Skin changes during pregnancy

When you’re pregnant, your skin changes. Sometimes it’s more than just having a healthy glow about you. You might not be so happy about things like stretch marks, dark spots, acne, rashes. Are these changes normal? Are they permanent?

Jade Elliott say down with Dylan Alston, a dermatologist with Intermountain Healthcare on this episode of the Baby Your Baby podcast to talk about why your skin changes during pregnancy and what’s normal and what you might want to ask your doctor about and when to see a dermatologist.

The causes of skin changes during pregnancy

Some skin changes are due to changes in hormone levels that occur during pregnancy. There’s a shift in the predominant hormones, progesterone during pregnancy. For most skin changes, however, health care professionals are not sure of the exact cause.

Good changes to your skin during pregnancy

That healthy glow, may not be physiologic, but it could be due to increased blood volume during pregnancy. Increased circulation can make skin look healthier and brighter. Hormones can make oil production more prominent and skin can shine or glimmer. Plus, some skin conditions, like rosacea, acne, or eczema can clear up during pregnancy.

Normal skin changes during pregnancy

There are many changes that occur in the skin during pregnancy. Most are considered normal and do not affect the health of the mother or the baby.

Dark spots or hyperpigmentation

The most common skin change is hyperpigmentation, or a darkening of the skin in certain areas. Dark spots and patches are caused by an increase in the body’s melanin—a natural substance that gives color to the skin and hair.

After childbirth, dark patches of skin typically return to their normal pigment after a period of months. However, some dark patches may never fade.

This can involve the face causing chloasma or melasma, also known as the “mask of pregnancy.” This can be very distressing to women as it can cause significant discoloration and it is most common on the face. It can remain throughout life. If you develop dark spots, or sun spots, be sure to protect yourself from sun, which can prevent it from worsening. Your skin is also sensitive to any visible light – indoor light, cell phone or computer screen light, TV lights, etc.

What can be done about melasma?

Use a sunblock with a high SPF and that contains ferric (iron) oxide which protects skin from visible light.

Other types of hyperpigmentation

Linea nigra is a hyperpigmented line that appears on the abdomen from the pubic bone all the way up to the navel or even the breast bone. It’s unsightly but tends to fade after birth.

Darkening of the armpits can also appear.

Moles can darken or change. Hormones are to blame. Know the ABCDs of skin cancer and see a dermatologist if you notice one of the types of changes.

Changes to hair and fingernails

Women can experience changes in their hair and nails. About three months after delivery, the hair can begin to fall out in large amounts. This is normal stress-related hair loss. The stress of delivery has shocked the hair into falling out and it is transitioning in to a new hair growth phase.


Many women have acne during pregnancy. Some already have acne and notice that it gets worse or better during pregnancy. Other women who have always had clear skin may develop acne while they are pregnant.

Tips to treat acne:

• Wash your face twice a day with a mild cleanser and lukewarm water.

• If you have oily hair, shampoo every day and try to keep your hair off your face.

• Avoid picking or squeezing acne sores to lessen possible scarring.

• Choose oil-free cosmetics.

• Prescription therapy may be needed and see your doctor or consult with a dermatologist to see what is safe. Many topical acne treatments are safe during pregnancy.

Pregnant women should not take the oral acne medication Accutane or the generic isotretinoin or the generic equivalent as it can cause severe fetal defects. Topical versions with Retin A should also not be used during pregnancy. Before or after pregnancy, birth control pills can cause acne.

Stretch marks

Stretch marks are indented streaks that often appear on the abdomen, breasts, hips, buttocks and thighs. They’re caused by the stretching of the skin and are common during the second and third trimesters. Stretch marks are more likely to happen with rapid weight gain, with twin pregnancies or in women who are already obese.

Typically, they’re just unsightly scars. Using a heavy moisturizer may help keep your skin soft, and aggressive moisturizing of the abdomen can help offset the risk of stretch marks. Coconut oil or bio oil can help, but it will not help get rid of stretch marks. Most stretch marks fade after the baby is born, but they may never disappear completely.

If you develop a rash near the stretch marks, you may want to see a dermatologist. It’s called PUPPP (pruritic urticarial papules and plaques of pregnancy). It’s a rash that starts in the stria or stretch marks in the third trimester and is more common in twin pregnancies. It is horrifically itchy. It can be so intrusive that an early delivery may be recommended.

When to see a dermatologist about a skin condition when you’re pregnant

When you are pregnant, there are really two patients: mom and baby. The needs of the baby may be more pertinent. Some skin changes are considered pathologic or abnormal and could affect the health of the mom or baby. Some rashes can affect the health of the mother and even more concerning, some rashes can impact the health of the baby. It is important to be seen by a board-certified dermatologist if you have one of these conditions:

  • Blistering around the belly button – This can impact morbidity or mortality of baby.
  • A rash with a large oval or circular patch on the chest, back or torso – Pityriasis Rosea. Usually, this starts as one large patch and then after 3-7 days, smaller versions develop in a Christmas tree pattern. It may be related to a viral infection. It is usually asymptomatic.
  • Severe itching of the palms of the hand or soles of the feet can be due to cholestasis of pregnancy – a liver condition where bile acids in the liver are getting obstructed. It causes severe itching on palms of hands or soles of feet and can spread to the trunk. It occurs in the third trimester, but goes away after childbirth. It can lead to preterm birth, or other problems.

For more information, click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.