Bump Beauty: How do your pregnancy hormones affect your skin?

You’re expecting a baby and you’re waiting for that special glow you’d been promised… But if your pregnancy glow is a no-show and you’re battling with brand-new skin concerns instead, read on.

There are a few skincare concerns that can affect women in pregnancy, even if they’d never experienced them before – and this is normal. 

Dr Nerissa Moodley, a dermatologist at Skin Couture in Durban, says that pregnant women may experience:

• Pigmentation conditions like linea nigra, which is a dark line that runs from the navel to the pubic hair, and/or dark spots on the breast, nipples or inner thighs.

• Stretch marks, particularly over the abdomen. 

• Acne or more severe or frequent breakouts. 

• Melasma – brown patches on the face around the cheeks, nose and forehead.

• Spider veins and varicose veins. 

• Changes in nail and hair growth.

• Existing skin conditions like eczema or rosacea may worsen due to hormonal fluctuations. 

How do pregnancy hormones contribute to these changes?

If you’ve never struggled with your skin before your pregnancy, you’ll be somewhat relieved to know that your shifting hormones may cause many of them. “During pregnancy there are hormonal shifts, particularly in oestrogen and progesterone that can cause these skin changes,” confirms Dr Moodley.

“Elevated levels of progesterone results in increased oil production, which can lead to acne and oily skin. An increase in oestrogen and melanocyte-stimulating hormone can cause melanocytes (pigment-producing cells) to produce more melanin. This leads to the darkening of existing moles, the appearance of new ones and the development of dark patches, especially on the face (known as melasma or the mask of pregnancy),” Dr Moodley explains. 

She adds that an increase in blood flow during pregnancy causes flushing, especially seen in areas with thinner skin like the chest and breasts. Additionally, as the skin stretches during pregnancy, the increased friction can lead to itchiness, flaking and the development of skin tags. 

Do the different trimesters of pregnancy bring up different concerns? 

As your body grows and changes, it’s adjusting to a new normal, even just for a few months, so the different trimesters of pregnancy can bring about different skin concerns and may exacerbate or improve existing skin conditions. 

Dr Moodley talks us through some of the common changes per trimester: “During the first trimester, acne may worsen due to increased androgen hormones, leading to increased sebum production. Other existing skin conditions like eczema or rosacea might improve or worse. 

“During the second trimester, stretch marks often appear on the abdomen, buttocks, breasts and/or thighs. Darkening of the skin, especially on the face (melasma), can occur. Acne may continue to be a concern due to hormonal fluctuations

“During the third trimester, stretch marks become more noticeable on the abdomen and other areas. Spider veins and varicose veins can develop,” she says. 

After your baby is born, in the postpartum period, stretch marks may become more noticeable as your body starts moving into its old (or a slightly or completely new) shape. Acne may improve or disappear, but breastfeeding can help prevent it, says Dr Moodley.  

How can pregnant women safely manage these skin changes? 

Management is key, and Dr Moodley says women should focus on skin hydration, gentle skincare and sun protection. “Be cautious when using products containing retinoids, retinol or salicylic acid as these are generally not recommended during pregnancy,” she warns. 

“Use fragrance-free moisturisers with ingredients like peptides or hyaluronic acid and drink plenty of water to help improve hydration. Wear a broad-spectrum sunscreen – SPF 30 or higher – a wide-brimmed hat and loose-fitting clothing to minimise the effects of melasma and protect against sun damage,” says Dr Moodley.  

Those with acne-prone skin should avoid harsh soaps and over-cleansing, says Dr Moodley. “Use an oil-free, alcohol-free cleanser to wash your face gently twice a day. Opt for cotton pillowcases and change them frequently to minimise skin irritation and breakouts.” 

Dr Moodley advises pregnant women to seek the help of a dermatologist if they experience: 

• Appearance of new rashes, especially if it’s itchy, painful or accompanied by other symptoms

• Changes in existing moles with regards to their size, shape, colour or the appearance of new moles. 

• Uncontrollable itching. 

• Worsening of pre-existing skin conditions, like eczema, acne or rosacea. 

• Concerns about skincare products, especially if unsure about the safety of particular products or ingredients.

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