Month 3: Skin changes – oh, why?

Stretch marks, pigmentation, acne: blame your hormones.

The hormones that race through your body when you’re pregnant affect just about every part of you, including your skin. And while this can work in your favour, and your skin will probably “glow” as a result of all the extra hormones and blood circulating around your body, you may also notice that it gets dry and scaly or starts to darken in certain areas. This, coupled with stretch marks and the emergence of visible dark veins, will probably leave you feeling like something out of a sci-fi movie. But don’t despair: it’s all completely normal.

According to Dr Dagmar Whitaker, a Cape Town-based specialist dermatologist, pigmentation changes during pregnancy are caused by an increased production of melanocyte-stimulating hormone (MSH), which acts on the cells that affect the colour of your skin, and these changes are usually more obvious on darker skin. “During pregnancy, hormone levels increase, and oestrogen increases stimulate the pigment-producing cells – hence the darkening of freckles, moles and the areolae of the breasts,” she says. Sometimes, your vagina, the skin on the inside of your thighs, underneath your eyes and in your armpits may even become darker, and a dark line on your abdomen, called the linea nigra, often appears in the second trimester too.

“This line appears down the middle of your tummy and marks the division of your abdominal muscles which separate slightly to make room for your expanding uterus.”

She also points out that not only does oestrogen stimulate melanocytes, but it makes the skin more sun sensitive – and that prevention is better than cure.

“Avoid the sun throughout your pregnancy, and use a SPF 50 sunscreen daily,” she advises.

Most moms-to-be will develop blue lines under the skin, most noticeably on the breasts and on the tummy. While they can be slightly freakish-looking, they’re there for a reason, and they serve as evidence of all that extra blood you’re carrying.

You might, however, develop spider and/or varicose veins. Spider veins are thin, wiggly red lines, and they usually appear on the cheeks. They are small broken blood vessels caused by the rapid dilation and constriction of your blood vessels when circulation increases during pregnancy. Varicose veins, on the other hand, are found on the legs as a result of your growing uterus and are often quite painful. What happens is that the uterus puts pressure on the large vein on the right side of your body, which in turn increases pressure in the leg veins.

“Veins must grow in pregnancy and are naturally more pliable,” explains Dr Whitaker.

“But if they don’t have enough elastic fibres, they either pop – spider veins – or enlarge – varicose veins.” Rest assured, veins will generally go away once your baby arrives, but be warned, in severe cases you may have to have them surgically removed. “Spider veins that don’t disappear after birth can be removed by sclerotherapy (injections), and big varicose veins would have to be cut out,” she says. “If you’re suffering from varicose veins, compression stockings should always be worn, and while it’s a good idea to put your feet up, avoid long periods without movement or exercise,” she cautions.

As your body begins to grow and change, you’ll start to spot stretch marks on your tummy and perhaps even on your thighs, hips, breasts and bum. In the beginning, they look like thin pink, red or purplish lines on pale skin and paler brown lines on dark skin, and they are the result of collagen fibres in the skin literally tearing and breaking.

“The same hormones that make ligaments relax during pregnancy also decrease the amount of collagen in the skin fibres, making them more fragile. The skin is held together by elastic fibres, and if, genetically, you don’t have enough elastic fibres, or your weight gain is too great and rapid, then the skin literally tears. “During this time you can use elastic fibre concentrates such as Dermastine to try and repair the tear, and if you’re genetically predisposed to stretch marks, you should, ideally, start using it from the beginning of your pregnancy.

“After pregnancy, stretch marks gradually fade to silvery lines on the skin, and once they turn white, it means the gap has been closed by collagen. This is scar tissue, and there is nothing that can be done then to remove it,” Dr Whitaker stresses.

While some women break out in hormonal acne – particularly in the first trimester – others land up with unbearably dry skin from hormonal changes that suck the oil and elasticity out of it.

Bear in mind, when you’re pregnant, your body also needs more fluids than usual to keep up with your increasing blood supply and developing baby’s needs. Insufficient intake of fluids can thus cause dry skin too.

“A pregnancy is a stress to all systems, and when you’re carrying a baby, the skin just does not produce enough moisture,” Dr Whitaker explains, adding that dryness is, at least, easy to manage. “Use a daily urea-based moisturiser on the body, even before you feel the skin getting dry, and don’t forget to drink lots of water.”