The most common physiological skin changes in pregnancy

How does pregnancy effect skin?

Pregnancy is a time of amazing change. At no other time in a woman’s life does she experience greater hormonal fluctuations. These massive hormonal changes result in changes in the body, including the skin.

The most common skin changes seen in pregnancy are hyperpigmentation issues mainly related to the increase in estrogen. Estrogen receptors are found on the pigment cells (melanocytes) and an increase in oestrogen leads to melanocyte stimulation. 90% of pregnant women will notice some type of hyperpigmentation issues on the skin.

Most commonly seen is the linea nigra or the brown demarcated line over the abdomen which usually appears in the second trimester of pregnancy but can appear earlier. Relax, it usually fades in the first weeks to months after pregnancy! Similar darkening of the skin can be seen around the nipples and in the skin folds (armpits, groins).

A different hyperpigmentation problem which can cause more trouble is melasma. Melasma is also known as the ‘mask of pregnancy’ or chloasma. It can appear in all skin types, but it is more common in darker-skinned patients. It often appears on the cheeks or on the forehead but can appear almost anywhere on the face including on the upper lip where it can give you the impression of a ‘moustache’. Trust me if I tell you to wear sunscreen during pregnancy because it is easier to prevent melasma than to treat it. Melasma can be very persistent, even after pregnancy and it can be very resistant to treatment too.

‘Striae gravidarum’ or simply stretch marks appear in 75% of pregnant women. They are not harmful but the permanency of the skin change does cause distress and embarrassment to a lot of women after the delivery. Predisposing factors are a positive family history, higher weight gain during pregnancy such as a multiple pregnancy, previous stretch marks in puberty and advanced maternal age. Stretch marks can appear on the stomach, but also breasts and thighs, and usually appear at the end of the second trimester into the beginning of the third trimester. Your best defence is to moisturize twice a day with a rich cream or oil! The latter can also help with the itch that is associated with the stretching of the growing belly. After the delivery, stretch marks may fade but may not fully disappear. Although they can be quite resistant to treat, it might be worth visiting your doctor to see what can be done. However, be kind on yourself shortly after delivery as only time will improve the appearance. It’s also worth remembering that for every woman who dislikes her stretchmarks, there is one wishing she had them!

There are many other less common physiological skin changes as well as pathological skin changes in pregnancy. If you worried about something, visit your doctor who will help you reassure or guide you further.

-Dr. Amelie Seghers