By Dr Zena Malinga, Dermatologist

Pregnancy is a wonderful time that brings about a multitude of changes for an expectant mother. The skin, being the largest organ is no exception to these changes. For many pregnant women, the expectation of rosy cheeks and glowing skin is not always met in reality.

Up to 90% of pregnant women will experience pregnancy-related skin changes that impact their daily lives. Despite this, few women seek the advice of a dermatologist who understands the unique challenges that pregnancy can bring about in the skin. Bearing this in mind, I have written this guide to help pregnant women to look and feel confident in their skin throughout this very special time.

Common skin changes that expecting mothers experience are brought about by a combination of hormonal, immunological and vascular factors. Stretch marks, acne and hyperpigmentation are some of the top complaints seen by dermatologists. In the chilly winter months, pregnant women may be more susceptible to dryness, sensitivity and itching of the skin.

Pregnancy’s iconic silver stripes are caused by the stretching of collagen and elastic fibres in the skin as a consequence of weight gain and the rapid growth of the uterus. The abdomen, breasts, thighs, and hips may develop stretch marks. The best way to prevent stretch marks is to maintain a healthy gradual weight gain throughout pregnancy. Using moisturisers rich in hyaluronic acid and ingredients such as centella asiatica extract early on in pregnancy may help reduce the appearance of stretch marks.

Pregnancy-related hormonal changes cause acne breakouts and worsen existing acne. Many of the prescription medications that are used to treat acne such as retinoids are not safe to use during pregnancy. Use gentle, non-comedogenic products. Formulations containing azelaic acid are a safe and effective option for treating acne in pregnancy.

As the seasons change from warmer to cooler months, there is a decrease in humidity. Coupled with the cold, dry winter air, pregnancy may also cause the skin on the face and body to become dull, sensitive, and flaky. Pre-existing skin conditions such as eczema and psoriasis may flare during this time. Substitute soaps and foamy cleansers with cream and milky formulations. Incorporate a heavier, emollient-rich moisturise into your skin routine. This addition will aid in the preservation of the skin’s barrier while preventing dryness and irritation. Look for moisturisers that contain ceramides, glycerin, and squalene, as well as natural oils like shea butter.

Melasma, a condition where dark patches appear on the face, is termed “the mask of pregnancy”, this increase in pigmentation (hyperpigmentation) results from excessive melanin production. Wear protective clothing like broad-brimmed hats and avoid sun exposure between the peak sun hours of 10:00 and 14:00. Skin serums which contain potent antioxidants like ascorbic acid, paired with the daily use of sunscreen improve melasma and prevent further pigmentation.

The use of sunscreen should be maintained throughout pregnancy. Mineral sunscreens containing zinc oxide and titanium dioxide are safe to use during this time. Look for sunscreens that are broad-spectrum and have a sun protection factor (SPF) of 30 or more. These offer protection against UV-A and UV-B sun rays. Chemical sunscreens containing ingredients such as oxybenzone and octinoxate should not be used by expectant mothers as more studies are needed to demonstrate their safety in pregnancy and nursing.

During pregnancy, expectant mothers are faced with the choice of many products which offer solutions to their skin concerns. Some may contain potentially harmful ingredients. Retinoids, prescription vitamin A derivatives, used in acne and anti-ageing treatments, are an example of such. While they are widely prescribed by dermatologists, their use in pregnancy is associated with birth defects and should be strictly avoided.

In conclusion, it is important to remember that every pregnancy’s skin journey is unique. Some women may have skincare concerns that call for individualised care. With proper care and attention, pregnant women can achieve healthy, glowing skin. Should you have a pregnancy-related skin concern, seek the advice of a dermatologist who has the necessary expertise to provide a personalised treatment plan that is safe for both the mother and the developing baby.