Skin Conditions During Pregnancy

During pregnancy, a woman’s body goes through a host of physical changes and the skin is not immune from these effects.

Commonly, women experience changes in the skin’s appearance, including dark spots on the breasts, nipples and inner thighs, melasma, linea nigra, stretch marks, acne, spider veins and varicose veins. Many of these conditions are due to hormonal changes.

Here are some key points about skin conditions during pregnancy. More detail and supporting information are in the main article.

  • Dark spots and patches can develop due to increasing levels of melanin.
  • Melasma, a form of hyperpigmentation, is also known as “the mask of pregnancy”
  • Many women have stretch marks by the third trimester of their pregnancy
  • Stretch marks may never fade completely from the skin
  • Even women who have always had clear skin can develop acne during pregnancy
  • Certain forms of acne medication should be avoided during pregnancy
  • The appearance of spider veins during pregnancy is due to hormone changes
  • Varicose veins that develop during pregnancy typically resolve after delivery
  • Some less common skin conditions can have hazardous and long-last effects.

Hyperpigmentation

Many women experience hyperpigmentation, the appearance of dark spots or patches on the skin. Hyperpigmentation is caused by an increase in naturally occurring melanin. Typically, these hyperpigmented areas will resolve after the birth of the baby, however, at times, it can persist for several years.

An example of hyperpigmentation in pregnancy is melasma – “the mask of pregnancy” – which is characterized by brown patches on the face, cheeks, nose and forehead.

A pregnant belly with stretch marks.
Stretch marks that occur during pregnancy will usually fade over time.

Speak with a dermatologist about the treatment of melasma during pregnancy. Consider taking some steps to stop worsening of the condition by limiting sun exposure between 10 am and 2 pm, using a 30+ sunscreen and wearing a wide-brimmed hat when outside.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a condition in which pale red bumps appear on the skin of a pregnant woman and cause itching, burning or stinging. These bumps vary in size, ranging from very small areas to larger areas forming a plaque.

Most commonly, these lesions are present on the abdomen, legs, arms, breasts or buttocks. PUPPP typically resolves after delivery.

You may be given an antihistamine or topical corticosteroid for relief, although self-care steps can be taken to minimize the symptoms of PUPPP. These steps include using lukewarm water when washing, using cool compresses, wearing loose or lightweight clothing and avoiding soap on skin affected with PUPPP.

Stretch marks during pregnancy

Pregnant women are all too familiar with the presence of stretch marks. Often, women will develop stretch marks across the abdomen, buttocks, breasts or thighs. Stretch marks initially appear reddish-purple in color and fade to a silver/white appearance.

Although they often fade, stretch marks never completely resolve. Postpartum treatment of stretch marks is frequently ineffective, although laser and prescription creams can be considered.

Learn more: What are stretch marks?

Skin tags

The development of skin tags during pregnancy is common, and these lesions typically appear on the neck, chest, back, groin and under the breasts. Skin tags are generally nothing to worry about and are not malignant.

Acne during pregnancy

Acne may develop or worsen during pregnancy. There are many ways to treat acne, including prescription and non-prescription options which should be discussed with your healthcare provider before use.

Acne on the forehead.
If pregnancy exacerbates acne, there are several over-the-counter acne products that are safe to use.

It is important to remember general hygiene practices such as washing your face with lukewarm water and a mild cleanser twice daily, keeping hair from touching your face, shampooing daily, avoiding picking at pimples and using oil-free cosmetics.

During pregnancy, it is safe to use over-the-counter products that include topical benzoyl peroxide or salicylic acid, azelaic acid or glycolic acid.

Not all medications (prescription and non-prescription) are safe during pregnancy, however, and some of the unsafe products include:

  • Hormonal therapy due to an increased risk of birth defects
  • Isotretinoin (a form of vitamin A) due to the risk of severe birth defects, intellectual deficits, life-threatening heart and brain defects, and other physical deformities
  • Oral tetracyclines (antibiotic) due to the risk of tooth discoloration in the baby when taken after the fourth month of pregnancy. This medication can also have negative effects on fetal bone growth
  • Topical retinoids (a form of vitamin A) which are can be found in both prescription and nonprescription products.

Vein changes during pregnancy

Spider veins are small red veins that appear most commonly on the face, neck and arms.

These pesky skin changes are caused by pregnancy-induced hormone changes and increased blood volume; these typically resolve in the postpartum period.

Varicose veins are sore enlarged veins caused by increased weight and uterine pressure during pregnancy which leads to a decrease in blood flow to the legs. Varicose veins can present on the legs, vulva, vagina and rectum (hemorrhoids); these typically resolve in the postpartum period.

Varicose veins in the legs.
Varicose veins are enlarged veins caused by a decrease in blood flow.

To minimize the effects of varicose veins and to relieve symptoms, consider the following precautions:

  • Limit periods of sitting and standing
  • Uncross legs when sitting for long periods
  • Elevate legs when possible
  • Exercise often
  • Use support hose
  • Avoid constipation.

Learn more: What are varicose veins?

Other skin conditions during pregnancy

Other less common skin conditions during pregnancy include prurigo of pregnancy, pemphigoid gestationis and intrahepatic cholestasis of pregnancy (ICP).

Prurigo of pregnancy

Symptoms of prurigo of pregnancy include tiny, itchy bumps resembling insect bites and are typically caused by pregnancy-induced immune system changes. Prurigo of pregnancy can affect women throughout their pregnancy, with symptoms often worsening daily.

This condition can take several months to resolve, even extending into the postpartum period.

Pemphigoid gestationis

Pemphigoid gestationis is an autoimmune disorder which typically appears during the second or third trimesters, or in the time frame immediately following childbirth in some cases.

Symptoms of this condition include blisters on the abdomen or other parts of the body. This condition increases – although only slightly – the risk for preterm birth or birth of a small baby.

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-induced liver condition characterized by severe itching without the presence of a rash. Itching is typically present on the palms of the hands, soles of the feet or trunk of the body, occurring in the third trimester.

Symptoms of ICP generally resolve within the first few days following birth. However, ICP also increases a woman’s risk of preterm labor and fetal demise.

Speak with your healthcare provider if you are experiencing any unusual, concerning or worsening skin conditions; seek advice before starting treatment modalities.

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