use a gentle cleanser that is oil and soap-free to wash your face twice each day. Rinse away any traces of cleanser with warm water and pat your face dry with a clean towel.
  • Avoid harsh chemicals, vigorous scrubbing or cleansing too often, as these can remove the natural oils from your skin, making it produce excess to compensate.
  • After cleansing, apply a mild, oil-free moisturising lotion to keep your skin soft, supple and hydrated.
  • Stay properly hydrated by drinking plenty of water; this helps your skin maintain its water content and appear smooth and bright.

References

BabyCenter 2010, ‘Breast changes during pregnancy’, retrieved 24 March 2011, <http://www.babycenter.com/0_breast-changes-during-pregnancy_262.bc>.

Boutros, S, Régnier, S, Nassar, D, Parant, O, Khosrotehrani, K & Aractingi, S 2009, ‘Dermatological Manifestations Associated With Pregnancy’, Expert Review of Dermatology, 4(4):329-340.

Gentili, A & Vohra, M 2009, ‘Folic Acid Deficiency’, eMedicine, retrieved 30 March 2011, <http://emedicine.medscape.com/article/200184-overview>.

Pomeranz, MK 2010, ‘Physiologic changes of the skin, hair, nails, and mucous membranes during pregnancy, UpToDate, retrieved 24 March 2011, <http://www.uptodate.com/contents/the-skin-hair-nails-and-mucous-membranes-during-pregnancy>.

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