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Skin in Pregnancy

All pregnant moms cherish the glow of pregnancy they see in the mirror and get complemented on. But, with the surging tides of estrogen, progesterone, and the dozens of placental hormones in the mix, there are a few other skin complications that are fairly common, most easily treated, and some that take modern technology to reverse.

1. Flushing in pregnancy. Some of the glow may be accompanied by mere extra flushing. Don’t worry, pop some cool water, or even use a small ice cube as a lozenge (no chewing ice, bad for the enamel and gum conditions already can compromise teeth in pregnancy!).

2. Deal with sweating apart from flushing. The flushing can be accompanied by increased sweating and feelings of heat. In fact pregnant women have an elevated core temperature. Gynos recommend Zeasorb powder very good and absorbant and Zeasorb AF has miconazole in it to reduce yeast in sensitive areas like the creases of your thighs.

3. The skin does darken naturally in pregnancy, this leads to some changes like the natural darkening of the nipples of the breast, and the darkening of the line that runs down the center of the abdomen changing it from a linea alba (white line) to a linea niagra (naturally tanner one). The reason some areas darken more has to do with regional differences in the melanocyte cells. On the face the darkening can be in patches, and is exaggerated by an actual tanning, something that should be avoided. What do about this condition called melasma: the best sun screen available and mineral make up.

4. Color match your palate for changes, but makeup can be a really good thing! Mineral make-ups that are easily applied and have the best SPF factors with protection against UVA and UVB are what we recommend at Women’s Health Practice and Hada Cosmetic Medicine. Some non-mineral cosmetics have been implicated in worsening the melasma. Post pregnancy: prescription medication like Triluma can lighten the dark patches of melasma, and if the darkening was on in the very surface dermal layers peels and bleaching creams may help. At Hada Cosmetic Medicine your lifetime skin consultans can recommended a combination of effective topical therapies which would include hydroquinones, retinoids, and limited corticosteroids. For those with deeper dermal layer pigmentation fotfacials with appropriate pulsed light therapy as in the Palomar StarLux technology and a home care regimen that includes mild exfoliation with appropriate tools like the Clarisonic Brush.

5. Lumps and bumps: expect them! Growth factor promotion and hormonal signaling seems to increase the production of other harmless lumps and bumps like skin tags, given the impressive name of molluscum fibrosum gravidarum, and cherry hemangiomas. It is very safe during pregnancy to have these snipped, or wait until afterwards. The hemangiomas can be hyfercated (treated locally with heat) or treated with the lasers, which are reserved for after pregnancy.

6. Acne tends to flare in 1st trimester, and seems to calm down mostly later on & often will be at a low level till post pg/ after D/C nursing-then can reoccur. If huge cysts, tiny intra-lesional injection of dilute steroids are permissible, and for women who regular exfoliating care isn’t helping you could consider a microdermabrasion. We do not recommend chemical peels in pregnancy, but dilute benzol peroxide washes have not been found to be harmful.

7. Estrogen cause increased numbers of blood vessels during gestation. Vascular spiders and small varicosities of varying description do appear in over 66 percent of Caucasians and 11 percent of blacks. Spider veins are easily and safely treated by saline injections (a type of sclerotherapy) even when pregnant. Post pregnancy lasers can be additionally effective and treat larger varicosities as well, there really hasn’t been proven harm from lasers in pregnancy, get an individual consultation.

8. Aid your moisture! Some appropriate moistness applied to the skin can help be preventative but none the less stretch marks due to connective tissue changes are most prominent on the abdomen, breasts, and thighs, but also arise on the lower back, buttocks and upper arms. Although these stretch marks called striae fade postpartum, they do not disappear. But they can be treated post partum with the Palomar IR laser.

9. It’s not a skin problem, but a hormone one that causes itching in pregnancy. Pregnant women may itch additionally. Keeping skin moist helps as do oatmeal baths, topical steroids, and antihistamines. Some of this is do to the natural chlestasis in pregnancy and sticking to a lower fat diet and staying well hydrated helps.

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Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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