There are several skin changes that occur during pregnancy and immediately after giving birth (postpartum). These can have a positive and/or negative impact on physical appearance. Some are expected changes that are due to a multitude of factors including hormonal changes associated with pregnancy. Some are conditions that result in illness and require medical intervention. Common changes that may be visible include

• Striae gravidarum, also known as stretch marks
• Chloasma, which is increased pigmentation on the skin
• Increased hair growth
• Postpartum hair loss
• Brittle nails
• Varicose veins
• Linea nigra, which is a vertical line of increased pigmentation over the abdomen

Stretch marks Notably, hormonal factors and physical stretching of the skin appear to be relevant in the development of stretch marks. To prevent or minimise their appearance, it is important to keep the skin well hydrated; topical products to consider are almond or coconut oil, however, there is weak evidence in the literature to support this.

Chloasma (hyperpigmentation) For pigmentation changes, consider vitamin C and/or niacinamide topical application. There are many over-the-counter products that contain these, but it is important to consult with your dermatologist before using any, for you and your baby’s safety. Definitive treatment is reserved for after giving birth. The changes can be quite distressing for the patient, but sadly cannot be predicted or prevented in most cases. These usually disappear or improve after giving birth. They may, however, persist and require dermatologist management. For some women, pre-existing conditions may flare up or worsen during pregnancy. This too is attributed to the hormonal changes. Examples of these conditions are acne, eczema, and psoriasis. Unfortunately, there are restrictions when it comes to treatment options for some of these conditions when you are pregnant. It is important to consult your doctor for clarity on which medication is safe during pregnancy and what is contraindicated (cannot be used). Pregnancy-specific skin diseases are a group of pruritic (itchy) skin eruptions which are seen only in pregnancy. These include the atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, and intrahepatic cholestasis of pregnancy. Simply put:

• Atopic eruption of pregnancy is an itchy rash that can be minor or involve the whole body.
• Polymorphic eruption of pregnancy is an itchy rash and vesicles which can be concentrated on st4riae on the abdomen.
• Pemphigoid gestationis is a blistering disorder.
• Intrahepatic cholestasis presents with an intense itch with subsequent skin lesions.

It is important to consult your dermatologist if any of these occur.  

Article by Dr Thembela Mfenyana-Luthuli Dermatologist T: 012 942 6611 dr.thembelamfenyana@gmail.com Location: BMR Family Health Clinic (Block DD)