Common Skin Changes During Pregnancy

Stretch Marks Causes and Prevention

Your skin is a living organ that will expand around your growing and developing baby. As this happens and depending on your genetics you may experience:

Stretch marks.  The average woman gains about 30 lbs over the nine months of pregnancy. That means your belly skin will stretch to accommodate your baby bump and that can lead to stretch marks. Almost 90% of pregnant women will experience stretch marks which appear as pinkish or reddish streaks running down your abdomen and/or breasts.

Exercising hydration and lotions that contain vitamin E and alpha-hydroxy acids have been said to help in the prevention of stretch marks. These remedies have not been medically proven to have a direct effect on stretch marks, but it never hurts to try. If you find that nothing is working for you, take comfort in knowing that these streaks will fade to silvery faint lines after delivery.

Line Nigra is a darkened vertical line in the middle of a pregnant belly. It’s a natural part of pregnancy so there is nothing you can do to prevent this pregnancy line. The good news is it usually fades shortly after delivery.

Mask of Pregnancy

“Mask of pregnancy” is also referred to as melasma and chloasma. Melasma causes dark splotchy spots on your face. These spots most commonly appear on your forehead and cheeks and are a result of increased pigmentation.

When you become pregnant your body produces more hormones, which causes an increase in pigmentation. Nearly 50% of pregnant women show some signs of the “mask of pregnancy.” These skin changes should fade after your baby is born. The good news is skin condition doesn’t cause cancer or turn into cancer. But, there are skin cancers that look similar to melasma, so if you suspect is something more than melasma, see your dermatologist for a definitive diagnosis.

To prevent “mask of pregnancy” from happening to you, you should wear a good sunscreen that is at least SPF 30 whenever you plan on being outside. You can also wear your favorite ball cap to protect your face from the sun. Your skin is extra sensitive, and exposure to the sun increases your chances of these dark spots showing up on your face. T

Pregnancy Glow

When you are pregnant your body produces 50% more blood, resulting in more blood circulation through your body.  This increase in blood circulation causes your face to be brighter.

Your body is also producing a fair amount of hormones that cause your oil glands to work in overdrive, leaving your face shiny. Both of these things can result in the “pregnancy glow” you have heard of.  If your skin becomes too oily you can use an oil-free cleanser to clean your face. Other than that, do nothing but smile!

Pimple Breakouts and Acne

If you have a problem with acne already, your acne may become more irritated during pregnancy. The extra hormones in your body cause your oil glands to secrete more oil, which can cause breakouts.  You should keep a strict cleansing routine. You can start with a simple over-the-counter face soap. It is a good idea to use fragrance-free soap to avoid nausea.

Cleanse your face every night and every morning. Washing your face more than this can cause your skin to become dry.
Next use an astringent to remove any remaining oil. Stay away from any acne medicated astringents; they may contain acne medicine that is not recommended for pregnant women.

Finally, follow this procedure with an oil-free moisturizer.  If you find that you are having problems with acne, consult with your health care provider on acne treatment during pregnancy.

Varicose Veins:

Varicose veins are bulky bluish veins that usually appear on the legs during pregnancy. This happens because your body is compensating for the extra blood flow that is going to your baby.

Varicose veins can be uncomfortable and sometimes painful. Unfortunately, if you have a family history of varicose veins, you may be prone to get them during your pregnancy. The good news is that you can take measures now to prevent or decrease the symptoms.

What can I do?

To prevent or decrease symptoms, you should:

• Avoid standing for long periods of time
• Walk as much as possible to help the blood return to your heart
• Always prop your feet up on a stool when sitting
• Avoid sitting for long periods of time
• Wear support stockings
• Get enough vitamin C (this helps keeps your veins healthy and elastic)
• Sit with your legs higher than your head for at least half an hour a day
• Avoid excessive weight gain

Spider Veins

Spider veins, also known as spider nevi, are minute, reddish blood vessels that branch outward.  These spider veins are also caused by the increase in blood circulation.

They will usually appear on the face, neck, upper chest and arms. Spider veins do not hurt and usually disappear shortly after delivery. Spider veins appear more often in Caucasian women than in African American women. Increasing your vitamin C intake and not crossing your legs can help minimize spider veins. Spider veins may also be hereditary, in which case there is nothing you can do to prevent them.

Fortunately, these will most likely fade shortly after delivery. Laser treatment can also be done to help remove any spider veins that have not faded away.

Dry Itchy Skin During Pregnancy

As your belly grows, your skin stretches and tightens. This causes very uncomfortable dryness and itching. If you begin to experience severe itching late in your pregnancy, possibly accompanied by nausea, vomiting, loss of appetite, fatigue and/or jaundice, you should contact your doctor.

This could be a sign of cholestasis, which is related to the function of the liver. Your doctor may take blood tests to verify if you are experiencing cholestasis. Cholestasis occurs in about one in every 50 pregnancies and is not a problem after pregnancy.
If the itching is intense and spreads to your arms and legs, it could be pruritic urticarial papules and plagues (PUPP). PUPP occurs in about one in every 150 pregnancies. PUPP is itchy, reddish, raised patches on the skin that will go away after delivery.

To help alleviate your dry itchy abdomen, you should keep your abdomen moisturized. You can also use an anti-itch cream such as calamine lotion to help provide more relief.

Cholestasis can be treated with medications. To help alleviate PUPP your health care provider can prescribe oral medicine and anti-itch creams. Try taking a nice oatmeal bath to help relieve some of the discomforts.

Skin Tags

Skin tags are very small, loose growths of skin that usually appear under your arms or breasts.  After pregnancy, your skin tags may disappear. If they do not disappear, there are ways to remove them.

Darkening of Freckles, Moles and Other Areas of Your Skin

Increased hormones cause changes in your skin pigmentation. You will notice that areas with dark pigmentation, such as freckles, moles, nipples, areolas, and labia, can become even darker.  There is nothing you can do to prevent this from happening. If you notice that a mole or freckle changes in appearance or shape, you should contact your health care provider.

These darker areas can remain darkened after pregnancy. The change in pigmentation can be noticeable, but not drastic.

Want to Know More?

• How Your Body Changes During Pregnancy
• Body Image: Loving Your Body Before, During and After Your Pregnancy

Compiled using information from the following sources:
WebMD, https://my.webmd.com/
Parents.com, https://www.parents.com/
Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 56.

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What Causes the Pregnancy Glow?

The specific cause for the pregnancy glow is not concrete, but there is solid educated explanations that suggest it is related to a couple of physiological changes that occur during pregnancy. As noted above, many of the skin changes are attributed to the influx of hormones. These hormones cause your glands to produce more oil, which makes your face shinier.

Another contributing factor is the increase in blood flow. During pregnancy, your body increases the production of blood by approximately 50%.  The proposed theory is that this increase in blood flow and circulation leads your face to be brighter, or more fuller.

Just Enjoy the Glow

As noted above, the pregnancy glow is a natural part of pregnancy. Most women appreciate the glow or shine that is revealed in their faces. Many people call this physiological change one of the blessings of pregnancy. However, the increase in oil can make your skin too oily and sometimes trigger acne, also known as pregnancy acne. If this proves to be the case, you are welcome to use an oil-free cleanser to clean your face and reduce the amount of oil on your skin.

Hopefully, you will be able to display your pregnancy glow and avoid the mask of pregnancy. Unfortunately, one of the physiological changes during pregnancy is the change in pigmentation of the skin. This “mask of pregnancy” involves brownish spots or patches that develop around the neck and face. Many women find these to be less desirable than the pregnancy glow.

The good news is the mask of pregnancy usually disappears after giving birth. The bad news is, so does the pregnancy glow.  Ultimately, the most important thing you can do is have good skincare practices on a regular basis, whether you are pregnant or not.

Want to Know More?

• Effects of Exercise on Pregnancy
• Pregnancy Nutrition

Compiled from the following resources:

Mayo Clinic: Mayo Clinic Complete Book of Pregnancy & Baby’s First Year (281).  New York, NY: William Morrow and Company, Inc.

Cunningham, F. Gary, Leveno, Kenneth J., et al (2005).  Maternal Physiology in Williams Obstetrics 22^nd edition (126). New York, NY: McGraw-Hill.

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Uterus Size During Pregnancy: First Trimester

Around 12 weeks pregnant, the uterus is the size of a grapefruit and starts to grow up and out of your pelvis, but still fits within it.

If you are carrying twins or multiples, your uterus will start growing and stretching sooner. Your OB/GYN will be able to feel your uterus by touching your belly.

Uterus Size During Pregnancy: Second Trimester

During the second trimester, your uterus will grow to the size of a papaya. It no longer fits inside the pelvis. It will be situated midway between the navel and breasts.

As your uterus grows, it is pushing organs out of their usual places and putting tension on surrounding muscles and ligaments. This will likely cause some aches and pains, but they are completely normal. The pressure from your uterus may cause your navel to stick out, but your navel should return to normal after birth.

Starting between 18 and 20 weeks your doctor will measure the distance from your pubic bone to the top of your uterus in centimeters. The top of your uterus is called the fundus, so the measurement is called the fundal height.
This number usually corresponds with the number of weeks pregnant you are, give or take two centimeters. For example, if you measure 32 centimeters then you should be about 32 weeks pregnant. If this is not your first pregnancy it is normal for this measurement to be a bit bigger.

If your uterus is the size it should be during your prenatal visits, this is a sign everything is progressing well with your pregnancy. If it is measuring too big or too small, it could mean your due date is off, some kind of pregnancy complication or additional testing may be required.

Uterus Size During Pregnancy: Third Trimester

During your third trimester, the uterus will finish growing and be the size of a watermelon. When you reach full term your uterus will extend from the pubic area to the bottom of your rib cage. As you get ready to give birth your baby should drop lower into your pelvis.

After Pregnancy

After birth, your uterus will gradually return to its pre-pregnancy size and position. The deflation of your uterus is called involution. It usually takes about 6 weeks for this process to be complete.

Want to Know More?

• How Your Body Changes During Pregnancy
• Medical Terms to Know
• Baby Development Month by Month Video

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Breast Changes During Early Pregnancy

There are a number of breasts changes during pregnancy that you should expect:

• Growth and enlargement – Around weeks 6-8, your breasts will get bigger and continue to grow throughout your pregnancy. Expect to go up a bra cup size or two. Your breasts may feel itchy as the skin stretches and you may develop stretch marks.
• Tenderness and hypersensitivity
• Darkening of nipples and areolas (the skin around your nipples) due to hormones that affect the pigmentation of the skin.
• Darkened veins along with your breasts (due to the increased blood supply to your breasts)
• Around month three, your breasts may start leaking a yellowish, thick substance known as colostrum. Some women may leak earlier, some never at all.
• Nipples stick out more, and the areolas and nipples will grow larger
• You may also notice little bumps on the areolas. These are small oil-producing glands called Montgomery’s tubercles

How can I ease breast pain and discomfort during pregnancy?

Here are some helpful suggestions you can follow to make some of these changes more comfortable and easier to manage.

Growth and enlargement: Buying a good supportive bra can help you feel more comfortable as your breasts grow. Consult a bra-fit expert at a large department store, maternity or specialty shop. If your breast size increases greatly, you may want to sleep in a cotton sports bra at night.

What to consider in a bra:

• Maternity and nursing bras usually have extra hooks and don’t have underwire cups. They’re also made for extra support and comfort. When you start breastfeeding, you’ll want to switch to a nursing bra for easier access.
• Sleep bras help provide support for larger breasts. Look for wide straps and a soft cotton lining. Maternity stores often sell these soft, nonrestrictive cotton bras too.
• Sports bra. When you exercise during pregnancy, it’s especially important to wear a supportive bra that fits properly because your breasts are heavier. A good sports bra can provide the additional support you need and minimize discomfort.

Sensitive and tender breasts: Hormones in your body are preparing your breasts for lactation. The milk ducts are growing and being stretched as they fill with milk early in pregnancy. All this causes your breasts to be more sensitive, particularly your nipples. This may cause you discomfort.

Colostrum: Colostrum, or pre-milk, is a sweet and watery fluid that is easy to digest. During your second trimester, your breasts will begin to produce colostrum. Colostrum appears thick and yellow at first, and as the birth draws near, it becomes pale and almost colorless. Colostrum will provide your baby with his first few meals before your milk comes in.

A discharge may occur at any time, when your breasts are massaged, or when sexually stimulated. There is no need to be alarmed when this happens, and there is no need to worry if it does not happen.

Women who do not experience discharge in pregnancy still produce milk for their baby.

What about breast cancer?

Continuing with self-breast exams during pregnancy is important. Unfortunately, during pregnancy, it is more difficult to accomplish because of all the changes your breasts are going through. Your breasts are growing in size, are tender, and sometimes may even be lumpy. It is still important for you to examine your breasts during pregnancy every 4-5 weeks.

Very common lumps found among women during pregnancy are clogged milk ducts. These are red, tender-to-the-touch, hard lumps in your breasts. Warm compresses (running warm water over your breasts in the shower or applying a warm washcloth) and massages will probably clear the duct in a few days. If you are unsure of any new lump, tell your doctor on your next visit.

Keep in mind breast cancer is rare among women younger than 35. If you are planning on having a baby and are over the age of 35, you may want to consider asking your doctor about a mammogram before you get pregnant.

Want to Know More?

• How Your Body Changes During Pregnancy
• Puberty: A Basic Guide for Young Women

Compiled using information from the following sources:

1. Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 30 and 57.

2. Planning Your Pregnancy and Birth Third Ed. The American College of Obstetricians and Gynecologists, Ch. 7.

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The ones you may not notice happening are the ones that cause many common symptoms of pregnancy. Things like acid reflux, needing to empty your bladder (constantly, it seems?) or feeling short of breath during pregnancy are caused by the changes happening in the respiratory, urinary and gastrointestinal systems. Let’s look at all the hidden and obvious body changes during pregnancy.

Body Changes During Pregnancy

Some of these changes are subtle, an increased respiratory rate for example, while other more obvious changes include a baby bump. All these changes occur to prepare for the development of your baby and to give birth during labor. Here are some systems, organs, and parts that undergo changes during pregnancy.

Body Parts and Systems That Change While Pregnant

• Endocrine System
• Abdomen
• Cardiovascular System
• Breast
• Respiratory System
• Body Temperature
• Integumentary System: Hair, Skin, and Nails
• Urinary System
• Legs and Feet
• Musculoskeletal System
• Body Weight

All these changes happen at different points of your pregnancy. The breasts are commonly the first changes most pregnant women notice. The second most recognized sign of pregnancy is the abdomen.
An Ob/Gyn or Obstetrician will help you adjust to these changes and make sure your pregnancy is progressing safely through regular prenatal visits.

Body Changes During Pregnancy Infographic

The infographic below breaks down how the body changes during pregnancy in more detail perfectly.

Learn More:

If you are interested in learning more about how your body is changing during pregnancy, we recommend signing up for our pregnancy week by week newsletter and reading the following amazing pregnancy books.
Guide to Healthy Pregnancy
The Pregnancy EncyclopediaThe Pregnant Body

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