Skin problems during pregnancy

Hormones during pregnancy can cause skin problems.

The most common skin problems are:

• acne
• melasma (patches of brown or grey discolouration)
• itching

Other common skin problems during pregnancy include:

• stretch marks
• hair loss
• varicose veins
• oedema (fluid retention)
• redness of the palms

It's common for pregnant women to get some darkening of the skin. This often happens with birthmarks, moles, freckles and the skin around the nipples.

Some women also get a dark line down the middle of their stomach, called a “linea nigra”. These changes usually fade after pregnancy, although the nipples may remain a little darker.

Treating skin problems during pregnancy

Pregnant women should not use certain skin medications. They can cause birth defects in babies.

If you are pregnant, breastfeeding or trying to conceive, avoid using the following:

• retinol or retinoids - these are tablets or creams made from vitamin A
• salicylic acid
• antibiotics like lymecycline (Tetralysal) and minocycline (Minocin)

If you want to try for a baby, wait a month after stopping these medications. Always talk to your GP before trying for a baby if you have been taking medication.

Treatments for skin problems that are safe to take during pregnancy include:

• glycolic acid - you can buy products containing glycolic acid at a pharmacy
• azelaic acid creams - your GP can prescribe these
• antibiotics like erythromycin

Lifestyle changes and things to avoid during pregnancy

Acne

Acne is a condition that causes spots, blackheads, whiteheads, red lumps and oily skin. It is most common on the face, neck, back and chest.

Around half of all women get acne during pregnancy. If you already have acne, it can get worse during pregnancy.

Acne is usually worse during the first trimester. It gets better as the pregnancy continues.

If your acne is severe, your GP may be able to refer you to a dermatologist.

What you can do

To reduce the symptoms of acne:

• try not to pick your skin or squeeze your spots - this can cause scarring
• talk to your GP and pharmacist about products that are safe to use during pregnancy
• use “non-comedogenic” makeup and skincare products - they are less likely to make acne worse
• avoid using strong or harsh soaps - they can irritate your skin
• gently wash your skin every morning and evening with a cleanser and warm water, then pat yourself dry with a towel

Melasma

Melasma is when patches of brown or grey discolouration appear on the skin. These patches are usually on the cheeks, forehead and upper lip.

Melasma is not skin cancer. It will not change into cancer.

About half of all women get melasma during pregnancy.

Melasma will usually fade a few months after you have given birth. It may return during later pregnancies. It may also come back if you take the combined oral contraceptive pill.

Exposure to sunlight, sunbeds and phototherapy can make melasma worse.

What you can do

To avoid getting melasma or reduce its symptoms, you can:

• wear sunscreen everyday - in Ireland, this means factor 50 in summer and factor 30 in winter
• avoid sitting in the sun
• wear a wide-brimmed hat

Contact your GP if your melasma does not fade after you have given birth and you're worried about it. They can refer you to a dermatologist.

Skin itching

Skin itching is common during pregnancy. This is because of the increased blood supply and stretching of the skin.

What you can do

To reduce skin itching, you can:

• moisturise regularly
• wear loose, cotton clothes

Treating itchy skin

PUPPP rash

PUPPP rash stands for pruritic urticarial papules and plaques in pregnancy. It's an itchy bumpy rash that affects the tummy, legs and arms.

PUPPP is not harmful. But it can be very irritating. It usually happens in the second half of pregnancy. It disappears soon after giving birth.

Around 1 in 400 pregnant women get PUPPP. This means that 399 in 400 do not get it.

What you can do

To reduce skin itching, use:

• emollients that do not have any perfume
• anti-itch medication
• antihistamines