Skin changes during pregnancy

This time we are not going to talk about diseases, but I will refer to the physiological (“normal”) changes that a woman’s skin undergoes during pregnancy. As you know, this is a complex stage associated with profound immunological, endocrine, metabolic and vascular changes and this is expressed in the skin. In addition, pregnancy can produce changes in skin diseases (atopic dermatitis, psoriasis…) and be associated with specific disorders, but we will not deal with them on this occasion.

Increased pigmentation is very frequent in pregnancy, more intense in darker-skinned women. There are already pigmented body areas, such as areolas, genitalia and abdominal midline that become more pigmented. There is usually an increase in the size and number of melanocytic nevi. Another very frequent and cosmetically annoying pigmentary change is melasma, chloasma or “cloth”. They are brown, irregular and symmetrical spots that usually appear on the face. Although in most cases it tends to subside after childbirth, it can sometimes be persistent or recur after sun exposure in summer. Depigmentation treatments are not indicated during pregnancy, so we only recommend sun protection measures using high sunscreens and waiting until the end of pregnancy to perform specific treatments. If it persists after childbirth, it is advisable to consult a dermatologist, and remember that a woman should not self-treat without consulting a doctor during this stage.

Women will notice that their hair is abundant and vigorous, but after childbirth there is a compensatory hair loss known as “postpartum effluvium”, which can take months to normalize. Hirsutism (increased body hair in certain areas) and acne may appear, but they are usually mild and return after delivery.

Many women may notice an increase in the size or number of nevi or moles. Vascular changes such as spider veins and palmar erythema (redness) are also very frequent. Annoying varicose veins in the legs or hemorrhoids may appear or worsen. It is not uncommon for women to experience edema (swelling) in the face, feet and hands, which is more pronounced upon rising and disappears as the day progresses.

Spider vein on the cheek
Spider vein on the cheek

Another well-known change is the appearance of acrochordons or fibroids, which are small “skin extensions” around the neck. They are known as “warts” although this is not the correct term. They are not contagious, do not spread and are not caused by rubbing collars. They are benign and are easily treated by the dermatologist.

Soft fibroids or acrochordons
Soft fibroids or acrochordons

And how not to mention the dreaded stretch marks: they occur in up to 90% of women in the third trimester. They are pink-purple or atrophic lines on the abdomen, hips and breasts. Most of them clear up after delivery, but they do not disappear completely. During pregnancy it is important to use moisturizers or specific products. If treatment is considered, there are several options and they should also be evaluated after delivery.

And that concludes this brief review. Finally, I would just like to emphasize the importance of hydration, facial protection from the sun, avoidance of self-medication, patience (some of the changes mentioned above resolve or improve after delivery) and consulting a dermatologist with any questions that may arise.

Beatriz Fleta