After having my first child I was surprised at how much pregnancy affected my skin. There are so many changes that, even as a dermatologist, I was totally unaware of until it actually happened to me. The most common complaint my patients have during pregnancy is acne. The good news is that acne during pregnancy usually gets better after the first trimester. The bad news is that there are only a few treatments available during pregnancy. While pregnant, women can typically usually use benzoyl peroxide and topical antibiotics. I also frequently prescribe azaleic acid which is safe during pregnancy. Topical retinoids cannot be used during pregnancy and I also do not recommend chemical peels. Microdermabrasion is a better option.
Another common complaint is hyperpigmentation. In women with darker skin, the hyperpigmentation can occur almost everywhere. The underarms, neck, and abdomen are very common locations, however, even the posterior thighs can get darker. This is a natural process and is likely due to an increase in estrogen. Fortunately, generalized hyperpigmentation does resolve after pregnancy, although it can take up to one year for some parts of the body to go back to the normal skin tone.
Melasma are the brown patches on the face that some women get during pregnancy. This is more common in Latina and Asian women but can occur in any skin type. This condition is so common during pregnancy that it used to be called “the mask of pregnancy”. While pregnant the best way to address melasma is to wear a lot of sunscreen to prevent it. The good news is that for most women, melasma resolves after pregnancy. For the unlucky few who have persistent melasma, there are many treatment options available.