For most women, pregnancy is a period of joy and fulfillment. Nonetheless, pregnancy brings with it enormous bodily changes, some of which may be uncomfortable or disturbing. The more we understand about the changes our bodies go through, the more likely we are to be able to experience them with some composure. While all women are familiar with the potential for nausea, vomiting, and fatigue in early pregnancy, many are not expecting changes in their skin.
If you are generally prone to acne, psoriasis, or atopic dermatitis, for example, the hormonal changes you go through during pregnancy may cause your condition to improve or worsen temporarily. As Karen Duarte, RPA-C with Advanced Dermatology PC explains: “Hormonal changes during pregnancy commonly affect the skin. Though the changes discussed below are perfectly normal, a patient who is uncertain about a particular skin anomaly should always consult with a reputable dermatologist to put her mind at rest.”
Stretch marks occur when the skin has been stretched by rapid weight gain, so it is not surprising that pregnant women frequently develop them. Stretch marks are a form of scarring, usually first appearing as reddish or purplish and then turning shiny, silvery white.Stretch marks usually appear on the stomach, breasts, upper arms, thighs, and buttocks. Women who take corticosteroids are somewhat more prone to them. According to Duarte, “under normal circumstances, stretch marks fade gradually over time.”
Skin tags, those small flaps of extra tissue hanging off the skin on small stalks, are extremely common and completely benign. While a significant proportion of the adult population has one or more skin tags, pregnant women have a heightened tendency to develop them because of their increased levels of growth factors. Skin tags most often are found on the neck, chest, back, under the breasts, and in the groin. They typically cause no problem or pain unless they are in a place where clothing rubs against them in which case they can be easily removed.
During pregnancy, the body produces more melanin (the substance that pigments the skin) than otherwise. For this reason, many women develop melasma, a hyperpigmentation in which gray-brown or dark brown spots appear on the face, typically across the bridge of the nose, cheeks, and forehead. While men and non-pregnant women may develop melasma, the condition so often affects pregnant women that it is also known as “the facial mask of pregnancy.” Melasma is more common in people with darker skin. “In the majority of cases, melasma goes away on its own; if it doesn’t, there are dermatological treatments for the problem. The best way to prevent melasma is to wear a strong sunscreen,” notes Duarte.
The extra melanin your body produces during pregnancy not only can result in melasma, but in other temporarily darkened skin as well. While some women notice that their freckles or areolae (areas around their nipples) darken, many women also develop a dark line that runs from the navel to the pubic hair, known as the linea nigra, during the middle of their pregnancy. This line will usually fade after childbirth, but may still be visible.
PUPPP, or pruritic urticarial papules and plaques of pregnancy, sound more significant than they are. Some women develop the outbreak of characteristic pale red bumps in the stretch marks on their abdomens and buttocks during late pregnancy, when the fetus is growing most rapidly. These lesions can cause itching or may burn or sting. They can vary greatly in size as an itchy rash and sometimes form together as plaques. Fortunately, PUPPP only occurs in about 1 in 150 pregnancies. In most cases, PUPPP disappears during the few weeks following the baby’s birth.
While all of the above-mentioned skin conditions are benign, you may want to treat one or another of them for cosmetic reasons during your pregnancy or, if they persist, after your child is born. Contacting a dermatologist can help you readjust to your new life stage. As Duarte notes: “The fact that you’re involved in a miracle entitles you to take steps to feel as beautiful as possible during and after the process.”
Bio: Karen Duarte, RPA-C, is a board-certified physician assistant. She is a member of the American Academy of Physician Assistants, the New Jersey State Society of Physician Assistants, and the Society of Dermatology Physician Assistants. Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com