Understanding Skin Issues During Pregnancy

At least 90% of women will experience some form of skin condition during their pregnancy. Some are benign and will go away once you deliver your baby, while other symptoms can be a sign of something more severe. It is important to understand the changes that are happening with your body and make your doctor aware of any concerns you may have.

Here are some examples of skin conditions that can occur during pregnancy

Melasma

skin issues during pregnancyMelasma is a skin condition that causes gray-brown patches on the face on the cheeks, chin, forehead, bridge of the nose, and upper lip. Although less common, the condition can also appear on other areas that get a lot of sun, such as the forearms and neck.

Known as the “mask of pregnancy,” melasma can be treated through the frequent application (every two hours) of sunscreen with a very high protection factor (SPF 50+).

Tyrosinase inhibitors are the most common topical therapy treatments. They aim to prevent new pigment formation by inhibiting the formation of melanin of the melanocytes.

The condition typically fades on its own a few months after delivery.

Striae gravidarum (stretch marks)

stretch marksApproximately 90% of pregnant women are affected by stretch marks based on a study performed by the British Association of Dermatologists.

Stretch marks are off-color blemishes caused by tearing of the dermis, which results in atrophy and loss of rete ridges. They appear as reddish or bluish streaks on the stomach, but can also affect the breasts and thighs.

Though there have been various creams and other treatments that purport to reduce the appearance of stretch marks, there has been no evidence shown to support that such treatments are effective.

Atopic Eruption of Pregnancy

This eruption of the skin is also referred to as eczema and results in an inflammation of the skin, causing it to be dry and itchy. The most commonly affected areas include the skin creases of the knees, elbows, wrists, and neck.

This inflammation typically occurs during the first half of pregnancy, with 75% occurring before the third trimester. Atopic eczema tends to run in families, so if your mother or sister experienced the condition during their pregnancy, this greatly increases the likelihood that you will also experience it.

The most common feature of atopic eruption is skin that is itchy enough to interrupt your sleep. Also, small blisters on your hand or feet may develop.

The condition does not affect the baby, and moisturizers, steroid ointments, and creams are used to alleviate the symptoms.

If your conditions are more severe, treatments such as steroid tablets may be required, but the use of these medications should be monitored carefully.

Impetigo Herpetiformis

Impetigo Herpetifomis is a rare condition that typically occurs during the last trimester. The rash begins as pus-filled bumps in the area of the inner thigh and groin. As the pustules grow together and join, they spread to other parts of the body. Fortunately, the face, hands, and feet are typically spared.

Additional symptoms of Impetigo Herpetiformis include:

  • Fatigue
  • Nausea
  • Vomiting
  • Diarrhea
  • Fever
  • Chills

This condition is typically treated with prednisone (an oral steroid). If the steroid is not well tolerated, other medications may be used in its place. Antibiotics are used only in cases where the rash becomes infected.

Though rare, a major concern with Impetigo Herpetiformis is the effect it can have on the unborn child. Stillbirth and placental insufficiency are known risks associated with Impetigo Herpetiformis.

The condition typically resolves itself once the baby is delivered.

Please feel free to contact Kristine A. Eule, MD, for more information on this topic or with any other questions you might have related to your pregnancy.

sources
https://www.ncbi.nlm.nih.gov/pubmed/25255817
http://www.eadv.org/patient-corner/leaflets/eadv-leaflets/atopic-eruption-of-pregnancy-aep/
http://www.dermnetnz.org/colour/melasma.html