Pregnancy and your skin
Our body changes more during pregnancy than at any other time in our lives. Growing a new life is hard work, and we dutifully accept some of the necessary physical changes, but when we think of stretchmarks and spider veins we solemnly hope that we will somehow manage a clean escape. The reality is, most women will experience some skin changes during pregnancy. Most of these changes will be temporary and resolve after birth, but some may bear a permanent reminder of the physical investment their body made to bring precious new life to the world.
Skin changes during pregnancy
Roughly 90% of pregnant women will see stretchmarks, or striae distensae, appear during their pregnancies. That swelling uterus causes pressure on the skin from the inside, known as distension. During pregnancy, distension and stress hormone production can lead to the tearing and reorganisation of collagen and elastin fibers deep within the cellular structure of the skin, resulting in the visible appearance of stretchmarks. Stretchmarks do have a strong genetic component, with women who have pre-existing breast and thigh stretchmarks being more likely to experience them during pregnancy. Although disheartening to witness in the beginning, stretchmarks will fade dramatically over time.
Spider angiomas, more commonly known as ‘spider veins’ appear as a central red spot with reddish extensions which radiate outwards, similar to a spider’s web. In pregnancy, spider veins typically occur on the neck, throat, face, upper chest, arms and hands. The effects of progesterone during pregnancy causes significant vascular changes that can result in spider veins, particularly the widening of blood vessels, or the vasodilation that occurs as progesterone relaxes smooth muscles. Spider angiomas may resolve after pregnancy, but often remain permanently.
Many women experience changes to the colour of their skin during pregnancy. Pigmentation changes are driven by increased levels of estrogen and progesterone, which increases the output of melanin by the melanocytes in our skin. Small changes in pigmentation typically occur in areas of the body that are already slightly darker in colour, or in places that undergo friction. These include the nipples and areola, the skin around the umbilicus, the midline of the abdomen (linea nigra) and the inner thighs and underarms. Some women experience pigmentation changes to the skin on their nose, cheekbones and forehead in the shape of a mask, commonly known as ‘the mask of pregnancy’. Wherever it’s located, pigmented skin usually lightens after delivery and returns to its normal colour not long after baby goes home.
Sweat gland activity generally increases during pregnancy often leading to excessive sweating or hyperhidrosis. Miliaria, commonly known as heat rash may develop.
Acne is common during pregnancy, affecting about 1 in 2 pregnant women. The likely cause of acne during pregnancy is our changing hormones, particularly the secretion of androgens, like testosterone and DHEA. Increased androgen secretion during pregnancy can increase sebaceous gland activity and sebum production leading to the development of acne. See ‘Acne relief for teenage skin’ for a more detailed acne overview.
What can be done?
Taking care of what we put in our bodies and on our skin is essential for proper skin health in pregnancy and beyond. Pregnancy is an ideal time to review and optimise your diet. The foods we eat during pregnancy can have profound effects on how we look and feel, and can have long-term health benefits for our baby.
Wearing loose, comfortable clothing made from breathable fabrics, especially in warmer weather, dissipates heat, reduces friction and can help mimimise some pregnancy-related skin conditions.
Remember, pregnancy-induced skin changes are typically mild in nature and will resolve after baby is born. Focus on enjoying the new-found radiance in your complexion and the remarkable function that your body is performing as it grows a whole new life.
Women experiencing extreme cases, or who are unsure, should seek advice from their obstetrician, midwife or pregnancy care provider.
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• Thiboutot D, Gilliland K, Light J, Lookingbill D (1999) Androgen metabolism in sebaceous glands from subjects with and without acne. Arch Dermatol 135: 1041-1045
• Sumit K, Ajay K, Varma SP (2012) Pregnancy and Skin. J Obs Gyne India 62(3):268-275