Expecting a Baby? Expect Changes in Skin, Hair, and Nails

July 26, 2001 -- In old Hollywood movies it's easy to tell if a woman is pregnant by looking at her face. She is glowing with a special, radiant beauty, and it always gives her away. Think Donna Reed as Mary Bailey in, "It's a Wonderful Life."

In real life, only a few very lucky women can list radiance and glow as their most dominant dermatological traits during pregnancy. The vast majority have to put up with one or all of the following: dark blotches on the skin, hair growth in unusual areas, thinning hair, rashes, pimples, stretch marks, and brittle or splitting nails.

If you are pregnant and feeling more like the Bride of Frankenstein than a Frank Capra heroine, relax, experts say. Skin, hair, and nail changes are to be expected, and they usually go away in the months after your baby is born.

"Women know about the stretch marks, but many of the other very common dermatological changes during pregnancy, like hyperpigmentation, aren't very well known," Massachusetts dermatologist Lisa M. Cohen, MD, tells WebMD. "I don't think they are talked about very much."

Cohen and colleague George Kroumpuzos, MD, reviewed published studies on dermatological changes during pregnancy and published their findings in the July issue of the Journal of the American Academy of Dermatology.

Hyperpigmentation, or the darkening of the skin, especially on the nipples and the abdomen, occurs in 90% of pregnant women. It is caused by the increased production of melanin, a substance that gives color to the skin and hair.

Melasma, more commonly known as the "mask of pregnancy," occurs in 70% of pregnant women, and may involve darkening of the cheeks, forehead, nose, and chin. This blotchy darkening usually disappears after pregnancy, but the best way to prevent it from occurring in the first place is with the diligent use of sunscreen, Cohen says.

"Even if you only go outside for 15 minutes, you can [worsen] this condition," she tells WebMD. "Just a little sun every day can really hurt if you don't protect yourself."

Connecticut dermatologist Robert Greenberg, MD, says stretch marks are the pregnancy-related skin condition that seem to upset women most. Unfortunately, they also tend to be permanent, and there is little that can be done to prevent them from occurring or diminish them.

"Creams and lotions don't really work," Greenberg tells WebMD. "There just is no good treatment to eliminate them."

Some other common pregnancy-related dermatological conditions include:

  • Hair growth on the face and chest. It's caused by hormone changes during pregnancy. Also known as hirsutism, it usually resolves within six months of giving birth.
  • Loss of hair in the months following delivery. Normal hair loss actually slows during pregnancy, leading to thicker hair. After giving birth a woman loses the hair she would have lost earlier. Cohen says she routinely sees new mothers who "are freaking out because they think they are going bald." But they are really just getting back to normal, she says.
  • A rash known as PUPPP, characterized by small red bumps and hives. This is the most common skin condition of pregnancy. The itchy lesions typically appear on the lower abdomen and can spread to the thighs, breasts and buttocks. They usually develop during the first trimester, during a first pregnancy, and itching can generally be controlled with creams prescribed by a doctor.
  • Changes in nails. Nails may become brittle and may chip more easily during pregnancy. Or, in some cases, they can become stronger. It is not clear why this happens.
  • Spider veins can appear on the trunk or anywhere on the body. These may or may not go away following delivery.

Preexisting skin diseases may be made better or worse by pregnancy, the researchers say. Psoriasis -- the chronic condition characterized by raised, thickened patches of red skin -- is more likely to improve than worsen. Symptoms associated with atopic dermatitis -- a chronic skin disease causing itchy, irritating lesions on the skin -- are likely to worsen.