Pregnancy brings with it a lot of physical changes–and one of them is to your skin. While we often hear about the “pregnancy glow,” the reality is that many moms-to-be are dealing with the opposite: acne, dry skin, melasma, and other skin ailments that plague us for nine months and beyond. Here, dermatologist and mom-to-be, Dr. Sejal Shah of the Clear Clinic–New York’s first dedicated Acne Treatment Center with offices in Midtown and the Flatiron District–offers advice for treating common skincare issues and tips on which products are safe to use.
What is a good basic skincare regimen that can be used throughout pregnancy?
Unfortunately, during pregnancy many of us have to give up our trusted daily skincare regimens. Fortunately, once you find pregnancy-safe skincare products that you like, you can usually continue the same regimen throughout your pregnancy. In general, I recommend gentle cleansers and a daily moisturizer containing a broad-spectrum sunscreen with an SPF of at least 30. A Clarisonic brush that gently yet thoroughly cleanses your skin is a helpful adjunct to your skin cleansing routine. If your skin needs some extra hydration, look for products containing hyaluronic acid.
While some women experiencing glowing skin during pregnancy, others are dealing with acne and other issues. Why is that?
The “pregnancy glow” that many mommies-to-be experience is due to physiologic changes in the skin. The increase in volume and flow of blood cause the facial skin to take on an attractive blush and appear brighter. Also, the increase in hormones during pregnancy can cause the oil glands to produce more oil, giving the skin a sheen. Unfortunately, in some women, these same changes can lead to common ailments of pregnant skin, such as acne and melasma.
If you’re experiencing acne throughout your pregnancy, what can you do about it?
Acne commonly occurs during pregnancy–typically during the first trimester due to an increase in hormone levels. The hormones tend to stabilize towards the end of the first trimester and the acne may subside at that time. However, some women do not improve until the third trimester or even until after giving birth. It is difficult to predict which women will develop acne, but women with a history of acne or peri-menstrual flares may be at a higher risk. Many of the usual over-the-counter and prescription acne medications are not safe during pregnancy, so you have to be careful about what you use. Topical products containing sulfur, azeleic acid, lactic acid, glycolic acid (under 10%) and other alpha hydroxy acids are safe to use during pregnancy. I generally do not recommend oral antibiotics for acne during pregnancy, but if the topical treatments don’t cut it, there are oral options that are safe. Red and blue light treatments, extractions and gentle microdermabrasion are also safe. In addition, a Clarisonic brush and products that soak up oil on the skin, such as mineral makeup, as well as mattifying products and blotting papers, may be helpful.
Melasma—also known as “pregnancy mask”—is a common complaint of many pregnant women. What’s the best way to treat it?
Melasma has been reported in up to 70 percent of pregnant women and tends to be more persistent in darker skin types. The increased pigment is likely a result of elevated hormone levels increasing melanin, or pigment production. During pregnancy, it is important to protect your skin from ultraviolet radiation, which can worsen hyperpigmentation (use a broad-spectrum sunscreen with an SPF of at least 30 daily, wear a broad-brimmed hat and other sun protective clothing, seek shade, etc). Azeleic acid, glycolic acid (under 10 percent), and topical vitamin C are safe treatment options during pregnancy. If melasma persists after pregnancy, there are several cosmetic treatments available, but I would not recommend them during pregnancy.
What tips do you have for dealing with dry and bumpy patches on the skin?
For dry skin, I usually recommend gentle skin care and moisturizers. Wash the skin with non-abrasive, non-drying cleansers, such as Dove Sensitive Skin Beauty Bar or Cetaphil Gentle Skin Cleanser. After washing, pat dry the skin and liberally apply a moisturizer while the skin is still slightly damp. Moisturizers containing glycerin and hyaluronic acid are helpful for dry skin because they act as humectants by attracting moisture to the skin. Lightly exfoliating the skin a few times a week is also helpful. If you are experiencing any skin irritation, skin rashes or itchy skin, you should be evaluated by your doctor, because rarely these can be a sign of something serious.
Can moms do anything to help with anti-aging while pregnant?
The foundation of any anti-aging skincare regimen is sun protection, and this is something that you can do throughout your pregnancy. Sun protection includes using a sunscreen (broad-spectrum with an SPF of at least 30), wearing a broad-brimmed hat, sunglasses and sun protective clothing, and seeking shade when ultraviolet radiation is the strongest during the day (between10am and 3pm). I also prefer titanium dioxide and zinc oxide sunscreens during pregnancy because they are physical blockers that do not penetrate the skin.
Vitamins C and E are antioxidants that are beneficial as part of an anti-aging regimen and safe in pregnancy when topically applied. Lactic acid and glycolic acid are also helpful. Retinoids, which are commonly used for anti-aging, are a big no-no during pregnancy. Before starting any skincare products, it’s best to discuss them with your doctor.
In general, what skincare product ingredients should best be avoided during pregnancy?
Benzoyl peroxide, salicylic acid (also known as beta-hydroxy acid or BHA), retinoids (e.g. Differin, adapelene, Retin-A, Renova, tretinoin, retinoic acid, retinol, retinyl linoleate, retinyl palmitate, Tazorac, tazarotene), which are commonly used to treat acne, should be avoided during pregnancy. Hydroquinone, a commonly used lightening agent, is also not safe to use in pregnancy. Although glycolic acid is safe, I do not recommend using higher than a 10% glycolic acid.
What are some recommend products that are generally safe to use during pregnancy?
Some of my favorite pregnancy-safe products are Belli Anti-Blemish Facial Wash, First Aid Beauty Facial Radiance Pads, Belli Acne Control Spot Treatment, and Pretty Mommies Truth Be Told Skin Brightener.
What impact can our diet have on our skin during pregnancy?
Some people with acne may notice their acne flares with certain foods, such as dairy products and foods with a high glycemic index, so avoiding those triggers may keep acne at bay. During pregnancy, it’s important to eat a well-balanced diet, stay hydrated, and make sure you are taking your prenatal vitamins.