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July 11, 2018

With pregnancy comes a host of changes to your skin - not all of them welcome

By Pamela McIntosh

Pregnancy is a journey of surprises - with a life-changing one at the end. Along the way, skin can become unsettled and undergo changes, some of them dramatic. We enlisted the help of Dermatologist Dr. Victoria Scott-Lang - new mum for the second time - to address our community's skin issues.

With my third and fourth pregnancy, I suffered fom loads of skin tags from my neck to my chest - Andrea

Dr Scott-Lang: These are harmless fleshy little growths which appear as we get older and also during pregnancy, typically in areas of friction (under the arms, under the breasts, around the neck and groin). They may shrink and disappear after you deliver your baby. If you notice that they are still present, they can easily be snipped off by a doctor under local anaesthetic.

I have spider naevi all over my hands! - Charlotte

Dr Scott-Lang: Spider naevi are dilated blood vessels which often appear on the chest, neck, face and arms but can also appear anywhere on the body. They are present when there is more oestrogen in the body, hence their development in pregnancy. Spider naevi are quite red and prominent in appearance, but this may improve after delivery. If they don't resolve they can be treated with Intense Pulsed Light (IPL) or laser. They're harmless but many women will seek treatment for cosmetic reasons, particularly if they affect the face or decolletage.

I got bad eczema around my hairline and I'm still suffering from it now that baby is two months old! - Kelly

Dr Scott-Lang: Women who have a previous history of atopic ezema (dermatitis) find it can return or flares up during pregnancy. It can also appear for the first time during pregnancy. Interestingly, some women find that their eczema improves when they are pregnant - it varies from person to person and can be unpredictable due to alteration of the immune system.

Depending on severity, eczema can be managed in different ways. Moisturising regularly is an important part of treatment. Studies have shown no adverse association with maternal use of topical steroids and pregnancy outcomes, but despite this many women prefer to avoid them. For others, they're an important part of treatment. In severe cases, UVB phototherapy can be safely used to treat eczema. In general, oral drug treatments need to be avoided during pregnancy. Avoidance of irritants e.g. fragrance, bubble baths, certain preservatives in cosmetics, wool and nickel can be an important part of keeping your skin as healthy as possible if you are prone to eczema.

My ache was rife with both my pregnancies - Dr Victoria Scott-Lang

I suffered from severe acne during both of my pregnancies. Part of the reason I wanted to become a Dermatologist is because of my own battle with acne, which started in my early teens. I have tried every drug you can think of and multiple different topical treatments. Due to this, I fully expected my acne to flare up during pregnancy - and it did with a vengeance.

I've read various different theories on whether carrying a girl or boy causes acne in pregnancy but the bottom line is everyone is different. I had two boys and my acne was terrible both times during the first and second trimesters. Treatment options for acne are limited in pregnancy. The best thing for me was topical Vitamin B3 (nicotinamide) which can be used safely. Good skincare is important but certain products must be avoided, particularly topical retinoids. Oral retinoids are a no-go in pregnancy as they cause birth defects in unborn babies. Some lasers and LED lights can be used in pregnancy, but should always be under the supervision of a Dermatologist. The acne will improve as the pregnancy goes on, and you should eventually get that beautiful glow in the third trimester.


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