Pregnancy Skin Care: Get That Glow!

Experts give tips to help treat pregnancy skin problems -- from acne to 'pregnancy mask.'

From the WebMD Archives

It isn't just an old wives' tale -- it's really true. A woman can look most ravishing during pregnancy. Well ... make that some women.

Indeed, while pregnancy can leave some lucky ladies looking luscious, for others, all that extra hormonal activity can have the opposite effect, causing a variety of pregnancy skin problems.

"Hands down, acne is the No. 1 skin problem to hit women during pregnancy -- but there are also a variety of bumps and rashes and discolorations that occur as well, most of them due to hormone activity," says Ellen Marmur, MD, chief of dermatologic and cosmetic surgery at Mount Sinai Medical Center in New York City.

Moreover, you might also find that at least some of the tried and true beauty products you relied on to keep your skin glowing before pregnancy are unsafe to use after baby is on board.

But fear not -- help is on the way! With just a few small changes to your grooming routine, you can get the glow going and join the ranks of the some the world's most beautiful pregnant divas!

Pregnancy Acne: What to Do

Even if it's been years since you've seen a zit, don't be surprised if pregnancy brings out a bumper crop, particularly around your mouth and chin.

"These are the most common areas for acne to occur during pregnancy, and if you don't treat it right away, it will continue until you deliver, and sometimes even after baby is born," says Marmur.

Although some over-the-counter preparations can help, dermatologist Sumayah Jamal, MD, PhD, says you must choose wisely.

"You should not use any products that contain benzoyl peroxide, salicylic acid, or any of the retinoids. They are not safe to use during pregnancy," says Jamal, an assistant clinical professor of dermatology and microbiology at NYU Medical Center in New York City.

What you can try, she says, are sulphur-based topical products, as well as those containing glycolic acid or alpha hydroxy acids, or any at-home microdermabrasion treatment.

If these don't help, says Jamal, there are topical prescription drugs that offer good results. "These include erythromycin cream and azelaic acid -- both very safe to use during pregnancy."

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And while Jamal does not advise using oral antibiotics for acne during pregnancy, Marmur says for patients who don't get results with topical treatments, prescription oral erythromycin is considered safe to use.

"It should not cause a problem, and if your acne is really making you miserable, this can help," she says.

What also works: switching to a foundation for oily skin, or using loose powder mineral makeup. Both have oil-blotting properties and won't irritate skin with acne.

"You can also use a mattifying product underneath your makeup to soak up excess oil, or dab your face with blotting papers during the day to help remove excess oil," says Jamal.

Pregnancy Mask and Other Pigment Problems

Among the most frustrating pregnancy skin problems is melasma, also known as chloasma or "pregnancy mask" - patches of dark, pigmented skin that appear on the face.

Pregnancy mask is related to pregnancy hormones and sunlight exposure. The American Academy of Dermatology says women with darker complexions and dark hair are at greatest risk.

But regardless of your complexion, Marmur says, other areas of darker skin can also develop on or around your nipples and between your thighs. "Many women also experience linea nigra or 'line of pregnancy' -- a darkened area of pigmentation that runs down the center of the belly," she says.

While there is no specific treatment for pregnancy pigmentation problems, staying out of the sun can definitely diminish the amount of discoloration you experience, so can wearing a sunscreen anytime you are outdoors.

While the jury is still out on the safety of traditional skin-lightening ingredients such as hydroquinone during pregnancy, Jamal says there are others with an established safety profile you can safely try.

"You can use azelaic acid, which is good for pigment, as well as any topical vitamin C product, which helps suppress pigment naturally," she says.

She also recommends Phytocorrective Gel by Skinceuticals, which she says safely suppresses pigment, as well as the Aveeno soy-based products. "They have a photo-stabilized sunscreen that contains soy and has been shown to lighten pigmented lesions on the skin," says Jamal.

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If all else fails, you can safely cover pregnancy mask with a high-pigment concealer or foundation. For best results, choose the color closest to your complexion and resist the urge to go lighter.

"If you select a light shade of concealer, you're not going to get better coverage, plus you're only going to draw attention to the mask by highlighting that area," says Holly Mordini, director of global artistry for Smashbox Cosmetics. Another tip, says Mordini, is to always use a good moisturizer before putting on your concealer. "This will help give better, more even coverage over large areas," she says.

If your mask does not clear after pregnancy, Marmur says a chemical peel "works like magic" to remove all traces.

Pregnancy Belly Itches

From annoying belly itches to potentially serious body rashes, there is no question that pregnancy can sometimes make your skin crawl.

"Part of the problem is caused by hormones and part is the result of skin stretching, which also causes it to itch," says Marmur.

Among the most common belly itches is PUPPP -- short for pruritic urticarial papules and plaques of pregnancy. This is a hive-type reaction that commonly begins in the third trimester. It's first noticeable near the belly button, but it can quickly fan out over a wide area, including the thighs, breasts, and buttocks.

While PUPPP isn't dangerous, and it often resolves soon after delivery, it can be incredibly uncomfortable. If you just can't stand the itch, Marmur says prescription-strength steroid creams can definitely help. You can also try dipping a cloth in some warm milk and applying it to the skin, or add a handful of oatmeal to a warm (not hot) bath.

If your rash is itchy and contains fluid-filled blisters, Marmur says talk to your doctor right away. This can be an autoimmune reaction known as pemphigoid gestationis or herpesgestationis. Although not related to the herpes virus, it can increase the risk of premature birth, and it may affect your baby's health as well, so it's vital to seek treatment early on.

Many women also suffer harmless, all-over itchiness during pregnancy. Often all that's needed to soothe the skin is calamine lotion or a good moisturizer. But again, Marmur cautions women to bring any skin irritations to their doctor's attention. In rare instances, she says, itchy skin can be a symptom of a pregnancy-related liver condition known as cholestasis, which may increase the risk of premature labor or cause some fetal distress.

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Pregnancy Stretch Marks

From old-fashioned cocoa butter to high-tech skin creams that claim to prevent stretch marks, there is certainly no shortage of products to try.

But today, most doctors believe that those red, blue, purple, and brown stretch marks that divide your belly like the Grand Canyon are largely hereditary, and most topical preparations won't prevent them from occurring.

"If there was something that worked to prevent stretch marks, believe me, we would all know it by now," says Jamal.

But while you might not be able to prevent stretch marks, Palm Beach dermatologist Ken Beer, MD, says in many instances a few laser treatments after baby is born will cause your stretch marks to fade as quickly as your memory of labor pains.

After the baby is born, "Treating stretch marks when they are red or purple can be accomplished with a pulse dye laser," says Beer, author of Palm BeachPerfect Skin. "Once they have turned beige, microdermabrasion, Retin A, Intense Pulsed Light and injections of fillers have varying degrees of success."

If you want to try a topical preparation during pregnancy, Beer suggests glycolic acid creams or those containing green tea as most effective on stretch marks.

Pregnancy, Botox, and Wrinkle Fillers

Finally, in case you're wondering whether or not it's safe to get antiaging wrinkle treatments like Botox or Restylane during pregnancy, it's important to note that there have been no tests to confirm safety.

Says Marmur: "I wouldn't advise a pregnant woman to intentionally have a wrinkle injection or a Botox shot. But many women, including myself, had wrinkle injections and then got pregnant within a couple of months and went on to deliver perfect, healthy babies."

Colette Bouchez is the author of Your Perfectly Pampered Pregnancy: Health, Beauty and Lifestyle Advice for the Best Years of Your Life and editorial director of PamperingMom.com.

WebMD Feature Reviewed by Louise Chang, MD on February 06, 2009

Sources

SOURCES: Ellen Marmur, MD, chief of dermatologic and cosmetic surgery, Mount Sinai Medical Center, New York City. Sumayah Jamal, MD, PhD, assistant clinical professor of dermatology and microbiology, NYU Medical Center, New York City. Ken Beer, MD, director, Palm Beach Esthetic Center; author, Palm BeachPerfect Skin. Holly Mordini, vice president of global artistry, SmashBox Cosmetics, Hollywood,Calif. American Academy of Dermatology, "Public Resource Pamphlet on Melasma" Bouchez, C. Your Perfectly Pampered Pregnancy: Health, Beauty and Lifestyle Advice for the Modern Mother-to-Be, Broadway Books, 2004.

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