How Your Skin May Change During Pregnancy and Nursing

Admittedly, finding new skincare products may rank low on your to-do list if you’re expecting. But you’ve probably already started to notice some changes to your skin, and some may continue or evolve through breastfeeding. So adapting your skincare routine to ensure it’s addressing your existing and emerging skin concerns makes a lot of sense.

A good place to begin is by determining what won’t work for the next few months while you’re pregnant and nursing. If you’re unsure about a product’s safety, ask a board-certified dermatologist to review your current skincare lineup. 

Two common skincare ingredients, retinol and hydroquinone, should be avoided by pregnant and nursing women. The use of topical salicylic acid during pregnancy has been debated, but the American Academy of Dermatology has deemed it acceptable when used for a limited time. Still, it’s a good idea to check with a dermatologist.

Common reactions

Once you’ve pared down your skincare regimen, it’s time to consider how your skin may change during pregnancy and breastfeeding. A surge in hormones, not unlike when you were a teenager, makes breakouts a common occurrence during pregnancy. Pregnant women are also more likely to experience pigmentation issues than they were prior to their pregnancies. That’s because melanin-stimulating hormones – which are the same type of hormone as estrogen – can ramp up during pregnancy and cause hyperpigmentation. 

These dark spots can appear anywhere on the body, including on the breasts, nipples, and inner thighs. When brown to gray-brown patches form on the face around the cheeks, nose, and forehead, it’s indicative of a condition called melasma.

A dark line may form from the navel to the pubic hair of some pregnant women. This is what’s known as linea nigra. It’s another result of melanin-stimulating hormones. The linea nigra will darken during the course of a pregnancy, but it will also resolve on its own after the pregnancy.

Also common are the development of stretch marks, spider veins, varicose veins, and deviations in typical nail and hair growth patterns. 

Higher amounts of blood in your body and hormonal changes can cause spider veins to appear on your face, neck, and arms. Varicose veins can occur when the weight and pressure of your uterus decreases blood flow from your lower body. In most cases, both spider and varicose veins will go away on their own after the pregnancy.

Similarly, changes to your nail and hair growth, including hair loss that can occur about three months after childbirth as hormones return to normal levels, should eventually subside on their own.

Stetch marks, however, are a different story. While there are many products that claim to prevent them, there’s no evidence that any of them work. Using a heavy moisturizing cream may keep your skin soft, but it will not help get rid of stretch marks. Most will fade on their own, but they may never disappear entirely.

Less common reactions – and what to do about them

Less common is a pregnancy-specific rash called pruritic urticarial papules and plaques of pregnancy (PUPPP), which can appear as itchy patches usually on or around stretch marks. These patches can show up during the third trimester, but, strangely, only during a woman’s first pregnancy. We’re not sure what causes PUPPP, but we do know that it clears up on its own after the pregnancy.

Another condition called prurigo of pregnancy is thought to be caused by changes in the immune system that occur during pregnancy. It usually starts with a few tiny, itchy bumps that can appear almost anywhere on the body. Each day, the number of bumps will increase, and they may continue doing do so even after the baby is born. It is usually treated with a topical anti-itch medication coupled with an antihistamine or a corticosteroid.

Women who already have certain skin diseases, such as psoriasis and atopic dermatitis, may see their conditions worsen or improve while they are pregnant. If your symptoms worsen, talk to your dermatologist to see if a change in your medication may be in order.

In general, itchy skin during pregnancy can be treated with an over-the-counter anti-itch cream. You may also want to start washing with mild, fragrance-free soap and applying a heavy moisturizing cream twice a day.