Category: Pregnancy

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Pregnancy and your skin

Pregnancy and your skin

Congratulations you are pregnant and while you’re expecting a beautiful glowing skin that we’ve come to associate with pregnant women, there may be a few unexpected surprises leaving you less than happy! To begin with pregnancy can affect not just your skin, but your hair and nails too.

Most body changes observed in pregnancy are regarded as physiological or normal and result from hormonal, vascular, metabolic and immmunologic alterations which are necessary to sustain a healthy baby.

Not all changes are bad and the good news is that most of these physical changes regress in the first six months after delivery anyway.

Some women experience healthier and better looking skin in pregnancy. The ‘pregnancy glow’ results from a combination of 50% more circulating blood volume giving you a brighter or flushed appearance, and a hormonally driven increase in sebum production making the skin more shiny.

Other common vascular changes are reddening of the palms (palmar erythema), spider veins and varicose veins. Most of these changes can be attributed to the effects of oestrogen and an increase in the circulating blood volume.

Stria gravidarum (stretch marks) are caused by changes in the connective tissue or literal ‘stretching of the skin’ in pregnancy. Stretch marks usually develop on the belly, hips, buttocks, breasts, or thighs during the later stages of pregnancy when the body is rapidly growing. Most stretch marks fade to pale or flesh-coloured lines and shrink after delivery, although they usually do not disappear completely.

Higher levels of oestrogen prolong the growth phase of the hair, resulting in less shedding and thicker, healthier looking hair especially in the third trimester. Unfortunately the hair may quickly go into the resting phase after delivery leading to a depressing loss of hair within the first 6-12 months after delivery. This condition is known as telogen effluvium and thankfully full regrowth is the norm.
Some may experience increased hair growth or hirsutism on the upper lip, chin and cheeks which luckily usually abates after delivery.

Pregnant women may develop harder, thickened nails, while others find that their nails are softer or more brittle. These changes are temporary, and the nails should return to normal.

Melasma also known as ‘mask of pregnancy’ is probably the most disturbing form of hyperpigmentation in pregnancy affecting as many as 90% of women. Other forms of hyperpigmentation include darkening of the areola, linea nigra (vertical pigmented line than runs down the middle of the abdomen) and darkening of pre-existing moles (melanocytic naevi). Hyperpigmentation is thought to be related to increased oestrogen, progesterone and melanocyte stimulating hormone. Fortunately the hyperpigmentation of pregnancy regresses in most cases. There are numerous treatments for Melasma but many of these are not suitable in pregnancy.

Eccrine glands activity increases in pregnancy with increased sweating making pregnant women heat intolerant and contributing to discomfort in the third trimester.
Increased androgens boost sebum production with a resultant oilier skin. Fortunately an oilier skin does not always mean acne. Acne breakouts usually occur during early pregnancy. Remember that not all treatments and products are safe to use during pregnancy and its important to check if your pre-pregnancy treatments are still suitable.

Besides these physiological or normal changes in pregnancy, pregnant women are also susceptible to common skin diseases or skin concerns.
Dry or sensitive skin may occur for the first time during pregnancy or be part of an ongoing problem.
Pre-existing skin conditions such as eczema, psoriasis and rosacea may improve or worsen.

While you are pregnant you may need to change your existing skincare regimen for one that doesn’t contain ingredients that are unsafe or have high irritation potential. In general vitamin A and its derivatives, including retinol, are not safe for use.
If you would like our advice on whether you can still use any of your existing creams, please email us or alternatively book an appointment with our medical therapist or dermatologist.

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Skincare in pregnancy – what is the evidence?


Pregnant women are wary of causing harm to their unborn babies during this vulnerable period in development. There is significant modification of lifestyle practices with huge emphasis on safer and healthier options. More than 50% of pregnant women also question their skincare regimen and seek guidance on the use of personal care products.

What are the common things that most women are most concerned about making them question use in pregnancy?
Women are concerned that certain ingredients in skincare products may be carcinogenic (causing cancer), teratogenic (harmful to the fetus) or unsuitable for their changing skin needs in pregnancy. In this article we explore the available evidence on a few commonly used ingredients to help you understand which products can be used safely when your pregnancy tests positive!

Vitamin A/ retinol
There is lots of evidence for the potential teratogenic effects of oral vitamin A and the drug commonly used for acne called isotretinoin. We do not actually know how much topically applied vitamin A is absorbed by the skin to eventually reach the circulation and the growing baby. There are however a few cases where birth defects were reported after using topical Vitamin A in pregnancy. The consensus opinion is that women should avoid products containing retinol during pregnancy, whether oral or topically applied.

Benzoyl peroxide
Benzoyl peroxide is a widely used over the counter treatment for acne. Minimal amounts are absorbed into the skin after topical application, but there have not been any reported ill effects in the babies whose mothers used topical treatment. Therefore this is one of the acne treatments considered safe for breakouts in pregnancy.

Topical antibiotics
Topical clindamycin and erythromycin are prescription antibiotics used mainly to treat acne. Studies have found both topical ingredients to be safe for use in pregnancy.

Salicylic acid
Topical salicylic acid is quite a common ingredient in acne treatments. The concentration in products as well as the amount of absorption into the blood stream varies. However it is still considered a small amount which is unlikely to cause any harm.

Glycolic acid
Glycolic acid is an alpha hydroxy acid found in many brands of resurfacing anti-ageing products. It is also used in face washes and creams to treat acne and hyperpigmentation.
There is minimal systemic absorption from topically applied glycolic acid so it does not pose a risk in pregnancy. However glycolic acid may be irritating to the skin especially in high concentrations, so first time users in pregnancy should be cautious.

Hydroquinone
Hydroquinone is a prescription skin lightening ingredient, banned as an over-the-counter product in South Africa. It may however be prescribed by doctors and dermatologists. There is a large amount of hydroquinone that is systemically absorbed after topical application. There is no conclusive evidence to suggest that hydroquinone will have an effect on your growing baby, but because of the large amount that is absorbed, it is not recommended for use in pregnancy.

Sunscreens
Sunscreens generally have very little systemic absorption and are safe to use in pregnancy.
The general consensus is that the benefits of sunscreens outweigh any unsubstantiated risk.

In summary, apart from notably hydroquinone and retinol there is no evidence to suggest that most other common topically applied skincare ingredients will cause harm to a developing baby.

Bear in mind that does not exclude the possibility of a localized cutaneous reaction (skin reaction) to the ingredients as we must take into account that pregnancy may cause a change in your skins’ condition and its ability to tolerate products.

In addition to this, skin reactions to skincare products may occur irrespective of whether you are pregnant or not.
Remember that a product recommendation or prescription given before you fell pregnant may no longer be safe or appropriate once your status changes, and its best to confirm with your doctor.

At Skinsmart we have a tailored pregnancy skin assessment to assist you with your product choice. We recognise that pregnant women would also like to look and feel their best without compromising the health of their babies.

Please email us on [email protected] to book an appointment  if you would like more specific advice.

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What to expect from your skin when you’re expecting

Physiological skin changes of pregnancy occur in virtually all pregnant women.

Various forms of Hyperpigmentation (increased pigmentation) occur in as many as 90% of pregnant women. Melasma also known as ‘mask of pregnancy’ is probably the most disturbing form of pigmentary alteration. Other forms of hyperpigmentation include darkening of the areola, linea nigra (vertical pigmented line than runs down the middle of the abdomen) and darkening of pre-existing moles (melanocytic naevi).

Melasma – the mask of pregnancy

Changes in the circulation also present with reddening of the palms (palmar erythema), spider veins and varicose veins. This is as a result of increased circulating oestrogen and an increase in the circulating blood volume.

Varicose veins

Hair changes during pregnancy result from higher levels of oestrogen which prolongs the growth phase of the hair, resulting in less shedding and thicker healthier looking hair. Some women also notice that hair becomes shinier during pregnancy or that it changes in texture. Another consequence of this is increased hair growth on the upper lip, chin and cheeks. Thankfully this reverts to normal after delivery. Unfortunately the hormonal alterations that occur after delivery may cause hair to transition the resting phase of the hair cycle, which can result in hair loss 6-12 months after birth of the baby. This kind of hair loss called telogem effluvium  thankfully corrects itself as the hair follicle goes back into the growth cycle.

Pregnant women may develop harder, thickened nails, while others find that their nails are softer or more brittle. These changes are temporary, and the nails should return to normal after giving birth.

Eccrine and sebaceous glands have increased activity in pregnancy, resulting in increased sweating during pregnancy and an oilier skin.

Stria gravidarum (stretch marks) are caused by changes in the connective tissue or literal ‘stretching of the skin’ in pregnancy. Many women notice stretch marks on their belly, hips, buttocks, breasts, or thighs during the later stages of pregnancy when the body is rapidly growing. How much and how quickly you gain weight when you’re pregnant may determine whether you get stretch marks. Genetics may also play a role. Most stretch marks fade to pale-or flesh-coloured lines and shrink postpartum, although they usually do not disappear completely.

Pregnancy stretch marks

 

What is ‘PREGNANCY GLOW’ ?

The physiological changes that occur in women during pregnancy contribute to a facial ‘pregnancy’ glow. So yes there is a scientific explanation for this: During pregnancy your body produces 50% more blood. The increase in blood flow through your body and skin causes your face to be brighter or ‘flushed’. The increase in hormones cause facial oil glands (sebaceous glands) to produce more sebum, making the the face more shiny. The combination of the flushing from the blood flow and the shine from the increased sebum create the happy ‘glow ‘ that we see on pregnant women.

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Pregnancy Skin Conditions

Pregnant women are still susceptible to everyday skin concerns that plague other women, though the treatment may need to be tailored to suit the changes of the skin and body in pregnancy and take into account the effects on the developing fetus. Here is some of our advice followed by a few product recommendations for common pregnancy concerns.

ACNE BREAKOUTS


Higher levels of hormones called androgens are at least partly responsible for pregnancy breakouts because they prompt the sebaceous glands in your skin to get bigger, and boost production of sebum. This often occurs during early pregnancy and may make the skin appear or feel oily. Acne during pregnancy may be mild, moderate or severe. It may be of new onset or an exacerbation of a pre-existing problem. It is important to remember that not all treatments and products are safe to use during pregnancy and if you were on a treatment regimen before you fell pregnant this may need to change. Consult your doctor, dermatologist or skincare professional to make sure you are on the right medication.

Product recommendations:

Neostrata Sheer Hydration-Sheer Hydration is a light, oil-free ,daily hydrator formulated with NeoGlucosamine to gently exfoliate the skin, promote cell turnover and help with minor acne problems.


Obagi NuDerm Foaming Gel – This foaming gel cleanser cleans the skin thoroughly of makeup and impurities. This product is safe to use during pregnancy.

MELASMA / CHLOASMA (PREGNANCY MASK)


Hyperpigmentation can occur for the first time during pregnancy as a result of hormonal and genetic factors, together with increased sensitivity to sun exposure The melanocytes in pregnant women are more sensitive to increased levels of melanocyte stimulating hormone(MSH), oestrogen and progesterone. Hyperpigmentation is one of the most common skin changes during pregnancy, and is also very hard to treat as options are few. It is often very distressing for pregnant women to deal with, in addition to all the other changes that come with pregnancy.
It may gradually improve or disappear after childbirth (normally 3-6 months after) but may persist in some women. There are numerous ingredients in cosmeceutical products that work synergistically to lighten and control pigmentation, but many of these are not suitable for use during pregnancy.

Product recommendations:

Heliocare 360 mineral – This innovative mineral fluid sunscreen is ideal for sensitive skin.


Neostrata Brightening cleanser – The Neostrata Enlighten range is clinically proven to treat and control pigmentory disorders, dark spots and signs of sun damage, while also reducing the appearance of fine lines and wrinkles.
Please note that not all products in the Enlighten range are safe in pregnancy.

DRY SKIN


Dryness of the skin is a common skin complaint and may occur for the first time during pregnancy or part of an ongoing problem. The skin feels tight and uncomfortable and may appear rough and dull. Pregnant women often look for more hydrating creams during pregnancy as their regular moisturiser may not provide enough hydration.

Product recommendations:

Neostrata Bionic Face Serum – Bionic Face Serum is a concentrated oil-free serum with 10% Lactobionic Acid designed to work synergistically with other Neostrata anti-ageing products in your regimen to improve radiance, skin texture and the signs of ageing.
It provides comfort and hydration for dry skins.


Neostrata Bionic Face Cream– Bionic Face Cream is an ultra-rich, anti-ageing emollient cream which provides intense hydration and skin smoothing effects without irritation.

SENSITIVE SKIN


Some pregnant women have the impression that their skin in more sensitive than before pregnancy. This may mean different things to different people, but in general, the skin is easily inflamed and irritated and reacts to numerous cosmetic products. Sensitive skin is a common complaint among pregnant women and is most likely due to changes in hormone levels. Pre-existing skin conditions such as eczema and rosacea may improve or worsen and your regular skin care regimen may no longer be suitable.

Product recommendations:


Obagi Soothing Cleanser – This calming gel cleanser offers relief from inflammation and irritation. It effectively removes make-up and impurities without disrupting the skins natural moisture barrier.


Obagi Skin Calming Cream– This non-irritating moisturising formulation contains plant-derived growth factors Kinetin and Zeatin. It effectively calms and soothes a sensitive and irritated skin.

Can I continue with my anti-ageing treatment during pregnancy?

A well-tailored anti-ageing skin care regimen can help slow the process of ageing. While you are pregnant you may need to change your existing regimen for one that doesn’t contain ingredients that are unsafe or have high irritation potential. In general vitamin A and its derivatives, including retinol, are not safe for use during pregnancy.
Please take our Skinsmart Skin Assessment to see our recommendations for anti-ageing skin care that is safe to use during pregnancy and while breastfeeding.

If you would like our advice on whether you can still use any of your existing creams, please email us on [email protected] or alternatively book a consultation with our medical therapist or dermatologist on 021 521 1107.