Pregnancy changes your skin—here's what to expect

Pregnancy brings about all kinds of changes to the body. After all, you’re growing a new life! You may be curious to know how these changes will affect the skin on your face and body—and what ingredients you should drop from your routine and replace with pregnancy-safe skincare products. To find out the most common pregnancy-related skin ailments and how to treat them safely, we consulted Dr. Isha Tiernan, a dermatologist with Tufts Medical Center in Boston.

Skin changes to the face during pregnancy

Due to an increase in estrogen, a female sex hormone, any number of conditions may occur, from developing acne or melasma (a discoloration) to changes in your skin’s oil levels, leading to oilier or dryer skin.

Acne: Hormonal acne during pregnancy tends to pop up in the lower third of the face, including the jawline, chin, and the upper neck area. If you deal with acne prior to conceiving, the change in hormones may actually clear it up, but it works the other way, too, causing many pregnant women to develop acne that persists until after they deliver their baby. “Most people do require some treatment or desire some treatment and even if the acne goes away, a lot of times it can lead to kind of red marks or dark marks on the skin that then they'll need to be treated,” Tiernan says.

You’ll want to avoid certain ingredients during pregnancy that may otherwise be used to treat acne, like salicylic acid or benzoyl peroxide, as they can be harmful to your baby’s development. Instead, Tiernan recommends using azelaic acid, which is an exfoliant that’s available in both prescription (15% concentration) and over-the-counter (10%) options. Azelaic acid not only can treat existing acne but also target dark spots and staining, or hyperpigmentation from breakouts. For an OTC option, go with The Ordinary’s Azelaic Acid Suspension 10%. You can also try glycolic acid, another exfoliant that can keep the skin’s texture looking smooth. Try The Ordinary’s Glycolic Acid 7% Toning Solution for daily use. In addition to any treatments, you want to use a gentle face wash and an oil-free (to avoid clogging the pores) moisturizer, regardless of your skin type.

Melasma: Also called “chloasma,” melasma, or discoloration of the skin in patches on the face, is another common skin side effect during pregnancy. The hyperpigmentation is caused by an increase in hormones, particularly estrogen, which increases the overproduction of melanin and results in darker blotches. “People can get this outside of pregnancy, but you’re more likely to get it during pregnancy,” Tiernan says. Melasma may fade after pregnancy, but you can treat the darkness during or after, if it lasts on the skin.

To counteract the excess melanin in the skin, you can use a lightening treatment. A popular one is hydroquinone, but Tiernan warns that you should avoid that during pregnancy as more studies are needed to determine how safe it is for the baby. Here, she suggests opting again for azelaic acid, as it works against the enzymes that create the melanin pigment, reducing discoloration. Another brightening ingredient you can try is vitamin C, an antioxidant that not only targets dark spots and hyperpigmentation, but also works to protect your skin against harmful environmental aggressors, like free radicals. One you may consider is the TruSkin Vitamin C Serum, which also contains hyaluronic acid to hydrate and plump the skin. The last brightening ingredient Tiernan recommends is kojic acid, which prevents darkness by blocking tyrosinase, an amino acid needed to produce melanin. One to try is the Skinceuticals Discoloration Defense, which combines kojic acid with niacinamide to even out the skin’s texture and tone.

Lastly, you’ll want to use a sunscreen that is at least SPF 30 and is broad spectrum to block both UVA and UVB rays. Sun protection is always necessary, but especially if you’re pregnant and if you have melasma. Tiernan explains: “It’s actually been proven that [any] visible light, like the light that you’re sitting under, can worsen melasma or chloasma.” Tiernan recommends using a physical (a.k.a. mineral) sunscreen as opposed to a chemical one, as the main ingredient, zinc oxide, is proven to be safe for babies and therefore there are no concerns about it absorbing through your skin and into your system. (In fact, zinc oxide is a common ingredient in diaper paste.)

Oily or dry skin: Another change you may notice is that your once-dry skin begins to lean oily or vice versa during pregnancy. Tiernan explains: “I think that ‘pregnancy glow’ is maybe partly because people have a little bit more oil production, so maybe they’re a bit ‘shinier,’” Tiernan explains. “And also because, in pregnancy, you tend to have an increase in blood flow and blood circulation, so maybe that’s part of it as well.” On the other end, some women whose skin skewed oily before conception, may experience dryness. (Thanks, hormones.)

While there’s no specific treatment for the change in your skin type (which will probably stabilize after you give birth), just remember to keep moisturizing regardless of whether you lean more dry or oily. “Even if the skin is a little oily, you still want to moisturize,” Tiernan says. “You don’t want to ever get into that situation where your skin is actually overproducing oil to compensate for lack of moisture.” Plus, oily skin may actually be a sign of dehydration. To keep the skin hydrated, drink plenty of water, look for a moisturizer that contains hyaluronic acid (like the Cerave Moisturizing Cream), or consider adding a hyaluronic serum (like the Cosmedica Hyaluronic Acid Serum) into your morning and/or nighttime routine.

Skin changes to the body during pregnancy

Your body goes through even more changes than your face as it makes room for your baby, which naturally can affect the skin. The most common dermal concerns are itchy skin, stretch marks, rashes, visible veins, skin tags, and a darkened vertical line on the belly called linea nigra.

Itchy skin: There are a number of reasons for your skin becoming itchy during pregnancy. The simplest one is that your skin is dry, either from changes in your hormones or even the weather. Either way, your skin needs more moisture, if that’s the case, so try moisturizing regularly with a rich cream, like the Cerave Moisturizing Cream. If the itching still persists, it’s possible that it’s related to the stretching of your skin, which causes inflammation, or you may have a noticeable rash (more on both of those below). Additionally, conditions such as eczema and psoriasis may worsen during pregnancy and cause itchy skin. If you have rough, dry patches that don’t respond to over-the-counter creams, you may want to talk to a dermatologist to develop a game plan for treatment.

Stretch marks: These indentations or slight depressions in the skin are due to a lack of collagen and elastin, both of which are proteins the body produces that act as connective tissue to uphold the skin’s structure. They can appear as ragged lines that are lighter or darker than your skin or pink or red in color. Rapid weight gains or losses and the stretching of skin because of the baby’s growth and your body’s weight changes commonly cause stretch marks. In pregnancy, rapid growth is hard to avoid, but Tiernan suggests steadying your weight gain as much as you can with a healthy diet and exercise routine. Still, stretch marks are likely unavoidable, especially if your baby is larger or you’re pregnant with multiples. Because these are scars in the dermis, the layer beneath the epidermis, treating stretch marks topically is not always effective, but the best way to try to treat stretch marks is by keeping the skin moisturized so that it remains hydrated and plump, as well as drinking plenty of water and massaging the skin to promote circulation to the areas you’re concerned about. If you’re bothered by their appearance after you’ve had the baby, you can receive in-office procedures, such as chemical peels, laser treatments, or microneedling, all of which cause intentional injury to the deeper structures of the skin, forcing the skin to rebuild collagen.

Skin rashes: There are several rashes that can develop during pregnancy and cause red, dry, blotchy, or itchy skin. “There’s something called polymorphism eruption of pregnancy where people can get these inflamed, very itchy, red stretch marks,” Tiernan says. “Stretch marks could also be itchy on their own, but this is more of an exaggerated rash that can develop.” Rashes have different causes and treatment methods, which is why it’s important to seek out a doctor if you notice one on your skin. “There are certain [treatments] that are not safe to use during pregnancy and even for some of the topical steroids you need to be counseled about how to use them so that it’s safe,” Tiernan says.

Visible veins: It’s normal to develop varicose or spider veins during pregnancy. Varicose veins appear as large blood vessels that bulge from the legs with a purple, blue, or green tint. Spider veins are smaller, purpley-red or darker-than-your-skin-tone vessels that often occur on the legs or face. Both veins are generally harmless and caused by increased blood circulation and you’ll want to consult your dermatologist for in-office treatments, such as laser procedures, and to make sure everything is otherwise OK.

Skin tags: Skin tags are tiny, harmless flaps of skin, often the same color as your complexion, but may appear lighter or darker. They can occur almost anywhere on the body and new ones may form during pregnancy. The growth of skin tags may be from the increase in hormones or genetics and there is no way to prevent them. Tiernan says they usually don’t go away on their own after pregnancy, but a dermatologist can remove them after you deliver if they really bother you.

Linea nigra: If you notice a darkened line that runs from your belly button down to your pubic bone, this is called linea nigra. “A lot of people have that before pregnancy—it’s just very, very light so they’re not able to see it, but it can darken during pregnancy and it can fade after the baby is born,” Tiernan says. The exact cause of the darkening is unknown, but it’s thought to be related to the influx of hormones and it should disappear after you give birth.