Pregnancy changes your body in many ways. Chemical messengers in your body – your hormones – are sending new signals that help make these changes happen. You will see some of these changes in your skin. They can include darkening of your skin, acne, stretch marks, skin tags, and an itchy red bumps. These changes are not exactly the glow of pregnancy you were expecting. [1-4]
“Pregnancy causes surprising changes in your skin. Although the changes can be unpleasant, most are a normal part of pregnancy, and they will usually go away after pregnancy,” says Karen Duarte, board certified physician assistant and member of the Society of Dermatology Physician Assistants. 
- Stretch Marks
Because your body is growing in new places, and growing quickly, your skin stretches. The stretching causes brown, red, or purple streaks to form on your skin. Almost all women will have some stretch marks by the third trimester. [1-4]
“Stretch marks are the most common skin condition of pregnancy. They usually occur on the belly, breasts, thighs, bottom, and sometimes on the upper arms. Avoiding excessive weight gain during pregnancy can reduce skin stretching. Using a moisturizer may also help,” says Duarte. 
Tips for stretch marks:
- Make sure to follow your health care provider’s recommendations for healthy weight gain. 
- Ask your health care provider to suggest a moisturizer to keep your skin soft. This may help prevent itching associated with stretch marks. 
- Nothing can prevent stretch marks. The color will fade after pregnancy, but some women will still have visible white or silvery marks that never completely go away. 
- Darkening Skin (Hyperpigmentation)
Hyperpigmentation is caused by a surge in pregnancy hormones, including the hormone melanin. Brown patches on your face are called melasma, or “the mask of pregnancy.” These spots usually appear on the cheeks, nose, and forehead. You may also notice that freckles and the area around your nipples get darker. 
Ninety percent of women will see a dark line form between the belly button and pubic area, called a linea nigra.  “Linea nigra is more common than melasma, but both are very common. Melasma tends to run in families. You can keep melasma from getting worse by using a sunscreen with a sun protection factor of at least 50. Melasma that continues after pregnancy can be treated by a dermatologist,” says Duarte. 
- You cannot prevent hyperpigmentation. Using sunscreen and a wide-brimmed hat can prevent further darkening from sun exposure.
- Most hyperpigmentation fades away after pregnancy, but melasma may remain for years in some women (especially women with dark complexions).
- Skin Tags
Skin tags are tiny, flesh-colored growths of skin. They are common in everyone but more common during pregnancy. Skin tags hang off your skin, attached by small stalk of tissue. Why they occur more frequently during pregnancy is not known. [3,4].
“Skin tags usually form in the folds between skin where skin rubs together. They may fall off after pregnancy. If you have skin tags that are unsightly or annoying, a dermatologist can remove them after pregnancy,” says Duarte. 
Skin tag tips:
- Skin tags are most common under your arms or breasts.
- There is nothing you can do to prevent them or treat them.
- They can be removed easily after pregnancy.
Pregnancy acne is caused by pregnancy hormones. If you already have a tendency for acne, pregnancy may make it worse. If your skin is usually clear, pregnancy can cause acne. Acne should improve after pregnancy. [1,4] “Talk to a dermatologist about treatment if your acne is severe during pregnancy. The acne medication Adapalene is available over the counter, but you should not use it during pregnancy. It belongs to a class of medications that may increase your risk for birth defects,” says Duarte. 
- Wash your face twice each day with mild soap and water.
- Shampoo every day and keep your hair off your face.
- Do not pick or squeeze pimples.
- Use oil-free cosmetics.
- According to the American College of Obstetricians and Gynecologists, these over-the-counter medications are safe during pregnancy: benzoyl peroxide, azeleic acid, topical salicylic acid, and glycolic acid.
- Check with your health care provider before using any other treatment. Do not use these medications: hormone therapy, isotretinoin, oral tetracycline, or topical retinoids.
For a complete review of acne in pregnancy, check out my previous blog here.
- Itchy Bumps
Two pregnancy conditions can make your skin break out in itchy bumps. These conditions are much less common than stretch marks, skin tags, hyperpigmentation, and acne. [1,4]
- Pruritic urticarial papules and plaques (PUPP) causes small, red bumps and hives. This pregnancy skin condition usually occurs late in pregnancy. The cause is not known. The bumps usually start on the belly and can spread to the thighs, breasts, and bottom. PUPP is not dangerous for pregnancy and it clears up after pregnancy. [1,4] “PUPP occurs in about one out of 150 pregnant women. If the bumps are very itchy, your health care provider may prescribe a topical medication to relieve the itching,” says Duarte. 
- Prurigo of pregnancy causes tiny, itchy bumps that look like insect bites. This condition may be caused by an immune system reaction to pregnancy. The bumps can form anywhere and at any time during pregnancy. They can last for a few months. In some cases, they can last for a few months after pregnancy. Medication can be given to relieve itching. Like PUPP, this condition is not harmful to pregnancy. [1,4]
It is important to remember that these five common skin conditions of pregnancy are harmless, but there are some other skin conditions that could affect your pregnancy. These conditions are much less common. Intrahepatic cholestasis of pregnancy (ICP) is a liver condition that causes severe itching. Pemphigoid gestationis is an immune system disorder that causes skin rash and blisters. Both these conditions can affect pregnancy and can be treated. [1,4]
“Common skin conditions of pregnancy are a nuisance but are not serious and will go away after pregnancy. To rule out anything more serious, the best advice is to let your health care provider know about any skin changes you experience during pregnancy,” says Duarte. 
- American College of Obstetricians and Gynecologists, Skin Conditions During Pregnancy.
- Karen Duarte, RPA-C, AAPA, Society of Dermatology Physician Assistants
- University of Texas Southwest Medical Center, 6 skin problems that can develop during pregnancy.
- American Academy of Family Physicians, Common Skin Conditions During Pregnancy.