Common Skin Changes During Pregnancy

With all the changes taking place inside your body as a result of your pregnancy, it should come as no surprise that you might see some changes on the outside, too (other than the baby bump!). While many people think that pregnancy only produces negative side effects for the skin and body, knowing what to expect and how to care for your skin can help make the next nine months just a little less stressful. And don’t worry. It’s not all bad!

What kind of changes can occur?

• Stretch marks (striae) – This is a form of scarring that occurs when the dermis is stretched beyond its limit or during drastic hormonal changes. They appear on the skin as pink, purple or red streaks and normally fade over time, resulting in shiny white or gray lines. For more information on stretch marks and preventing them, check out our blog post on the subject here.
• Skin darkening (pregnancy mask) – It is common for pregnant women (especially women with darker complexions) to develop blotchy areas of darkened skin. These patches may be caused by hormonal changes that stimulate a temporary increase in your production of melanin, the substance that gives color to your skin, hair and eyes. New patches may appear and current spots may worsen with sun exposure.
• Fixes: Protect your skin by using a broad-spectrum SPF 30 sunscreen every day and avoid sun exposure as much as possible during pregnancy. Wash your face twice daily using gentle oil-free and soap-free cleansers. For more information on facial cleansers, read our blog post here.
• Pregnancy glow – This isn’t just an old wives’ tale. The increased volume of blood causes the cheeks to take on an attractive blush. Increased secretions of the oil glands give the skin a waxy sheen, which also make your skin appear to glow.
• Acne breakouts – More than half of pregnant women experience problems with acne during their pregnancy. An increased level of hormones and retention of fluids that can contain toxins are often the root cause of the breakouts. Always tell your dermatologist if you’re expecting, as some acne drugs should not be used during pregnancy.
• Fixes: Like with other problems, washing your face gently twice a day with oil-free and soap-free cleansers will reduce existing breakouts and help prevent more from occurring. Avoid using harsh chemicals, vigorous scrubbing or cleansing too often as this can remove natural oils from your skin, making it produce excess oil to compensate.
• Varicose and spider veins – During pregnancy, the extra blood in your body and growing uterus can cause your veins to expand. Varicose veins are often blue, red or flesh-toned in color, usually appearing on the thighs, backs of calves, buttocks or on the inside the legs. Varicose veins may look like clusters of veins surrounded by thin red capillaries, known as spider veins. Spider veins are similar, but appear smaller and closer to the surface of the skin.
• Fixes: Exercise regularly and try to maintain your recommended weight to ensure healthy blood flow. Avoid sitting or standing for long periods of time. While sitting, elevate your feet when possible and don’t cross your legs or ankles.
• Itchy abdomen – As your bump grows, the expanding skin becomes moisture-deprived, leaving it uncomfortably itchy.
• Fixes: Don’t scratch as this will only cause further skin irritation. Cocoa butter, lotion or even petroleum jelly will help provide your skin with the necessary moisture it needs as your skin expands. Too many baths and overheated water can also strip your skin of moisture, and will often make skin itchier. Stick to short showers in warm water. Taking an oatmeal or baking soda bath can help moisturize skin while easing itching.
• Linea nigra – This is a dark line running from your belly button to pubic bone. It was there prior to your pregnancy, but you probably didn’t notice it because it was the same color as your skin. The same increase of melanin that is responsible for darkened skin spots causes this line on your belly. This will more than likely fade to its normal color after delivery.
• Red palms and soles – This condition is caused by an increase in estrogen and blood volume, but will disappear after you give birth.
• Eczema – Eczema, or dermatitis, is a chronic skin condition or rash that is hereditary and can be triggered by exposure to environmental allergens, chemicals, detergents, yeast and metals. Pregnancy tends to either make you experience more flare-ups or go into remission, but there’s no way to tell which will happen to you.
• Fixes: Moisturize your skin gently and frequently. Again, sticking to short showers in warm water (instead of long, hot baths) will help your skin retain its moisture. 
• Heat rash and chafing – This is caused by hormones, sweating and friction from skin rubbing against itself or clothing. Symptoms are usually found under the breasts or on thighs.
• Fixes: To combat a heat rash, avoid further friction from scrubbing the skin with loofahs or sponges. You may also try applying cornstarch to your skin after you shower. Wear loose-fitting, natural fiber clothes. Breathable fabric like cotton is best. Tight clothing may cause chafing, heat rash or itchy skin.
• PUPPP (pruritic urticarial papules and plaques of pregnancy) – The PUPPP rash is relatively uncommon, found in just one of every 150 pregnancies. It is usually found on the abdomen, but can spread to the thighs. While PUPPP is annoying, it is benign and poses no threat to your baby.
• Fixes: As previously stated, oatmeal or baking soda baths may help sooth itchiness. Applying a cold compress may also help relieve itching.
• Sensitive skin – Surging hormones make skin more sensitive to substances and materials that might not normally affect you. These may include sunlight, heat, detergents, chlorine and even certain foods. Your stretching belly is usually the most sensitive spot, but you may also experience sensitivity on your hips, thighs and buttocks.
• Changing keratin levels – Keratin is a structural component of your skin, hair and nails. During pregnancy, keratin levels are affected, but everyone experiences these changing levels differently. Some women’s hair and nails may become shiny and luxurious, while others may get greasy and oily. No matter which change you experience, it will most likely return to normal after giving birth.

General skin care during pregnancy

• Stay hydrated by drinking 64 ounces of water each day to make skin appear smoother and brighter.
• Maintain a healthy diet. For more information on foods that promote skin health, read our blog post here.
• For extremely itchy and irritated patches of skin (from PUPPP, heat rash or eczema), a dab of calamine lotion should temporarily ease itching.
• Consult your doctor or dermatologist before taking any skin-related medications or steroids, or applying anti-itch creams.

The Scar Solution

Scars are like tattoos but with better stories. Have you ever heard that quote? It’s so true. Scars are the result of a change to the skin as it heals from a wound. Scars can result from just about any type of wound, from abrasions to incisions. (For more info on the types of wounds, read my blog post here.) This blog post will give you some basic info on scars, as well as how to prevent them or make them less noticeable.

What is a scar?

Scar tissue is comprised of collagen, which is the same tissue content as normal skin. What makes it look different than the skin around it is that collagen fibers in scar tissue will form a different pattern. Where normal collagen has a woven pattern, scar tissue exhibits a “cross-stitch” type of pattern.

Scar tissue is weaker than normal skin tissue. It is more susceptible to damage caused by the sun’s ultraviolet rays, and sweat glands and hair follicles do not grow back after the wound heals.

Are there different types of scars?

Yes. While all scars are composed of the same type of tissue as the once-healthy skin they occupy, not all scars are created equal.

• Hypertrophic scars are a result of the body producing too much collagen. They present as red bumps on the skin on the scarred area. They typically take shape a month or two after the wound heals.
• Keloids are a type of hypertrophic scar. They also present as red bumps on the skin, but can grow beyond the original wound site and do not go away over time. Keloids are most common in people with darker skin. While they are often the result of a wound, some people do form them spontaneously. It is important to note that keloids are not dangerous, although they are a cosmetic issue for some people.
• Atrophic scars make the skin appear sunken. They are generally the result of losing fat or muscle in one area, causing the skin to sink a little. Acne scarring or surgical scars are generally atrophic.
• Stretch marks are a result of the skin stretching rapidly and for prolonged periods of time. Often caused by quick weight gain or loss, growth spurts or pregnancy, stretch marks are also more of a cosmetic issue than a medical concern. For more information on preventing stretch marks, read my blog post here. 

Can I prevent scars?

Not really. Not all wounds will form scars. For example, a simple knee scrape or a scratch will generally not cause enough damage to form scar tissue. A deeper wound will form scar tissue. A general rule of thumb is that the longer it takes your skin to heal, the more likely you are to develop a scar. If you want to prevent a scar, prevent any injury or wound on your skin.

Can I treat a scar or make it less noticeable?

Absolutely. There are a variety of treatments available for scars, some more effective than others. It’s important to note that no treatment will result in complete restoration of your healthy skin, but there are several options for reducing the scar’s appearance. Some options include:

• Over-the-counter treatments – Creams like Mederma often advertise their ability to reduce the appearance of scars. To be honest, it isn’t going to speed up the process a whole lot, if at all. Most scars will become less noticeable over time anyway, particularly things like stretch marks. If you don’t want to break out the big guns and visit a dermatologist, you should consider waiting before trying anything from the drugstore.
• Collagen induction therapy – Often referred to as “skin needling,” this procedure is performed by a doctor and is meant to introduce normal collagen into the scarred area.
• Exfoliation, chemical peels or dermabrasion – Removing the scarred layer of skin can often result in a lighter appearance for a scar. Traditional at-home exfoliation is probably not enough, depending on the depth and size of the scar. I recommend visiting a trusted dermatologist to discuss whether a chemical peel or dermabrasion procedure can help you.
• Fillers – Like collagen induction, fillers will introduce normal collagen into an atrophic scar, helping raise them to the level of surrounding healthy skin. You can read my post on fillers here.  It’s important to note that fillers are not permanent, so if this is your chosen solution you may need to have the procedure done every few months to maintain your desired results.
• Laser treatments – Different types of laser treatments are available for all types of scars. You’ll need to meet with a dermatologist to understand your options and which treatment, if any, is right for your scars. Like chemical peels or dermabrasion, most lasers work by burning or removing the most scarred layer of skin to reduce the appearance of a scar.

Have any more questions about scarring? Leave them in the comments and I’ll try to help if I can. Additionally, if you’d like to make an appointment at Advanced Dermatology to discuss your treatment options, click here.

Stretchy Skin - Avoid Those Marks!

Going through pregnancy, weight gain or loss or puberty can be stressful enough. Who has time to worry about stretch marks, too?

Let’s be real, no one likes stretch marks. Stretch marks, or “striae,” are a form of scarring that appears on the skin as pink, purple or red streaks. While they normally fade over time, they usually result in shiny white or gray lines. They can appear on men and women and occur when the dermis is stretched beyond its limit or during drastic hormonal changes.  Most people develop stretch marks due to rapid weight gain or weight loss, pregnancy or puberty. They usually develop on the abdomen, upper arms, breasts, buttocks, thighs or lower back.

Prevention

The best way to deal with stretch marks is to try to prevent them!

• Stay hydrated – It may seem excessive, but try drinking the recommended eight glasses (or 64 ounces) of water every day. Water helps keep your skin healthy by keeping your skin cells plump and more likely to bounce back from the stress caused by stretching.
• Eat healthier – If you aren’t currently pregnant, chances are you have yet to associate stretch marks with your diet. Including foods containing vitamin E, vitamin A, omega 3 fatty acids and antioxidants will greatly benefit your skin health. If you need more information on the best foods for your skin, check out our blog post on the subject.
• Some of these super foods include fresh fruits and veggies, nuts, seeds, walnuts, red bell peppers, fish, eggs and oysters. 
• Exercise – No exercise will eliminate or reduce stretch marks (and for guys bulking up at the gym, it can cause them if you gain too quickly), but may help prevent them from occurring. Exercising helps the skin retain its elasticity by improving circulation. It may also help you avoid gaining too much weight, too fast. 
• Avoid scratching – Don’t do it! Scratching areas where you are likely to get stretch marks will further harm your skin from the pulling and stretching. If you feel itchy, apply massage oils or creams instead of scratching. Massaging the skin will promote new skin growth and blood circulation.
• Use stretch mark creams – People anticipating stretch marks, especially pregnant women, should apply a stretch mark cream or ointment at least twice each day. Did you know that 75 percent to 90 percent of pregnant women get stretch marks related to their pregnancy? By applying the recommended creams (listed below), you can decrease your chance of developing stretch marks.

Best Creams for Stretch Mark Prevention

• Dermology
• Revitol
• Strivectin

These products are relatively cheap (between $20-50) and can be purchased from Amazon or other online retailers.

Treatment

While treatments may help stretch marks fade, they will not completely remove them. Remember to treat stretch marks as early as possible for the best results. In the later stages, stretch marks are much more challenging to reduce.

• Tretinoin cream – Use if the stretch marks are only a few months old (still red or pink). Tretinoin works to help rebuild collagen, making the striae look more like your normal skin.
• Microdermabrasion – This involves a hand-held device that blows crystals onto the skin. The crystals help exfoliate the skin while the tiny vacuum removes the crystals and skin cells. This method promotes the growth of new, more elastic skin.
• Laser therapy – By using intense wavelengths of light, laser therapy stimulates the growth of collagen and elastin production in your skin.
• Glycolic acid – This is a type of fruit acid used in chemical peels that can be applied at home or by a dermatologist.
• Vitamin C – Certain formulations and supplements of vitamin C may also increase collagen production.

Please note, your degree of success with any treatment will be impacted by your age, skin tone and even your diet. Talk to your doctor or dermatologist before starting any treatment or prevention methods to determine the best approach for you.

Have more questions? Leave them in the comments, and we’ll try to answer them there. If you’d like to make an appointment with Advanced Dermatology, click here.