SKIN TO SKIN
Pregnancy skin solutions
Pregnancy is a journey of surprises – with a lifechanging one at the end. Along the way, skin can become unsettled and undergo changes, some of them dramatic. We enlisted the help of dermatologist Dr. Victoria Scott-lang – new mum for the second time – to address our readers’ skin issues. 1 “With my third and fourth pregnancy, I suffered from loads of skin tags from my neck to my chest” – Andrea Dr Scott-lang: These are harmless fleshly little growths which appear as we get older and also during pregnancy, typically in areas of friction (under the arms, under the breasts, around the neck and groin). They may shrink and disappear after you deliver your baby. If you notice that they are still present, they can easily be snipped off by a doctor under local anaesthetic. 2 “I have spider naevi all over my hands!” – Charlotte Dr Scott-lang: Spider naevi are dilated blood vessels which often appear on the chest, neck, face and arms but can also appear anywhere on the body. They are present when there is more oestrogen in the body, hence their development in pregnancy. Spider naevi are quite red and prominent in appearance, but this may improve after delivery. If they don’t resolve they can be treated with Intense Pulsed Light (IPL) or laser. They’re harmless but many women will seek treatment for cosmetic reasons, particularly if they affect the face or décolletage. 3 “I got bad eczema around my hairline and I’m still suffering from it now that baby is two months old” – Kelly Dr Scott-lang: Women who have a previous history
of atopic eczema (dermatitis) often find that it returns or flares up during pregnancy. It can also appear for the first time during pregnancy. Interestingly, some women find that their eczema improves when they are pregnant – it varies from person to person and can be unpredictable due to alteration of the immune system. Depending on severity, eczema can be managed in different ways. Moisturising regularly is an important part of treatment. Studies have shown no adverse association with maternal use of topical steroids and pregnancy outcomes, but despite this many women will prefer to avoid them. For others, they’re an important part of treatment. In severe cases, UVB phototherapy can be safely used to treat eczema. In general, oral drug treatments need to be avoided during pregnancy. Avoidance of irritants e.g. fragrance, bubble baths, certain preservatives in cosmetics, wool and nickel can be an important part of keeping your skin as healthy as possible if you are prone to eczema.
4 “A heavy dose ofmelasma resulted in a panda effect around my eyes and around the top of my forehead” – Sarah
Dr Scott-lang says: Melasma is relatively common during pregnancy, and is probably one of the hardest skin conditions to treat. I treat a lot of women looking for help with melasma following a pregnancy as it has not resolved. Melasma is essentially brown or greyish pigmentation which affects the forehead, cheeks and above the lip, more often seen in people with darker skin. It is thought to be related to high oestogen levels (also seen in women who take hormonal contraceptives). We know that melasma is exacerbated by ultraviolet light, so New Zealenders need to be strict with applying a good-quality sunscreen (with UVA and UVB protection) every day, along with wearing a hat when outdoors. Using make-up with good coverage can be helpful for camouflaging it, and will also offer some UV protection (my personal favourite is Estee Lauder Double Wear which confers SPF 10 or SPF 25, depending on the product). For women whose melasma does not fade post delivery, it can be treated with different approaches. My preference is to start with a lightening cream, usually four per cent hydroquinone. Following a month of hydroquinone, a specific laser (called Q-switched ND:YAG) can be tried for patients with fairer skin types (not suitable for individuals with darker skin types). Laser should be performed by a nurse or doctor who has trained and is skilled in this field, ideally under the supervision of a dermatologist.