Q&A: Is my skin reflecting my health?

My skin goes crazy when I’m pregnant. First it was acne, and now I’m dealing with pigmentation. Both of these will be temporary, I’ve heard. But now I’m so afraid that stretch marks will be next, as those don’t go away, right? My heritage is Mediterranean, so I’m olive toned – not sure if that makes any difference. I also worry that my bad skin is a sign that my pregnancy isn’t healthy, but I’m really eating well, and otherwise I feel great. On the positive side, my hair and nails are thicker and stronger than ever. Why this positive effect, and then my skin is so bad? Are they all related?

DR TARRYN JACOBS ANSWERS: During pregnancy, our bodies undergo a variety of changes in many systems, and our skin, the largest organ we have, is no different. While some women report glowing skin and luxurious hair and nails during pregnancy, for many the changes are not so welcome. Acne, pigmentation and stretch marks – even rashes – all present a challenge. This is not a reflection of your health but rather of normal physiological changes during pregnancy.

ACNE

One of the more common skin disorders that can develop or worsen during pregnancy is acne, which tends to occur during the first and second trimester. This is because of increased levels of the hormone progesterone, which results in sebum (oil) production. Managing acne in pregnancy can be tricky, as most standard treatments should be avoided. Some topical treatments can be absorbed into the skin, which can present issues during the pregnancy.

There are several topical ingredients like benzoyl peroxide, glycolic and azelaic acid, which are considered safe in limited amounts. Therapies using light may also be of benefit.

If your acne doesn’t improve within a few weeks of following a consistent routine, or if your acne is severe or bothers you, consult your dermatologist for a safe treatment plan.

STRETCH MARKS

The dreaded stretch mark is another skin change that very few people escape. It affects nearly 80 percent of women in pregnancy to some degree. It is not only due to the stretching of the skin but also the hormonal changes associated with pregnancy. Although many products are promoted to prevent the development of stretch marks, sadly, they have limited scientific evidence of working. It may just be the act of massaging alone that is beneficial, more than the product itself.

The best advice I have is to keep your skin well moisturised during pregnancy but not to fall into the trap of spending a small fortune on creams to prevent stretch marks from forming. Moisturising helps to maintain skin’s elasticity, making it less likely to tear when your body starts expanding.

Once stretch marks have formed and you are in the post-pregnancy period, there are options that may improve the appearance to some degree. These include retinoid (vitamin-A-based) creams, microneedling and treatment with radiofrequency devices or lasers.

MELASMA

Melasma is sometimes known as the “pregnancy mask” and is a discolouration that usually affects the forehead, cheeks, and upper lip. It is commonly attributed to a combination of hormonal factors and UV light exposure.

It is vital to wear sunscreen every day during pregnancy, as sunlight can drive the melasma process. Fortunately, studies show that sunscreen can lighten pigmentation in pregnant women. Treatments should be avoided until baby’s birth, but I can recommend using topical products that contain vitamin B3 (niacinamide) and vitamin C, as they both have skin-brightening and pigment inhibiting properties.

I think it’s important to enjoy your pregnancy journey and not to get too caught up with skin issues at this stage. Many options will be available in the postpartum period to treat any of the common conditions experienced. ●