I am thrilled to offer our PYC community a guest blog from Dr. Zoe Veritas, a well respected Manhattan dermatologist, about the many skin and hair issues that arise during and after pregnancy. Enjoy!
I often tell my patients to expect to see many changes in her skin during her pregnancy. These are called physiologic changes, meaning they are normal and expected, and there is nothing to do to avoid them. Many of these changes disappear some time after delivery, and that is usually welcome news. Here are some things a pregnant woman may expect:
~For some women acne develops for the first time during pregnancy. For others, acne which has been present for years will suddenly disappear!
~ Most women will see darkening of the skin including areolae, nipples, genital skin and inner thighs and the development of a linea nigra (a dark line from the navel to pubis). Many women develop melasma, or dark patches of skin on the face.
~Vascular changes result from the natural pregnancy state of blood vessel stretching, instability and new vessel formation. This can be seen in pregnant woman as redness to the palms, varicose veins, redness and easy bleeding of gums, hemorrhoids and specific growths on the skin. Most do not need treatment as they will resolve postpartum, although anything that is painful and actively bleeding should be evaluated and treated.
~A pregnant woman’s hair will grow strong and often look luxurious during pregnancy. This is because the scalp goes into a phase of hair retention, or hanging onto new hairs, during pregnancy. During the postpartum phase all women experience something called telogen effluvium in which they see abrupt shedding of many hairs. Hairs will be seen to fall out from the root. This typically begins 3 to 5 months after delivery. This generally resolves spontaneously within a few months, but may last up to 15 months postpartum. (Interestingly, your baby may develop his or her own postnatal telogen effluvium between birth and 4 months of age! Usually regrowth occurs by 6 months of age.)
~And finally we get to stretch marks. Stretch marks, or striae gravidarum will develop in up to three-quarters of pregnant woman on the abdomen and sometimes on the breasts and thighs. This seems to be due to both hormonal factors as well as the physical stretching of the skin. They occur more commonly in women who gain significantly more weight in pregnancy and carry bigger babies. They are more common in younger first-time moms than in older pregnant woman. A woman is much more likely to develop stretch marks during her pregnancy if she has a previous history of stretch marks. There also appears to be a strong familial tendency, so a good predictor of stretch marks would be whether a pregnant woman’s mother developed stretch marks during her pregnancies.
Of note, studies have shown that coco butter does not help to prevent stretch marks and along those lines, I tell my pregnant patients not to waste their money on expensive creams and lotions that claim to diminish stretch marks. Nothing has been convincingly proven to prevent stretch marks, and I have seen allergic reactions in my patients to these creams. One small study showed that abdominal message with oil can help prevent stretch marks, although a more recent study disproved this. In this recent study pregnant women in their second trimester messaged twice a day with olive oil and this did nothing to prevent stretch marks. I recommend keeping the skin well-moisturized in general, including the pregnant abdomen, for good overall skin health and decreased itching.
Once a pregnant woman has developed stretch marks she often wonders what she can do to treat them. Studies have shown the addition of a retinoid cream can help the appearance of the stretch marks if started early, although retinoids are not prescribed for breastfeeding woman. Glycolic acid may also improve the look of stretch marks and this is a safe option in a woman who is breastfeeding. More recent studies have shown that some of the newer lasers can improve the appearance of stretch marks. The appearance of stretch marks tend to improve spontaneously over time, thus it is hard to determine through studies which treatments are helpful versus nature just taking its course.
Dr. Zoe Veritas is a Dermatologist in private practice in downtown Manhattan. She practices general and cosmetic Dermatology, and enjoys seeing pregnant patients.