We talk a lot about the so-called ‘pregnancy glow’ that moms-to-be experience. And while a lot of women do enjoy a certain radiance while they are pregnant, it doesn’t necessarily counteract some of the other skin concerns and conditions – acne, melasma, erythema, stretch marks, dryness, itchiness, and spider veins (to name a few) – that crop up during gestation and often linger postpartum.
Under normal circumstances, you could just pop on over to your nearest drug store or beauty retailer to pick up an over-the-counter remedy or two. But, during pregnancy, there is a little more thought involved since not all ingredients are considered safe. “While pregnant, it’s best to avoid a number of skincare ingredients since there is insufficient evidence that they are safe for pregnant women and the developing fetus,” says Michele Green, MD, a board certified dermatologist in New York City. “In order to prevent any adverse effects, pregnant women should stay away from retinol, like Retin-A, since these products can cause severe birth defects.” Additionally, she says to discontinue use of benzoyl peroxide, salicylic acid, chemical sunscreens, and hydroquinone. “If you are unsure as to whether or not a product is safe to use during pregnancy, always check with your OBGYN,” she shares.
So, what’s a girl to do? We tapped two top dermatologists to get a better understanding of why women experience certain skin conditions during pregnancy and how to safely and effectively treat them.
1. The Concern: Acne
We probably don’t need to tell you that hormones are raging during pregnancy. Due to hormonal fluctuations – particularly, increases in estrogen and progesterone that increase sebum (a.k.a. oil) production – many women experience breakouts. “Pregnancy acne is common,” Dr. Green says. Just how common? “More than half of pregnant women are expected to develop acne,” she notes. As she explains it, the severity of the acne will vary from person to person, and you are “more likely to have pregnancy acne if you have a previous history of acne.” Even so, you may experience flare-ups “even if you have not had acne for years,” she adds.
The Solution: Clarifying Skincare
Pregnancy acne is a type of hormonal acne, which means a solid topical skincare routine can go a long way towards calming inflammation and clearing your complexion, But, since breakout-busters like benzoyl peroxide, salicylic acid, and retinoids are out of the picture, you need to be a bit more creative with your product selections. “Some safe alternative treatment options include antibiotics like clindamycin, which kills acne-causing bacteria, and sulfur-based washes which can help with skin inflammation,” Dr. Green says.
First and foremost, Dr. Green recommends washing your face twice a day with a gentle cleanser like her MGSKINLABs, Inc. Gentle Cleanser or the CeraVe Hydrating Facial Cleanser. “Washing your face frequently will help remove the dead skin cells and other bacteria that get trapped in your pores,” she explains. “It will also ensure that your sebum production is under control.” She designed the MGSKINLABs formula “to clear acne without stripping the skin of its natural barrier,” and she likes the CeraVe cleanser because “it contains ceramides and hyaluronic acid to nourish and protect skin.”
When it comes to the rest of your routine, she says to avoid comedogenic (read: pore-clogging) products and to instead opt for water-based or non-comedogenic options to “prevent further exacerbating your acne.” If you make these changes but don’t notice an improvement, look at your locks. “If you have oily hair, try to keep your hair out of your face and shampoo more often so the oil from your hair does not transfer to your face,” Dr. Green says.
Her final tip may be the most important: Don’t touch your face. “If you do have active acne, try not to pick or squeeze them,” she cautions. “This can introduce more bacteria into them and lead to infection and scarring.”
2. The Concern: Stretch Marks
It wouldn’t be an article about skin concerns during pregnancy without talking about stretch marks. Medically known as striae, these etched-in lines are technically a form of scarring within the dermis and pose no threat to skin health – though that doesn’t mean they aren’t a cosmetic concern for many. “Technically speaking, stretch marks are like scars in that they are considered permanent but treatment can make them less noticeable,” says Marisa Garshick, MD, a NYC-based board certified dermatologist. “In general, they will always be there to some extent, but often the earlier they are addressed, the less noticeable they will be.”
During pregnancy, certain parts of the body are expanding at a relatively rapid pace. When the skin is abruptly stretched or forced to expand, collagen and elastin proteins in the dermis can rupture and leave scar tissue (i.e. stretch marks) behind. Stretch marks typically start surfacing at the end of the second trimester and can appear on the stomach but also around the butt, breasts, thighs, arms, and hips.
The Solution: Moisturizing Skincare
Genetics and lifestyle can play a role in skin elasticity and how it responds to changes during pregnancy, but one of the only ways to decrease the likelihood of stretch marks or at least minimize the appearance of them is with a nourishing skincare routine. “Oftentimes, during pregnancy, the best and most important thing you can do for your skin is to continue to moisturize,” Dr. Garshick shares. “This not only will help to keep the skin looking and feeling healthy, it can also reduce the potential for dryness and itching.” When using moisturizers, she says to “massage the product into the stretch marks” for best results.
You might be surprised to learn that, although commonly used, there isn’t enough research to show almond oil, cocoa butter, olive oil, or vitamin E fade stretch marks. “It is important to remember that while there are various topicals available to help prevent and treat stretch marks, there is limited evidence to support their use,” Dr. Garshick notes. “That said, anecdotally, people have seen improvement with various topicals.”
There is, however, research to suggest hyaluronic acid (a humectant that draws moisture into the skin) and centella asiatica (an anti-inflammatory botanical used to promote healing) can help prevent and treat striae. “Two large studies have shown that applying hyaluronic acid to early stretch marks may make them less noticeable,” Dr. Garshick shares. Centella asiatica, meanwhile, has “been shown to help in wound healing and it is thought that this may be through helping to promote fibroblast proliferation and collagen synthesis, suggesting benefits for wound healing as well as for anti-aging,” she explains. “Due to this mechanism, it has also been thought to be helpful in the management of stretch marks.”
Like acne, however, some of the most efficacious actives are not safe for use during pregnancy or breastfeeding. “Tretinoin, a type of retinoid, was shown in a study to make stretch marks less noticeable when used for 24 weeks,” Dr. Garshick says. “But retinoids should not be used during pregnancy.” If you are concerned about stretch marks that have already formed and you are not currently breastfeeding or pregnant, consult with a board certified dermatologist or plastic surgeon to review possible solutions. As she explains, they can include “topical treatments, microneedling, lasers, and more.”
That said, Dr. Garshick reiterates that “it is always best to treat stretch marks early when possible,” which means adopting a moisturizing skincare routine from the beginning of your pregnancy. She says the following products may fit the bill:
- Palmer’s Cocoa Butter Massage Lotion for Stretch Marks: “A tried-and-true classic for stretch marks, this is formulated with cocoa butter, shea butter, vitamin E, and Bio C-Elaste, which combines collagen, elastin, and centella asiatica to help reduce the appearance of stretch marks and improve skin elasticity. It is free of mineral oil, parabens, phthalates, fragrance allergens, and dyes, which makes it a great option for those with sensitive skin. It can be used in any area prone to stretch marks including the stomach, hips, thighs, or chest.” $13, walmart.com
- Vaseline Healing Jelly Ointment: “As an occlusive, Vaseline works to lock moisture in helping to reduce dryness of the skin, it may help to reduce the appearance of stretch marks and keep the skin on the belly, breast, and hips looking and feeling healthy throughout pregnancy. Additionally, by keeping the skin healthy and moisturized, it may reduce the likelihood of stretch marks developing. It can be particularly helpful if massaged into the skin one to two times per day.” $3, cvs.com
- Trofolastín Anti-Stretch Mark Cream: “This topical is considered safe in pregnancy, and contains centella asiatica, vitamin E, and collagen-elastin hydrolysates. It can be used daily to help reduce the potential formation of stretch marks.” $45, walmart.com
- Bio-Oil Skincare Oil: “Bio-Oil is a great option if you prefer an oil as compared to a cream or lotion. Through a blend of oils, vitamin A and vitamin C, it continues to help nourish and moisturize the skin to minimize the appearance of stretch marks and has also been used for scars as it can improve the overall texture of the skin.” $13, ulta.com
- Mama Mio The Tummy Rub Butter: “It contains a blend of shea butter and various oils, including avocado and rosehip oil, to provide moisture and vitamin E to serve as an antioxidant to improve the appearance of stretch marks. It smells nice, but, for those with sensitive skin, they have a fragrance-free option as well.” $30, us.mamamio.com
- Mustela Stretch Mark Cream: “This contains maracuja oil, which helps to improve skin elasticity, as well as avocado oil and avocado peptides to keep the skin healthy, hydrated, and nourished throughout pregnancy.” $22, mustelausa.com
Postpartum, once you are done breastfeeding, Dr. Garshick says an over-the-counter retinoid, like Differin Gel, can be used to try to help treat stretch marks. “In general, it is always best to speak with a board certified dermatologist to determine the best treatment options for you,” she adds.
3. The Concern: Pigmentation & Melasma
Hyperpigmentation and melasma are common during pregnancy and are also the result of – you guessed it – fluctuating hormone levels. Different types of pigmentation show up on different areas of the body. Some women might notice darkening of already pigmented body parts (i.e. nipples, armpits, genitals, freckles, etc.). For many, one of the earliest indicators of pregnancy is linea nigra, a dark vertical line that runs down the belly and appears during the first trimester.
And then there is the face. “You may also notice dark splotches or patches appearing on your face as a result of melanocyte-stimulating hormones making excess melanin,” Dr. Green shares. Known as the ‘mask of pregnancy,’ melasma affects many women (it’s more common in melanated skin, though anyone can experience it). It most often shows up on the cheeks, temples, jawline, and upper lip, the latter of which can make it appear like a mustache. While the exact cause is unknown, it's believed to be exacerbated when estrogen levels increase, such as during pregnancy or when taking oral contraceptives.
For most, pregnancy-caused melasma and hyperpigmentation resolve on their own. For this reason, Dr. Green does not recommend treating the conditions during pregnancy. Additionally, “many treatments may be too harsh and may have unknown effects on the fetus,” she notes. As such, “it is best to wait a few months after pregnancy to see if the hyperpigmentation and melasma will go away on their own,” Dr. Green says. If you are still concerned with hyperpigmentation at that point, you can consult with a board certified dermatologist on treatment options.
The Solution: Brightening Skincare & Sun Care
Dr. Green admits that there are “limited options for fully treating melasma and hyperpigmentation,” but there are a few lifestyle changes you can make to minimize any dark spots:
- Apply & reapply sunscreen
- Limit sun exposure
- Use vitamin C in your skincare routine
“The best way to prevent hyperpigmentation or melasma from getting worse while pregnant is with sun protection,” Dr. Green says. “Always wear a physical sunscreen with an SPF of 30 or above whenever you are going outside and be sure to reapply every two hours.” Her MGSKINLABs, Inc. Advanced Formula SPF 50 is a broad spectrum mineral sunscreen that protects against UVA and UVB rays to decrease the risk of skin damage and pigmentation. “It is also a physical sunscreen meaning that the product will sit on top of the skin and reflect the sun’s rays,” she shares. “Chemical sunscreens absorb into the skin and can have adverse effects on the fetus.”
While physical sunscreen is a non-negotiable and should be worn daily regardless of what you have planned, staying out of the sun is your best bet. As she explains, prolonged sun exposure can exacerbate pregnancy-caused melasma and hyperpigmentation. “Try to stay in the shade and wear protective clothing, like wide-brimmed hats and rash guards, when possible,” she adds.
In addition to sun care, there are some upgrades you can make to your skincare routine. Dr. Green says vitamin C is a “safe way to fade and prevent” discoloration. “Vitamin C works by blocking the action of an enzyme known as tyrosinase, which is essential for the formation of melanin,” she explains. “Over time, vitamin C can fade away deposits of hyperpigmentation and help give the skin a more even skin tone and texture.” Her MGSKINLABs, Inc. Vita-C-Serum was created to promote skin cell renewal, support collagen synthesis, help with hyperpigmentation, and prevent damage caused by free radicals. An added benefit of vitamin C? It boosts the benefits of your sunscreen.
The Solution: Professional Chemical Peels
Melasma should naturally go away within a few months of giving birth. “If you notice that the melasma or hyperpigmentation is still present after three to six months, it means that you will likely need treatment to get rid of it,” Dr. Green says. There is an array of in-office solutions that can fade and brighten pigmentation, but she considers chemical peels, including Mesopeel® and Cosmelan® – in conjunction with certain medications and products like retinoids, azelaic acid, vitamin C, vitamin K, and/or hydroquinone – to be “the most effective methods.”
Professional peels are “excellent ways to rejuvenate the skin by gently exfoliating the outer layers of the skin, the epidermis,” she notes. A chemical solution is applied to the skin, causing the old and damaged skin cells to peel off, and revealing new and unblemished skin underneath. “The new layer of skin is more even in tone and texture and hyperpigmentation should be visibly faded,” she says. These treatments can be performed at different depths anywhere on the body.
Dr. Green specifically like the Cosmelan® Peel because it has 51 active ingredients that actively work to depigment the skin. “These ingredients contain key tyrosinase inhibitors, which block the production of melanin in the skin and other lightening agents to restore beautiful, clear skin,” she says. The system, which can be customized to your skin type and the extent of your pigmentation, involves a series of two peels spaced three weeks apart that are applied to your skin for several hours. based on. In between and after the sessions, you use specially formulated skincare to further reduce the discoloration. “Patients have seen great results from the Cosmelan® peel and, for many, it is the only thing that has worked for melasma,” Dr. Green shares. “If you have tried other treatment options without improvement, give Cosmelan® a try.”
4. The Concern: Spider Veins & Redness
Some women develop spider veins and other redness while pregnant. “During pregnancy, there are higher amounts of blood and hormones circulating, which can cause tiny red veins, known as spider veins, to appear throughout your body,” Dr. Green says, adding that it is also common to have “itchy red rashes” and “general redness.” Hormones and genetics are the primary culprits. “Due to genetics, some people may be predisposed to developing them,” Dr. Garshick notes.
Spider veins and erythema usually fade postpartum, though Dr. Green says it is “not unusual” if the red spider veins and some red splotches remain. When it comes to spider veins “no specific product will make them go away,” but “it can help to wear compression stockings – both during pregnancy and after – which helps to reduce swelling and improve circulation,” Dr. Garshick shares. Another tip: “Keep the legs elevated when possible,” she adds.
As it relates to other redness, Dr. Green says to always use sunscreen, seek shade, and wear protective clothing to prevent any sun exposure that may exacerbate the issue. “Be sure to use gentle skincare products and moisturize when needed to alleviate any accompanying discomfort,” she notes.
The Solution: Body Makeup
Body makeup is probably the quickest and easiest solution to conceal veins, redness, or discoloration that is bugging you. “To help improve the appearance of the spider veins, there are certain cosmetics that can help to cover them up despite not treating the underlying condition,” Dr. Garshick says. She is a fan of Dermablend Leg and Body Makeup Foundation with SPF 25 “to help camouflage” and also likes the pigmented complexion offerings from Cover FX and IT Cosmetics that can be used from head to toe.
The Solution: Sclerotherapy & Laser Therapy
While makeup can cover up spider veins and redness in a pinch, it is a temporary solution that doesn’t address the root cause. There are, however, in-office treatments that can treat these concerns after childbirth. “If the spider veins persist after pregnancy, some options include laser or sclerotherapy to directly target the veins,” Dr. Garshick says. “Depending on the extent of the veins involved, sometimes other treatments to be considered include endovenous laser ablation or radiofrequency ablation.”
In her practice, Dr. Green uses Vbeam®, a pulsed dye laser, to “treat a wide range of skin issues from red spider veins to pigmentation to rosacea to redness.” She says it is a “safe and effective treatment for any remaining redness” because “the laser solely targets the hemoglobin in blood or blood vessels without damaging the surrounding skin.” The pulsed dye laser treatment can “greatly reduce the appearance of your spider veins and diminish the appearance of any redness,” while also offering benefits like “stimulating collagen production, reducing pore size, and improving the texture of your skin,” she adds.
It should be noted that, “while spider veins can improve and fully go away, there is always the chance of new ones developing,” Dr. Garshick cautions. “Additionally, if there are deeper veins that are also impacted, these may need to be addressed as well to improve the overall treatment outcome.”
5. The Concern: Dryness & Itchiness
There are a number of reasons why you might experience dry skin and itchiness – especially on your belly – during pregnancy, but it usually boils down to, yes, hormones. “Hormones can cause your skin to lose elasticity and moisture as it stretches to accommodate the life growing within you,” Dr. Green says. It also shouldn’t come as a surprise that your body requires more liquids when pregnant. A combination of not drinking enough fluids and dehydration from the vomiting and diarrhea caused by morning sickness can also impact the suppleness of the skin. And, while it sounds counterintuitive, swelling (also known as edema) can also play a role in dryness. Water retention can stretch the skin, causing it to crack and feel itchy.
The Solution: Moisturizing Skincare
To combat dry, itchy skin, a moisturizing skincare routine – not unlike the one you should be using for stretch marks – is needed. “The best ingredients to use include natural oils and body butters that can help keep your skin hydrated and reinforce your skin’s protective barrier,” Dr. Green shares. “Great options include coconut oil, shea butter, cocoa butter, and argan oil.” As she explains, “these products can help relieve dryness and itchiness while simultaneously preventing stretch marks.” In fact, you might recognize a few of her favorite products from Dr. Garshick’s picks for striae:
- Mama Mio The Tummy Rub Butter: “This product contains deeply moisturizing body butter and natural oils, like coconut oil, shea butter, and argan oil. These ingredients help the skin lock in moisture while improving elasticity and soothing delicate skin. This product is also safe for pregnant women and can be used all over the body – from your arms to your stomach to your hips and thighs.” $30, us.mamamio.com
- Palmer’s Cocoa Butter Massage Lotion for Stretch Marks: “This lotion helps visibly improve skin elasticity and reduce the appearance of stretch marks while helping relieve dry and itchy skin. It contains cocoa butter, shea butter, vitamin E, argan oil, and coconut oil, among other ingredients that help support healthy, supple skin.” $13, walmart.com
- Motherlove Pregnant Belly Salve: “This is specially made to address the itchy skin and dry skin that accompanies pregnancy. This salve contains apricot oil, shea butter, lavender, and beeswax to moisturize and soothe your skin. In addition, this product is women-owned and 100 percent organic, so you can feel good about buying this product.” $18, motherlove.com
From acne and melasma to stretch marks and spider veins, pregnancy can have a pretty significant impact on the skin. If these conditions are bothering you during pregnancy or if they haven't resolved postpartum, there are safe and effective solutions that can help minimize the effects of all the hormonal changes. If you are unsure about the safety of a treatment or ingredient, be sure to consult with your OBGYN and dermatologist.
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