During pregnancy, the skin is actively stretching with changes noted week to week as the baby develops. Although this may seem obvious and we are all familiar with the potential for stretch marks to develop during this process, you may not have given as much thought directly to what the skin is experiencing. Read more...
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Pregnancy comes with a lot of skin changes. When it comes to your bump specifically, what should women expect?
During pregnancy, the skin is actively stretching with changes noted week to week as the baby develops. Although this may seem obvious and we are all familiar with the potential for stretch marks to develop during this process, you may not have given as much thought directly to what the skin is experiencing. The stretch on the skin is similar conceptually to a balloon that is expanding. While stretching, the skin will thin and experience excess dryness as it becomes more challenging to hold onto moisture. The elastic fibers in the skin may break down and collagen thins out. Initially, the stretch marks that develop will appear reddish then fade to white over time. Along the way, there can be excess dryness, and the skin can even take on a cracked porcelain appearance from the lack of moisture. Itchiness may also accompany this dryness as well.
Broadly speaking, when looking for products that will address pregnancy-related skin changes, what should we consider?
In seeking products for stretch marks, there are several key features to consider. Studies have demonstrated Centella asiatica and Trofolastin are the two ingredients that have demonstrable benefits in reducing the tendency towards stretch marks during pregnancy. In terms of delivery method, seeking products that offer ease of application with the need to gently massage the product into the skin such as an oil or a lotion can be beneficial. Interestingly ingredients commonly recommended such as olive oil, cocoa butter, and even almond oil have not demonstrated significant benefits in studies compared to massage alone.
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What factors contribute to stretch marks? Can any cream really prevent them?
The main factors that contribute to stretch marks are genetics, hormones, and mechanical stress on the skin. The ingredients that tend to benefit stretch marks appear to work by increasing collagen and elastic fiber production in the skin likely counteracting the impact of stress on the tissue as it expands.
Which skincare ingredients should be avoided during pregnancy and why?
There are two ways that topical skincare ingredients can pose a risk during pregnancy. The first is by directly irritating the skin which can simply make your skin uncomfortable or inflamed. In this category, avoiding ingredients that can sensitize the skin or trigger exfoliation can reduce this risk. Avoiding alpha and beta hydroxy acids is important to reduce the irritation. The second is the risk that absorption of the product can play in terms of impacting the fetus. I tend to recommend that patients avoid products with ingredients that have known risks during pregnancy if taken orally as the absorption can vary widely if applied topically. This would include retinol and salicylic acid.
Are there any product recommendations?
Palmer’s Cocoa Butter Lotion for stretch marks is one of my top recommendations based on the ease of application and the presence of Centella asiatica in its formulation.
For dryness, Vanicream Lotion is a nice product line with its simple formulations and minimal use of preservatives and fragrances.
For acne during pregnancy, Azelaic Acid by The Ordinary is a nice product given its benefits for acne and the pregnancy category B rating for the ingredient.
Any other tips for how to shop for pregnancy bump care?
Talk to your doctor about your skincare during pregnancy. I have so many patients who do not give the ingredients much thought at first and panic when they come across an article that suggests an ingredient can be of concern. Think about each product you use critically during this time. With each of my pregnancies, I remember feeling as though I would never quite know where to begin with so much conflicting information available. Make your life easier and just talk to your doctor.
Are there skin changes during pregnancy that warrant a call to your doctor?
Excess itching and the development of red bumps, especially along your stretch marks, may indicate the possibility of PUPPP (pruritic urticarial papules and plaques of pregnancy). Any blisters, sores, or ulcerations in the skin should be immediately reported to your doctor. Any rashes associated with systemic symptoms like joint pains, fevers, chills, and/or malaise are essential to report to your doctor.