Have you seen the movie What to Expect When You’re Expecting? It’s about a handful of women’s experiences with pregnancy and how they differ vastly. If you haven’t seen it, it’s hilarious and wicked relatable and you should go watch it. Alas, I digress. Elizabeth Banks’ character is who I specifically want to highlight for just a second. She ends up experiencing all of the not-so-groovy effects that pregnancy can have: swelling, gas, excessive sweating, feeling like a house, oily skin, acne, stretch marks, the list goes on and on.
I know a lot of us to feel that sub-goddess status whilst carrying a fetus. If you’re like “Nah, girl, I was a glowing dewdrop who loved every second of my pregnancy”, move along, this article is not for you. I say that with love and a smidge of jealousy because I was NOT that girl.
Now, if you’re a fellow mortal who had any of the things listed above, I’m here to help! Well, in the skincare department at least.
I’ve shared before that I am a Nurse Practitioner specializing in the field of Dermatology. That may seem boring so some, I mean, it is just skin. But hold up ya’ll,”just skin” is amazing and extremely complex. It’s your body’s first line of defense when coming into contact with potential threats, it holds all your innards in, and it can also be a serious pain in the patoot, especially during pregnancy.
When we dig down to the core of what causes a lot of skin woes during pregnancy, it boils down to hormone fluctuations. Growing the precious little nugget gets those hormones raging and that can mean a few different things for expecting mamas.
Pregnancy is a wonderful time of transformation and growth, in more ways than one. But for many women, they just don’t feel their best. The following problems are super common in pregnancy, and have solutions that can be utilized to help you feel more like a dewdrop than a swamp monster.
You may also be at a loss because there is so much overwhelming information about what is safe and what is not when your skin-caring for two. I’m embarrassed to say, even with my medical training, I wasn’t aware that there are some OTC acne products that are a no-go during pregnancy. I’ll help you break down what’s ok and what’s most definitely NOT ok to use on your skin with a bun in the oven.
The Problem: ACNE
Acne can get better or worse when pregnant. I wish I could look at a patient and determine which it will be. There’s really no way to know. I also think it’s important to know that each pregnancy is different as well. If you had bad breakouts with your first, you might get coveted dewdrop status the next go-round.
This is going to be the biggest category of “No-Go’s”. Acne is an inflammatory condition that can range from mild to severe. There are medications that are derived from vitamin A that improve acne and some that even cure acne. Sounds great, right? Not when you’re expecting.
Vitamin A derivatives, in general, are linked to known cases of fetal harm like birth defects and even spontaneous abortion. There is a specific medication called isotretinoin that is used for severely nodulocystic acne that is a known teratogen. Tazarotene which is a topical form of a very similar medication is a definite no go as well, even though it is topical. Both Isotretinoin and tazarotene can cause severe fetal harm and even death, so HARD NO for those ingredients.
Retinoids, which are used for acne as well as fine lines and wrinkles, also fall under the category of a vitamin A derivative and should be refrained from using while pregnant or breastfeeding.
Salicylic acid and Benzoyl peroxide should also be refrained from using if at all possible. There are not enough studies done to conclude that they are totally safe to use in pregnant and breastfeeding mamas. Watch labels for these ingredients. they tend to be in the “acne washes” and “acne moisturizers”.
Ok, so what can you use?
A regimen is key! Ideally, if you’re having acne, you should be washing 1-2 times daily with a gentle cleanser. Gentle meaning not medicated and nothing with chunks that you can see (I’m looking at you, apricot scrub). Neutrogena has an ultra-gentle foaming cleanser that I love. Also take care to not over-mask, over tone, or do anything that causes the skin to be overly dry. Sometimes, if you dry your skin out too much, your body sees that as a signal to pump out more oil, landing you back to square one in the acne department. I’d say a modest approach to masks, exfoliation and toners is ideal. No more than 1 mask a week, tone only once daily, and exfoliation 1-2 times weekly is a good soft rule of thumb.
Azelaic acid is my absolute favorite for pregnant women to use to help with acne. It is safe for baby and is actually effective in reducing inflammation and unclogging pores. There are prescription-strength products, but there are also some OTC that can be bought. The Ordinary is a brand carried at Sephora that is very affordable and actually effective. you can find it here.
The Problem: MELASMA
Melasma is often referred to as “the mask of pregnancy”. It’s a hyperpigmentation of the skin, generally, on the face, that is a result of hormones and sunlight exposure. This is another unpredictable skin condition that can kill any pregnant woman’s vibe. Personally, anytime I’m pregnant, I get this discoloration over my upper lip. It’s like a mustache I can’t shave off. It’s great. Super spectacular.
The No- Go’s
Hydroquinone is a definite no-go during pregnancy due to the risk of the baby. hydroquinone is a bleaching agent that helps the skin go back to its previous un-blotchy self.
SUNSCREEN. You heard me. Don’t let UV touch your face, and ideally, melasma shouldn’t be as big of an issue. UV makes melasma worse always. Even just walking to and from a parking lot can add up enough to impact it.
Sunscreens should be zinc or titanium-based as these “physical” sunscreens sit on top of the skin and block UV instead of soaking into the skin and reflecting UV back ala chemical sunscreens like avobenzone and oxybenzone. Less absorption in the skin means less risk to the baby.
Azelaic acid is also an all-star here. It can help to gently exfoliate out darkened areas over time without causing irritation.
Vitamin C serums are also great to integrate into a daily regimen, not just for hyperpigmentation like melasma, but for the general health and well being of the skin. It is safe to use when pregnant and works as an antioxidant to decrease hyperpigmentation and promote an even skin tone. Here are some of my favorites:
The problem: STRETCH MARKS
Stretch marks are tiny scars caused when the skin expands quickly. Like when you’re busy making a leg, or an ear of, you know, a human. NBD. Stretch marks are a bummer in that once you got ’em, you got ’em sister. While I, for one, am proud of my stretchmarks and what they symbolize, I can get behind not wanting them to appear in the first place.
The solution: The good news here is there really aren’t any no-gos. Most things, other than laser treatments, are ok to use while pregnant or breastfeeding. But an ounce of prevention can yield gallons of results. Prevent stretch marks by thoroughly moisturizing the affected skin including belly, breasts, butt, and legs. The whole point of moisturizing skin is to lock moisture in not necessarily add it to the skin. This means getting the moisturizer on the skin ASAP after a bath or shower to lock all that precious moisture in.
Think of your skin like a rubber band. When it’s new, it can stretch without cracking. This is like moisturized skin. When you leave a rubber band out and it gets dried out, what happens when you stretch it? It cracks! Make sure you’re keeping yourself moisturized so your skin doesn’t crack!
My favorite moisturizers are creams instead of lotions (too thin to lock in moisture), and ones that mimic the natural skin barrier. Products like Cerave and Eucerin are great go-to’s.
What are your favorite go-to pregnancy skincare goodies? I’d love to hear about them!
We just talked about things that I generally recommend to my patients that I see in my office. There are plenty more out there. I know pregnancy can be a rough time but it doesn’t have to be! A dermatology provider can always offer help and insight when continuing to struggle with your skin during pregnancy. As always, be sure to clear any new product with your OBGYN before starting.
Happy pampering, mama!