We’ve all heard the horror stories from loving friends and family members about how their skin changed during pregnancy – stretch marks, hair loss, acne, oh my! But how often do these skin changes occur, and which ones should we you weary of?
During pregnancy, women can experience normal physiological skin changes, alterations of their current skin conditions, and (more rarely) specific pathologic skin diseases.
Normal Skin Changes
A study of 905 pregnant women aged 15-45 years found that 88.95% of women experienced physiologic changes during pregnancy. The most common skin changes included increased pigment in the woman’s skin, such as linea nigra (a darkened vertical down the middle of a woman’s abdomen), melasma (facial pigmentation), mucous pigmentation, and increased size of moles; while just less than half of the women developed new stretch marks or vascular changes (ex. spider veins) (Fernandez).
Changes of Current Skin Conditions
While some skin conditions may worsen in pregnant women, others can improve, and yet others follow a more variable course. Atopic dermatitis often worsens during pregnancy and is the most common skin complaint diagnosed in pregnant women at dermatology referral centers. In contrast, psoriasis has been reported to improve during pregnancy, while acne and rosacea follow an unpredictable clinical path. Some studies show acne worsening during pregnancy; whereas, other studies find that it can improve. For those women who do experience acne flares during pregnancy, the third trimester has been noted as the worse time due to the increase in the number of glands from which acne forms (Yang).
Although rare, specific pathologic skin conditions or dermatoses can occur during pregnancy and should be distinguished from physiologic skin changes. When these dermatoses occur, it is later in pregnancy (3rd trimester), and low versus high-risk pregnancies do not play a role in their frequency (Fernandes).
The four main pregnancy specific dermatoses include pemphigoid gestationis (PG), polymorphic eruption of pregnancy (PEP), intrahepatic cholestasis of pregnancy (ICP), and atopic eruption of pregnancy (AEP). Each condition presents in a slightly different manner in terms of location on the body and time of onset during pregnancy; however, one common symptom for all of these conditions is that patients will feel very itchy. Although only PG and ICP have been associated with fetal risks, it’s important never to neglect pruritis in pregnancy as these dermatoses can have similar symptoms (Saverall).
Ultimately, the take home point is that many skin changes occur during pregnancy, the majority of which are completely normal. However, never dismiss the oddities such as a very itchy rash or a mole that has grown dramatically and looks suspicious. More than likely, the rash is benign, and the mole has stretched with your skin to support your growing fetus, but it’s much better to be safe than sorry and to trust those “Mom Instincts” you will only continue to hone with time.
- Fernandes LB & Amaral WV. Clinical study of skin changes in low and high risk pregnant women. Anais Brasileiros de Dermatologia. 2015;90(6):822-826.
- Sävervall C, Sand FL, Thomsen SF. Dermatological Diseases Associated with Pregnancy: Pemphigoid Gestationis, Polymorphic Eruption of Pregnancy, Intrahepatic Cholestasis of Pregnancy, and Atopic Eruption of Pregnancy. Dermatology Research and Practice. 2015(2015), Article ID 979635. 7 pages. doi:10.1155/2015/979635
- Yang CS, Teeple M, Muglia J, Robinson-Bostom L. Inflammatory and glandular skin disease in pregnancy. Clinics in Dermatology. 2016;34(3):335-43.
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