HOW PREGNANCY AND MOTHERHOOD CAN CHANGE YOUR SKIN
It’s International Mother's Day on May 8, and we celebrate our mums of all ages - thank you for all you are and do for us! This Journal edition focuses on how pregnancy and new motherhood change the skin of new mums and mums-to-be.
Pregnancy and new motherhood are an exciting time in a woman’s life, but when it comes to your skin, things can go either way. Some are lucky enough to have that glorious pregnancy bloom. Unfortunately for some of us, though, the reality of the hormone rollercoaster is severe acne breakouts or dark pigmentation marks. And let’s not forget the dreaded stretch marks on our bellies.
Who doesn’t want the pregnancy bloom – skin that looks smooth and radiant with health? This comes about because our blood volume increases by 40 % during pregnancy, so our skin is reaping the benefit of all that extra oxygenation, while the surge in oestrogen thickens the dermal wall to smooth and plump the skin.
But the unfortunate reality for some of us is quite different. If our hormones are not in sync, we can experience acne, skin rashes, eczema or hyperpigmentation, or increased sensitivity.
It’s impossible to predict how each of us will be affected by the hormonal overload. Everyone is different, and our skin’s condition can even change during each trimester.
Here are the main skin issues that affect pregnant women, and how to deal with them:
How pregnancy and motherhood can change your skin:
Melasma aka ‘mask of pregnancy’
What it Melasma:
Darker patches of pigmentation on the face. It used to be called chloasma. It’s also known as the butterfly mask because of the ‘butterfly’ shape it forms over the cheeks, forehead, nose bridge, chin and jaw areas.
Nearly half of us will experience melasma to a lesser or greater degree during pregnancy and afterwards. It affects women of all skin tones but is more common in darker-skinned women, especially if they have a genetic predisposition to melasma.
The culprit is the female sex hormones oestrogen and progesterone that stimulate production of more melanin pigment in your skin. This also causes your nipples to darken and the dark line on your belly called the linea nigra, but these fade after giving birth. When your skin is exposed to sunlight and visible light, the marks darken, so it is important to shield the skin.
What you need to know about Melasma:
- The dark melasma marks may fade after the event if the pigmentation is situated in the superficial layers of the skin.
- If the melasma is situated in the deeper dermis layer of your skin, it will take longer to fade. This also makes treatment more challenging. And it may become a chronic, lifelong condition.
- Removing or lessening the melasma takes a combination of strategies, and there are no quick fixes, unfortunately. But you can use make-up with SPF to camouflage the marks.
What you can do to improve Melasma:
Treat the problem. Use an effective, pregnancy-approved hyperpigmentation treatment range that breaks up existing pigmentation and prevents new marks forming.
Choose treatments with niacinamide (vitamin B3) or non-irritating forms of vitamin C, such as ascorbyl tetraiosopalmitate, which is effective, highly stable and less likely to cause a skin reaction.
For severe pigmentation, see a dermatologist for combined therapy. But remember you can’t use melanin-busting active ingredients hydroquinone or arbutin during pregnancy. You should also avoid any vitamin-A creams (retinol, etc.) during pregnancy to be safe.
Protect, protect, protect. Summer or winter, avoid direct sun exposure where possible. Wear a broad-spectrum SPF 50+ sunscreen (with UVA, UVB and blue light protection) daily even when staying indoors, as UV rays penetrate through windows, and blue light from our screens may worsen the problem.
Recent studies show that physical sunscreens (also referred to as mineral sunscreen, i.e., sunscreens with titanium dioxide or zinc oxide), or combination chemical-filter and physical blocker sunscreens are more effective than chemical filter sunscreens alone in protecting against visible light.
When outdoors, wear a wide-brimmed hat and cover up with clothing as well.
What is pregnancy acne?
Acne triggered by pregnancy hormones, which cause an overproduction of skin oil (sebum). This can block pores and lead to acne. More than half of women will experience mild or severe acne during pregnancy.
If you’ve had acne in the past or if you experience hormonal acne when you menstruate, you may be more prone to acne while pregnant. It usually goes away when your hormones normalise after pregnancy.
Which skincare products can you use when you have pregnancy acne?
For mild cases, use a gentle, pregnancy-safe anti-blemish treatment. Benzoyl peroxide and azelaic acid are generally considered safe in mild doses, but check with your obstetrician before using it.
More serious acne problems are treated with a prescription antibiotic cream, as well as professional facials, mild pregnancy-approved peels and treatments such as microdermabrasion.
SKIN SENSITIVITY AND ECZEMA
What is eczema?
Skin redness, itching, tenderness and irritation may occur even if you’ve never had them before. You may find that fragrance, products and even foods you’ve used for years suddenly cause your skin to react. A flare-up may be more common if you are prone to skin irritation. The culprit, again, is likely to be hormones.
What you can do to soothe skin sensitivity?
Skin rashes during pregnancy need to be seen by dermatologist. Use mild, soothing, fragrance-free cleansers and skin treatments to strengthen the skin barrier against water loss and against irritation. Avoid using harsh products such as physical or chemical exfoliators, and handle your skin with great TLC.
How do stretch marks develop?
They are scars from small tears in the skin’s supportive collagen and elastin which develop when the skin is stretched rapidly. About 90 % of us will get at least a couple of stretch marks. And they are often hereditary – ask the women in your family how they will be affected. While fresh, stretch marks look raised and red and may be itchy, but they fade with time to soft, silvery lines. Your belly deserves a prize for stretching from its normal size to accommodate a baby and all its accessories. No wonder the skin is stretched to its limit and sometimes beyond. Stretch marks can also occur on your breasts, thighs and/or bottom.
How can you prevent stretch marks?
Some experts say there’s nothing you can do, while other swear by certain treatments (many different remedies and ingredients are promoted, including hyaluronic acid, centella asiatica, elastin and vitamin E).
You may not be able to avoid them, especially if they are hereditary, but you can keep the skin supple, stimulate circulation and improve the skin’s elasticity. In that way, you may hopefully lessen the severity, at least.
Massage your belly, breasts, bottom and thighs daily throughout your pregnancy with a good quality plant oil that’s rich in Linoleic acid, or stretch mark treatment.
What you can do about stretch marks
Stretch marks can be treated with pulsed dye laser or – after you’ve stopped breastfeeding – with retinoids (vitamin A creams). You need to treat them while they are still red, fresh and active. The older and whiter they are, the harder they are to treat.
Skincare ingredients you must avoid during pregnancy and while breastfeeding
Avoid ingredients such as
- Vitamin A, which is deemed to be a teratogenic, meaning they may cause birth defects to the baby. An alternative to retinol that is often promoted as having similar action and effects is Bakuchiol. It’s sometimes even presented as a ‘safe’, natural retinol. Although the efficacy of the ingredient in skincare appears relatively well established, more research is needed to determine whether it is safe for use during pregnancy.
- Avoid using hyperpigmentation products with arbutin or hydroquinone.
- Sunscreens that are hormonal disruptors, such as oxybenzone and avobenzone. Rather use a mineral-based sunscreen with titanium dioxide and/or zinc oxide, as this forms a UV barrier on the skin’s surface.
- Certain essential oils: Jasmine and clary sage may trigger contractions, sage and rosemary oil can cause bleeding. Rosemary’s also been shown to cause increased blood pressure.
Motherhood and your skin
We are often exposed on social media to celebrity new mothers who leave the hospital practically in their pre-pregnancy jeans. This image is unrealistic - some have been known to have a quick nip and tuck while they were having their caesarean.
Unfortunately, this can lead to impossible expectations about ‘regaining your body’, causing many women frustration and unhappiness when they aren’t able to achieve these impossible goals. The reality is that it can take the body six months to a year to recover fully.
Along with the baby, you will immediately lose about 7 kg of placenta and pregnancy fluids when you give birth, but it will take about a week to lose the extra water you are carrying.
It will also take a couple of months for your skin to return to normal after being stretched to accommodate your pregnant belly. Your ligaments may take a while longer to firm up.
Be kind to yourself and accept the fact that your body has just been through a major event – with a brilliant result! Exercise gently and eat healthily and you will soon feel more yourself again.
The skin disruptors
You may experience no problems with your skin, but many women find this life stage brings some skin challenges.
Two major factors cause skin disruption - sleep deprivation and stress. And these, unfortunately, go hand in hand with the stage of life you’re in, which is an extremely busy and sometimes stressful one.
When you’re sleep-deprived from broken nights, running after children while juggling a career and still trying to be a goddess to your partner, you may also not give yourself the self-care you would like and deserve. It can also become a vicious circle. Sleep-deprivation (common to most parents in the first few years) causes stress, and stress causes insomnia.
How stress affects you...
It’s widely accepted that stress throws the body’s balance out of whack, triggering insomnia, moodiness and increased susceptibility to colds and flu.
...and your skin
Increasingly, stress has also been scientifically linked to skin problems. The US journal Archives of Dermatology shows a direct link between high stress levels and abnormal functioning of the skin. In fact, your skin may be one of the first places you notice that you’re stressed.
Adrenal glands release stress hormones such as epinephrine, norepinephrine and cortisol.The bottom line is raised cortisol is implicated in adult acne, rosacea, premature skin ageing and even melasma.
Cortisol and your skin
- Too much cortisol in your body will increase your body’s production of oil. You’ll know you have adult acne if cystic acne (deep-seated, painful acne) starts sprouting on your chin.
- Cortisol also stimulates certain hormones that cause an increase in melanin production.
- Inflammatory compounds like histamine are also triggered by stress hormones. This causes skin to become more sensitive and reactive.
- If you’re prone to eczema, psoriasis or rosacea as well as alopecia, you could get a flare-up.
- And, of course, stress ages you prematurely. A surplus of cortisol has been linked to a breakdown in collagen and elastin in the skin.
- It also disrupts the skin’s barrier function, causing dehydration, dullness and fine lines.
What should you do if your skin is showing signs of distress?
The answer is simplicity.
- When practicing skin care, gently does it. You may no longer be doing your 47-step Korean facial anyway (ha!). But pare things right down. Go for skin cocooning with simple, soothing products that strengthen your skin barrier function and address your acne and dampen sensitivity/irritation. Treat your skin with great TLC.
- Don’t succumb to the quick-fix temptation of adding highly active treatments like retinol and fruit acids to bring back your glow. You shouldn’t anyway if you’re breastfeeding.
- Choose products with as few ingredients as possible. As a rule of thumb, the more ingredients in the product, the greater likelihood of irritation.
- If you have eczema and sensitivity, stick to dermatological skin care ranges for sensitive and atopic skin.
Of course, removing the source of the stress will also help bring back your healthy glow. Try to manage your stress with proven aids such as meditation and deep breathing, talk therapy, yoga and gentle exercise.
Caring for your baby’s skin
When babies are born, their protective skin barrier is still under-developed. The barrier is only fully formed at age two. This means their skin is more permeable, allowing substances to penetrate more easily. Therefore, they are prone to developing eczema if they have a genetic predisposition – there’s a 35 % chance if one parent has eczema, and 70 % chance if both parents have it. Or if their skin is exposed to potential irritants.
For this reason, the first six months are a critically important window for possibly preventing the development of eczema.
Dermatologists recommend keeping the skin well moisturised with a dermatologically approved baby product to strengthen the barrier against irritants.
- Massaging your baby after bathing is also an important bonding ritual. It helps them relax and sleep well, as well as soothing colic and stimulating growth, some experts believe.
- Use an unfragranced, skin-nourishing oil that’s high in Linoleic acid such as evening primrose oil, cotton seed oil, pure Kalahari melon oil, or rosehip oil.
Things to avoid during pregnancy
- Do not use oils high in oleic acid such as olive, avocado, argan or marula oil as their primary component (oleic acid) has been shown in to disrupt normal skin barrier function.
- Other oils such as tea tree and other pure (neat) essential oils are also not recommended for baby massage use.
You can distinguish plant oils from essential oils by the scent. If the odour is neutral or nutty, it’s known as a plant/vegetable oil, and is generally nourishing to your skin.
An oil with a strong, fragrant odour is likely an essential oil, and should be used for fragrance only, not for skincare.
A final word
The purpose of this article is to educate, not to provide medical advice. Please
speak to a medical professional or certified dermatologist if you have specific concerns, and check whether our recommendations are suitable for your specific needs.
Happy Mother’s Day!