By Dr Edel Woods - ORA
Congratulations, you are pregnant! This is an exciting and beautiful time in your life, but it can also be a confusing time, particularly when it comes to maintaining your skin health routine. Hormones, along with physiological changes, can disrupt your usual skin balance, and a pregnancy glow on some complexions might be a greasy slick on others.
Before we look at the various pregnancy related skin problems that can arise, a word on pregnancy skincare for the mama-to-be who just needs to maintain her skin health during pregnancy. For this mama-to-be, it’s important to go back to basics. Ditch the retinoids and any salicylic acid based products. In particular, check your cleanser as many contain salicylic acid. Ensure you stick to the basic gold-standard routine of: cleanse, antioxidants and sunscreen protection during the day and at night you want to cleanse and hydrate. A word of caution, if you are considering switching all of your products to ‘natural’ alternatives. Many of the ‘natural products’ contain unknown quantities of essential oils which could aggravate your skin. They can also increase the skin’s sensitivity to UV, which isn’t good news, considering the risk of pigmentation is higher during pregnancy
Instead, we would recommend sticking with your current regime so long as it doesn’t contain Vitamin A, Salicylic acid or hydroquinone.
Why do we need to change our skincare routine in pregnancy?
The concern is that certain active cosmetic ingredients may be absorbed through the skin during pregnancy. There is increased systemic blood flow in the body whilst pregnant so absorption through the skin means that certain agents may pass into the blood stream. Once in the circulation, they have the potential to cross the placenta and affect the developing foetus.
With this in mind, you need to become very good at reading labels whilst pregnant!
- Retinoids (Vitamin A based products)
- Beta Hydroxy Acids (Salicylic Acid)
- Hydroquinone (lightening agent)
Unfortunately, saying with certainty, what we can use is the trickier question. For ethical reasons, research is never carried out on pregnant women therefore it’s difficult to give absolute guidance. However, the following is quite well accepted as standard guidance:
Caution (considered safe at low dose and used sparingly):
- Alpha Hydroxy Acids (Glycolic Acid)
- Azelaic Acid
- Antioxidants (Vitamin C)
- Hyaluronic Acid
- Physical sun filters (zinc oxide/titanium dioxide)
If you have any specific concerns or queries, I would consult with your doctor.
Suggested skin health products:
What about treatments?
Unfortunately, most treatments are out! You need to avoid all injectables and chemical peels until after pregnancy.
Problem-skin during pregnancy:
For those women suffering with pregnancy related skin problems, please don’t worry, you are not alone. Acne, pigmentation and dryness in pregnancy are extremely common. Pregnancy affects the skin due mainly to hormonal changes but there are also some physiological changes taking place in the body such as increased blood flow which can cause blood vessels to dilate leading to telangectasia or spider veins.
As a leading cause of pregnancy related skin problems, let’s firstly get to grips with what hormones are. Simply put, they are chemical messengers that trigger a response in specific cells or tissues in the body. They are the drill sergeant dictating how other cells or tissues work! Hormonal skin changes are often related to fluctuation in the sex hormones. In particular, testosterone and oestrogen. Progesterone also has a role albeit to a lesser extent.
Let’s look at some of the specific pregnancy related skin concerns:
Acne & Pregnancy
The first and arguably the leading skin concern in pregnancy is acne. It is surprisingly common. In fact nearly 50% of pregnant women suffer with acne and those with a history of acne are unfortunately more susceptible. It is most prevalent in the 1st trimester and occasionally extends into the 2nd trimester. The good news is that acne does tend to improve as the pregnancy progresses.
Acne in pregnancy is related to surges of the hormone, progesterone. This hormone leads to over-activation of the oil producing glands leading to increased oil production and as we know, excess oil production (along with excess skin cell growth and bacteria) is a root cause of spot formation.
Unfortunately, many of the traditional methods of controlling acne are not suitable for use in pregnancy. We cannot use retinoids (oral or topical) and we cannot use salicylic acid.
Acne Skin Essentials during pregnancy:
- Ensure you are not using any oil-based products. Look for products labelled oil free or non-comedogenic.
- Don’t over scrub your face as this can trigger more oil production.
- Use a mineral based sunscreen. Ideally one with Zinc Oxide as this can have skin calming benefits and is less likely to irritate the skin.
If these simple measures are insufficient, the following are generally considered ‘safe’ and can be useful as short-term acne ‘holding measures’ during pregnancy.
Targeted Acne support during pregnancy:
- Glycolic Acid , Lactic Acid & Mandelic Acid. These alpha hydroxy acid’s (AHA) help exfoliate dead cells that can block pores and over-the-counter preparations can be used sparingly in pregnancy. However, higher concentration AHA’s such as found in chemical peels must be avoided.
- Azelaic Acid. This lesser known skin superhero can be used to reduce inflammation associated with acne. It also kills the P.acnes bacteria and can minimize pigmentation.
Suggested acne products:
AlumierMD AHA Renewal (Lactic Acid)
The Ordinary Azalaic Acid Susopension
Pigment & Pregnancy:
Another common skin concern during pregnancy is pigmentation. Hormones are again to blame. This time it’s the over production of melanin stimulating hormone (MSH) that causes pigmentation, often called melasma, to form.
This pigmentation often affects the forehead, cheeks and upper lip but thankfully it tends to fade after delivery. It can, however, return with subsequent pregnancies.
Pigmentation Essentials during pregnancy:
It is vital for everyone to wear sunscreen every day but in pregnancy it is even more important as sunlight can accelerate the formation of pigmentation in pregnancy. Ensure your sunscreen is broad spectrum and at least SPF 30. Ideally choose. Physical sun filter such as zinc oxide or titanium dioxide. These act as a shield on the surface of the skin and reflect the sun.
Targeted Pigmentation support during pregnancy:
Use of a high quality antioxidant is also important to keep pigmentation at bay. Specifically vitamin C which inhibits the enzyme tyrosinase. The ideal vitamin C is L-Ascorbic Acid at a concentration of between 10-15%. We would recommend that everyone uses a well formulated antioxidant as part of their skincare routine as it has a myriad of benefits beyond just minimizing pigment formation.
Suggested pigmentation products:
Skinceuticals CE Ferulic or Phloretin CF
AlumierMD Clear Shield Sunscreen
Dryness & Pregnancy
For some pregnant women, dry skin can become an uncomfortable problem during pregnancy. The culprit again are hormones! Hormonal changes can disrupt the hydrolipidic barrier. This barrier, when functioning correctly, keeps moisture within your skin.
Though it’s hard to resist the urge to scrub the dry, flaky skin, try to avoid this as it will further damage the barrier. Instead, treatment for dry skin during pregnancy should focus on keeping moisture in your skin. The best way to do this is to use products that preserve and replenish the hydrolipidic layer.
If you are suffering with dry skin we recommend that you:
- Don’t use overly hot water to wash you face. Tepid water only
- Avoid harsh scrubs
- Choose a gentle over-the-counter chemical exfoliants such as lactic, glycolic or mandelic acid.
- Only exfoliate (with your chemical exfoliant) once per week
- Use a nourishing, hydrating serum under your sunscreen in the daytime
- Use a nourishing, hydrating cream at night. Can also be used during the day if you are extremely dry.
Suggested dry skin products:
Gentle exfoliant: AlumierMD AHA Renewal
Nourishing serum: Skinceuticals B5 Hydrator or AlumierMD Ultimate Boost Serum
Nourishing cream: Skinceuticals Triple Lipid Restore.