Acne – occurs when the skin pores become clogged with excess sebum, dirt and dead skin cells. Bacterial infection can then lead to further inflammation of the skin and the eruption of pimples.
While occasionally, pregnancy improves acne, more often it causes flares ups. This is because the high levels of hormones circulating throughout the body stimulate the sebaceous (oil-producing) glands to increase their production of oil, or sebum.
Although the physical effects of acne are usually only cosmetic, the condition can have a negative effect on your state of mind and self-esteem. You will need to speak with a dermatologist before you begin any treatments while pregnant or breastfeeding, as some must be avoided for the health of your child.
For more information on acne and its causes, symptoms and prevention, refer to the Acne article on our Science of Skin website.
Linea nigra – 75% of pregnant women have linea nigra, a narrow line of dark skin down the middle of the abdomen. As with other areas of increased pigmentation, it is thought to occur due to hormones stimulating the production of pigment in the skin. It appears on the midline as the abdominal muscles pull away from one another and extend, adjusting to the expanding uterus. Many women notice this streak below their navel only, whereas in others it can reach right up to the breastplate (sternum). Generally appearing during the second trimester, linea nigra tends to fade or completely disappear in the weeks following the birth.
Melasma (Chloasma or ‘mask of pregnancy’) – the darkening of skin in grey or brown patches on the face, usually on the forehead, cheeks or chin. The colour change is due to an increase in the skin pigment called melanin and is brought about by hormonal changes during pregnancy. Since exposure to UV radiation aggravates the condition, avoiding the sun and using a broad-spectrum, high SPF sunscreen can help to prevent the excess pigmentation developing. The pigmentation usually disappears following birth and, in the meantime, cosmetics can be used to cover any irregularity in skin tone.
Prurigo – the medical term for itchy skin, a common complaint during pregnancy, especially on the palms and soles of the feet. The itchiness can be caused by a number of factors, including cholestasis; a build-up of bile in the blood. Sometimes there is an underlying skin condition, such as contact or atopic dermatitis, which is exacerbated by pregnancy, other times the cause is unknown. Treatment usually involves applying emollients and topical steroids, plus addressing any other contributing factors, which should always be done in consultation with a medical professional.
Psoriasis – as with many preexisting skin conditions, pregnancy can affect psoriasis, a chronic skin condition in which patches of skin become red, inflamed and covered by white, flaky skin. These outbreaks occur because skin cells are produced more quickly than normal, causing a build-up which creates the plaques; this is thought to be caused by faulty signals from the immune system. Pregnancy can occasionally exacerbate psoriasis, however more often, women notice an improvement in their condition during this time.
Skin tags (Acrochordons) – small, light coloured nodules attached to the body by a stalk. During pregnancy, these commonly grow in the folds of skin of the armpits or beneath the breasts and are thought to be caused by skin rubbing against skin; there may also be some hormonal involvement. Skin tags are soft, benign growths consisting of collagen fibres and blood vessels covered in skin. While they usually regress in the period after the delivery, those which remain or become bothersome can be removed by; electrocautery (using an instrument heated with an electric current to burn tissue), cryotherapy (freezing) or surgical excision.
Stretch marks (Striae gravidarum) – red, purple, pink or white striations which occur as a result of over stretching the skin. They commonly arise on the abdomen of pregnant women as the connective tissues beneath the skin tear as it stretches to accommodate the rapidly growing fetus. The breasts and hips are other sites commonly affected during pregnancy.
Studies show that somewhere between 60% and 90% of caucasian women who are pregnant develop stretch marks, with the lesions being less prevalent in women with darker complexions. While stretch marks rarely lead to further complications, many women find them cosmetically unappealing. Over a length of time, stretch marks often fade to a pearly or flesh colour, becoming much less visible. In severe cases, where the lesions may be troubling, the following treatment options may offer some improvement, though effectiveness varies significantly from patient to patient; moisturising oils, topical retinoid therapy, chemical peels or pulsed-dye laser therapy.
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