As soon as you know that you are pregnant, there is an unmistakable glow in your skin.

First because of the hormonal changes and second because of the happiness it brings.

There are a lot of changes that happen in your body in the course of pregnancy.

Lets talk about the changes in the skin, from head to toe.

1. Hair has 3 phases, the growing phase, the resting phase and the dropping phase. So in pregnancy, the hair goes into the resting phase and so you do not see much of hair fall unless you have some deficiency which can be treated. But once you deliver, a couple of months later the hair goes automatically into the dropping phase, which is normal.
2. Do wash your hair often if its oily.
3. Don’t wash too often if its dry.

–      Avoid chemical treatments like permanent straightening, curling, ironing etc.

• Hair can get dry if you have a thyroid deficiency, it can get oily too depending on the hormonal levels.
• Acne or pimples may increase which is again hormonal. Not all acne treatment, whether oral or topical is safe in pregnancy. consulting a dermatologist is a must to know what can be used to treat Acne.
• Do as told by your doctor.
• Don’t try un prescribed medicines on your own.
• Avoid picking or pinching your acne as it can leave scars.
• Small, red veins can appear on the face, neck and arms because of the increased blood volume and hormone.
• These don’t need treatment unless cosmetically disfiguring.
• May disappear later.
• Multiple skin tags can appear on the neck, chest, back, below the breasts and groin. These have to be removed by a doctor by doing electro cautery if they are big or causing irritation due to friction.
• Do not interfere with these lesions.
• Get them removed by your Dermatologist.
• Increased pigmentation is very common in pregnancy due to the increase in the naturally occurring melanin. Seen as darker colour of the nipples, breasts, inner thighs, a dark line in the abdomen called the Linea Nigra, Melasma or the pigmentation on the face, nose and cheeks called the mask of pregnancy. All this slowly resolves in months after delivery.
• Do not try bleaching or depigmenting creams and avoid contact allergies.
• They fade away after delivery.
• Stretch marks or striae gravidarum as it is called, are seen due to the stretching of the skin on the breast, abdomen, buttocks and thighs. They start off as reddish lines when they are new and later turn to silvery or white lines. These are hard to treat as once they appear they do not disappear as the stretched skin or the elastic tissue does not come back to normal.
• Moisturize your skin well to avoid over stretching.
• They are not due to scratching.
• Varicose veins may be seen in the legs because of the increased weight and also the pressure of the uterus which deceases the blood flow to the legs.
• Consult a Vascular surgeon, if there are big veins and swelling in the legs.
• You may have to wear stocking if advised.
• Cell mediated immunity is depressed during normal pregnancy, this accounts for increased severity and frequency of skin infections. Bacterial, Viral or Fungal infections may occur or increase if they are already present. This needs immediate treatment as these infections can spread widely and also affect the baby as it can be transmitted through the placenta.

Most often Bacterial infections will have pus and pain and has to be treated with antibiotics that are safe in pregnancy.

• Do not try to squeeze the pus out as you may spread the infection further.
• Keep yourself clean and hygienic.

Fungal infections occur in the areas where you sweat most, like under the arms, below the breast, inner thighs, in between the toes and also on the body surface areas, these will cause intense itching, and continuous scratching can lead to secondary bacterial infection.

• Bathe everyday and twice a day in summer if you sweat more.
• Wear cotton and comfortable clothes.
• Keep your nails trimmed.
• Avoid self medication.

Viral infections like warts, Molluscum contagiosum etc need immediate treatment to avoid spread to the baby.

• Do not neglect these lesions as there are no symptoms.
• A lot of other inflammatory skin conditions/ pregnancy dermatoses are specific to pregnancy and need immediate treatment, though they are benign and resolve after delivery, like
• Early onset

     Atopic eczema

    – prurigo of pregnancy

    – pruritic folliculitis

b) Late onset

• PUPPP- pruritic urticarial papules and plaques of pregnancy
• Pemphigoid gestationis
• Pruritus gravidarum – pregnancy jaundice

Meet your doctor immediately if you have sever itching, rashes, water bubbles, pain full or pus filled skin lesions, fever with a rash, on the abdomen or anywhere on the body.

Dr T S Vidya
MBBS, MD, FRGUHS (Aesthetic Dermatology)
Consultant Sagar Hospitals
And
Skin & Cosmetic Clinic, Bangalore.