Expecting a Baby?
Expect Changes in Skin, Hair and Nails
pregnancy, changes in the skin, hair and nails are common. The correct
diagnosis and treatment of these conditions during pregnancy are
essential to ensure the health of mom and baby, experts say.
experiences profound adjustments during pregnancy, which make pregnant
women susceptible to changes of the skin, hair and nails," said Dr.
George Kroumpouzos, a dermatologist and co-author of "Dermatoses of
Pregnancy," published in the Journal of the American Academy of
history and thorough examination by a dermatologist can relieve anxiety
about the nature of these skin conditions and the possible fetal or
maternal risks associated with them."
Some things you should know, he said:
is common during pregnancy, affecting more than 90 percent of pregnant
women. Hyperpigmentation is a skin disorder in which dark spots appear
on the skin. This benign condition is attributed to an overproduction
of melanin, a natural substance that gives color to the hair, skin and
iris. Normally hyperpigmented areas, such as the breasts and nipples,
genital skin and inner thighs, may become darker in pregnancy.
Freckles, nevi and scars may appear darker as well.
This condition disappears in the months following pregnancy.
Melasma or chloasma,
known as the "mask of pregnancy," has been reported in up to 70 percent
of pregnant women. This common condition causes an increase of
pigmentation that occurs almost exclusively in sun-exposed areas.
presents in three facial patterns," explained Kroumpouzos, an
instructor in the Department of Dermatology at Harvard University,
Boston. "The centro-facial pattern involves the cheeks, forehead, upper
lip, nose and chin. The malar pattern involves the cheeks and nose, and
the mandibular pattern involves the side of the cheeks and jawline."
can develop on the forearms. Dermatologists encourage the use of proper
sunscreen to prevent this condition; they also recommend treatment with
topical corticosteroids, bleaching agents, chemical peels or tretinoin.
Most cases of melasma resolve after pregnancy.
Hair and Nail Changes
affects every area of the skin, including hair and nails. Undesirable
changes may occur that leave pregnant women feeling anxious," said
Kroumpouzos. "A discussion with a dermatologist can put a woman at ease
regarding these changes."
a condition in which a woman grows hair in areas where only a man would
-- such as the face or chest -- can be triggered by the endocrine
changes of pregnancy. This condition usually regresses within six
months following birth.
is the excess shedding of hair that usually occurs one to five months
following pregnancy. During pregnancy, an increased percentage of scalp
hairs go into the resting phase that is part of the normal growth-loss
cycle of scalp hair. After pregnancy, these hairs begin to fall out and
thin. However, this condition does not cause permanent hair loss or
obvious bald patches. Telogen effluvium resolves slowly, beginning six
to 12 weeks postpartum. There is no medical treatment available.
hair, can change noticeably during pregnancy. Some women find that
their nails tend to split and break more easily during pregnancy. Like
the changes in hair, nail changes aren't permanent.
Pruritic urticarial papules and plaques of pregancy
(PUPPP) is the most common skin condition of pregnancy, occuring in the
third trimester. It is characterized by small red bumps and hives and,
when severe, the bumps form large patches. This rash usually develops
on the abdomen and spreads to the thighs, buttocks, breasts and arms.
itching from PUPPP may cause mild discomfort. However, PUPPP does
disappear after delivery. Anti-itching topical medications,
antihistamines and topical corticosteroids can be used to control the
develop in more than 90 percent of women during the sixth and seventh
months of pregnancy. These occur in response to the pulling and
stretching forces in the underlying layers of skin during gestation.
They most often occur as pink or purple bands on the abdomen and
sometimes on the breasts and thighs. While common in Caucasian women,
stretch marks are uncommon in African-American women.
use of lotions or creams with alpa hydroxy acids can be used to prevent
striae," said Kroumpouzos. "The use of retinoid products can also be
used to fade the marks, but usually some silvery discoloration
Although not related to the herpes virus, herpes gestationis, also known as pemphigoid gestationis, is the most well-defined dermatosis of pregnancy and the most important to diagnose.
gestationis is characterized by blisters on the abdomen during the
second trimester; in severe cases, the blisters can be very expansive.
Herpes gestationis usually resolves during the later parts of pregnancy
and will flare at the time of delivery. The condition usually
disappears in the weeks and months following delivery and may reappear
with menses or with subsequent use of oral contraceptives.
Treatment includes oral or topical corticosteroids.
Prurigo of pregnancy
consists of very itchy, tiny bumps that appear almost anywhere on the
skin. This condition can appear during any trimester, with a few bumps
appearing and increasing in number each day. It usually remains for
several months and may even persist postpartum. Reoccurrence during
subsequent pregnancies is variable. Treatment usually includes topical
corticosteroids and antihistamines.
Skin Diseases Affected
women with certain skin diseases are more likely to experience an
aggravation or, less often, an improvement in their condition," said
Women with atopic dermatitis,
a chronic skin disease causing itchy, irritating skin lesions, are
likely to see a worsening of the condition during pregnancy. The
condition also may develop for the first time during pregancy.
is more likely to improve than worsen during pregancy. Psoriasis is a
chronic genetic skin disorder characterized by raised, thickened
patches of red skin covered with silvery-white scales that can affect
any part of the body. This improvement may be attributed to the high
levels of interleukin-10 in pregnancy, a protein that is released by
one cell to regulate the function of another.
important for women to speak with their dermatologists if they notice
any of these changes," said Kroumpouzos. "Though the origin of many of
these conditions remains unknown, there are many treatment options
available that will relieve the discomfort and anxiety, and lead to a
more relaxed pregnancy."