HEALTHY FAMILY
Protect Your Skin During Pregancy
Common prenatal skin conditions
and how to treat them
W BY HEATHER M. ROSS
What kinds of skin conditions can
occur with pregnancy?
HYPERPIGMENTATION One of the most common changes that can
occur during pregnancy is a change in the
pigmentation of your skin, Goldberg says.

Nearly all women experience some hyper-
pigmentation during pregnancy, but this
doesn’t always look the same.

Melasma is a condition in which women
see dark patches on the face, cheeks, fore-
head or temples. It’s usually related to
hormones and can be triggered by sunlight.

For Melasma, Goldberg usually advises the
use of hats and daily use of sunscreen.

Linea nigra, also called the “pregnancy line,”
is another form of hyperpigmentation—a dark
vertical line over the lower abdomen, and it can
fade completely after pregnancy.

RASHES Saurabh Singh, who cares for patients in
Rockville and Silver Spring at U.S. Derma-
tology Partners, adds that among the most
common pregnancy-related skin condi-
tions he sees are PUPPP (pruritic urticarial
papules and plaques of pregnancy), pem-
phigoid gestationis and different types of
itching, including prurigo of pregnancy and
34 Washington FAMILY OCTOBER 2022
cholestasis of pregnancy.

Singh, co-founder of nation-wide online
skincare service, Skintap, has been practicing
medical, surgical and cosmetic dermatology
for adult and pediatric patients in the D.C.

metro area since 2011.

PUPPP typically appears first on the abdo-
men, sometimes involves the extremities
and rarely involves the face, he says. PUPPP
rashes can look and feel a lot like hives and
there are some things doctors can do to
provide relief, such as providing an oral anti-
histamine or other medications.

“I recommend fragrance-free products or
moisturizers anytime moisture is needed, a
lot of people are actually sensitive or allergic
to fragrance. So that can make itching or dry
skin or eczema even worse,” Goldberg says.

Prurigo of pregnancy often looks like
small pimples or acne. This rash typically
shares a color palette with stretch marks.

Some women report that the bumps feel
itchy or uncomfortable, but the rash is typ-
ically nothing to be too concerned over for
mother or baby.

A fairly common condition, it occurs in
approximately 1 out of every 300 pregnan-
cies, according to an article published in
the American Family Physician, and it isn’t
uncommon for it to last weeks—or even
months—postpartum. Some people who have acne experience
relief while pregnant, Goldberg says. Others
develop acne, or their acne gets worse with
the hormonal changes that come with preg-
nancy. However, while there are many acne
products that are safe to use during preg-
nancy there are some that aren’t.

“You should always check with your doc-
tor [first] to ensure safety,” Goldberg says.

“Delivery is often the treatment for
most of the aforementioned conditions,”
Singh says.

STRETCH MARKS
Another common change to the skin during
pregnancy is the appearance of stretch
marks. Stretch marks look like red, pink or
purplish lines in areas that stretch. Accord-
ing to Goldberg these are most common on
the belly, thighs and breasts. Most of the
time stretch marks fade after pregnancy but
not always completely.

BLUE PLANET STUDIO / GETTY IMAGES
ith any pregnancy comes
changes to a mother’s skin—a
growing belly stretches the
skin—but beyond that there are other skin
changes brought about by hormones.

“Because of (hormones), we see changes
to our skin, hair and nails,” says Jamie Gold-
berg, who has been a dermatologist for 10
years and is currently working with Kaiser
Permanente in Halethorpe.

Pregnancy-related skin conditions can occur
at any stage in the pregnancy, though most are
most intense during the third trimester.

According to Goldberg, most of these
changes are normal and many of them go
away—or are significantly reduced after your
pregnancy—but it’s helpful to know what
they are and how to treat them.




HEALTHY FAMILY
“There are many creams marketed to
reduce stretch marks but most studies don’t
report significant changes,” Goldberg says.

However, she notes that plain, fragrance-free
moisturizer helps.

When should you be concerned?
There are some conditions that may warrant
further supervision or evaluation by a der-
matologist or your OB/GYN.

“If you have a severe rash, see your doc-
tor, particularly one where you have blisters
or intractable itching. [Intractable] itching
is itching that keeps you awake at night and
doesn’t go away with the dry skincare meth-
ods I mentioned,” Goldberg says.

Of course, most expectant mothers’ num-
ber one concern is for their baby, so if you
are worried, seeing a doctor may help put
your mind at ease.

“The only two conditions (discussed here)
that could harm the baby are cholestasis of
pregnancy and pemphigoid gestationis,”
Singh says.

Cholestasis of pregnancy is a liver condition
that can occur late in pregnancy, according
Mayo Clinic, a nonprofit that serves patients
worldwide and is based in Arizona, Florida and
Minnesota. This condition causes intense itching but
presents without a rash. The itching typi-
cally occurs in the hands and feet but has
been known to affect other parts of the body.

Sometimes, due to the risk of complications
with this condition doctors can recommend
early delivery, according to the nonprofit.

Complications can include preterm birth,
lung problems in the infant, or even still-
birth. There is no known way to prevent
cholestasis of pregnancy, and doctors aren’t
certain what causes it.

Pemphigoid gestationis is not as common
as cholestasis of pregnancy. Also known as
herpes gestationis, it occurs in 1 out of every
50 thousand mid-to late-term pregnancies,
according to the American Family Physi-
cian. The American Osteopathic College
of Dermatology (AOCD) notes that it usu-
ally presents during the second trimester of
pregnancy, but can occur at any time.

Despite its name, PG is not related to the
herpes virus. It is an autoimmune condition
where the body attacks proteins found in
the skin.

PG presents as a red, itchy rash that
forms plaques and papules around and
sometimes including the belly button. Ini-
tially, the lesions resemble hives but after a
couple of weeks, blisters may form. PG typ-
ically flares shortly after delivery and then
resolves within three months, according
to the AOCD.

PG data does not suggest an increased risk
of death for the baby, however AOCD notes
the baby may be small for its gestational age.

The More You Know
It’s important to know the risks of any
changes you notice during pregnancy, but
remember that most changes are common,
temporary and nothing to be embarrassed
about. For more details on these and
other dermatological conditions, talk to
your doctor. T
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