By: Megan Couvillion, MD, MS, FAAD.
Expecting a baby is such a special and exciting time. Though there are lots of books, websites, and other resources out there to guide you through all 10 months of pregnancy, the sections on skin concerns are often pretty slim. Here, I discuss the top 5 pregnancy skin questions I am asked in my clinic. I hope all of you pregnant mamas and mamas-to-be find this information helpful and empower you to take great care of your skin.
1. My skin is dry and sensitive, but I haven’t ever had dry skin or eczema before. I haven’t used any new products or perfumes. Am I allergic to something?
This is a common complaint during pregnancy, and it seems to be related to a decrease in the skin’s ability to hold in moisture. We don’t fully understand how this happens, but it is transient and does not happen in every pregnancy. When the skin is dry, tiny microscopic cracks form where fragrances and other product components can cause irritation. So, soaps, cleansers, lotions, and other skin care items may cause a problem, even when you have been using them for years.
You can treat the skin dryness with a few simple steps:
• Choose a cleanser that is made for sensitive skin and is fragrance-free. Some “all natural” soaps can be too drying, and it is important to note that natural products can still be irritating to dry skin.
• Follow your bath or shower with a moisturizing cream applied to all of the skin while still damp – within a minute or two of getting out of the water. Like I suggest for the cleanser, moisturizers should be fragrance free and intended for sensitive skin. In general, creams and ointments are more hydrating than lotions and can be more soothing to dry, irritated skin. Great cleanser and moisturizer options can be easily found on your local pharmacy shelf – look for brands like Cetaphil, CeraVe, Eucerin, and Aveeno.
• Consider putting perfumes and fragranced lotions to the side until after your baby arrives.
• Choose laundry detergents that are “free and clear” – free of perfumes and clear of dyes.
It’s important to note that dry skin is usually not related to internal dehydration. While it’s important to ensure you are drinking enough water, this won’t help your skin be more moisturized.
Sometimes true skin allergies or more severe eczema develop and require prescription treatment. If your skin isn’t getting better after a week or so of good moisturization, it’s time to seek out your dermatologist.
2. Can I do anything to treat my acne while I’m pregnant?
The increasing hormone levels in pregnancy can fuel oil production and lead to new or worsening acne. Though the pregnancy-safe options are fewer, there are still effective over the counter and prescription treatments available to you.
In general, products that contain retinoids (tretinoin, tazarotene, adapalene, retinol), salicylic acid, and benzoyl peroxide should be avoided during pregnancy. These are found in both prescription and over the counter medications, so it’s a good idea to review the ingredient list of the acne products on your bathroom counter.
Here’s a list of pregnancy-safe treatment options:
Glycolic acid treatments
o Glycolic acid is an alpha-hydroxy acid that gently exfoliates the skin, helping unclog pores and removing dead skin cells
o Washes can be used on the face, chest, and back. A favorite, inexpensive option is Mederma glycolic cleanser.
o Peels using glycolic acid are superficial or light peels that can be done once a month.
o Red and blue LED lights are a great option as an add-on to other treatments, or as a solitary drug-free treatment option. The red and blue wavelengths of light decrease inflammation and bacteria on the skin’s surface, improving acne.
o LED treatments are available as an in-office procedure (where you’ll get a stronger dose, performed every 2-4 weeks), or can also be found over the counter in the Neutrogena Light Therapy Acne Mask (the light is a lower dose, used at home daily).
Prescription medications: If you aren’t getting where you want with over the counter options, you may need to see a dermatologist to optimize your treatment with prescription medications such as topical antibiotics (clindamycin or erythromycin) and/or azelaic acid.
3. Are stretch marks preventable and/or treatable?
Pregnant women carry their babies differently, and this is due to multiple factors, including genetics, body type, and weight gain – all of which can influence whether or not you develop stretch marks.
Most of these factors are out of our control (yay pregnancy) but it can be helpful to facilitate stretching of the skin by keeping it moisturized. I recommend a gentle massage once daily of your baby bump with a moisturizing oil or cream. Staying active and maintaining a healthy diet can prevent excessive weight gain, and also may minimize stretch marks.
That being said, sometimes these marks are unavoidable despite our best attempts at prevention. The great news is that there are treatments to help improve them once your baby is born. Keeping the skin hydrated will help it heal, and often redness will fade over time. Any residual redness or light colored stretch marks can be treated with vascular and resurfacing lasers to help that skin return to its normal color and texture. I encourage you to talk to your dermatologist to see what options would be best for you.
4. I have new skin growths – what should I be worried about?
Along with many of our other body changes during pregnancy, we can sometimes see appearance of new skin growths. Most spots that appear during pregnancy are benign – skin tags, benign keratoses (stuck – on warty, scaly growths), and angiomas (cherry-red bumps on the skin).
Sometimes these spots will regress after pregnancy, but some will remain, and can be removed if you like.
In general, the growths that should catch your attention and have you see your dermatologist are changing, growing, bleeding moles. I also like to use the “ugly duckling sign” – if a spot doesn’t look like the others on your skin, you should have it checked. This does not mean that all changing or “ugly ducking” moles are bad, they just need to be evaluated by an expert eye.
5. Can/should I still see a dermatologist while pregnant?
I hope this blog has helped you realize that yes, it is safe and often helpful to see a board-certified dermatologist while pregnant, whether dealing with a new skin problem, or worsening of an existing skin problem. Your dermatologist will work with you to choose a safe and effective treatment plan for the duration of your pregnancy, and also can develop a future plan of action for any additional treatments once your baby has arrived. For more information, give our Houston location a call at (713) 850-0240.
About Megan Couvillion, M.D.
Dr. Couvillion has been practicing dermatology since 2017. A graduate of Louisiana State University School of Medicine, she completed her internship in internal medicine and her dermatology residency training in at Tulane University where she served as Chief Resident. Prior to starting medical school she also received a Masters of Science in Cell and Molecular Biology from Tulane University. She is certified by the American Board of Dermatology and a Fellow of the American Academy of Dermatology. She is a member of the American Society of Dermatologic Surgery, the Houston Dermatological Society and the Women’s Dermatologic Society.
Check out Dr. Couvillion’s Instagram Profile here