SKIN DURING PREGNANCY: PIGMENTATION

Pregnancy is often considered a time when the complexion blooms, when the skin looks better than ever. Although this is true for many women, there are others who begin to develop skin blemishes at this time. Moreover, women may develop stretch marks, varicose veins and spider leg veins, and suffer from very itchy skin and cracked nipples during pregnancy. There are preventative measures which can help women avoid these problems, and most of them can also be treated once they have occurred.Disfiguring pigmentation, especially of the cheeks and upper lip, commonly occurs in pregnancy and when the oral contraceptive pill is taken. This is caused by a combination of oestrogen hormones and ultraviolet A light, which penetrates windows and most conventional sunscreens. The pigmentation may disappear spontaneously after pregnancy, but in most cases it will lighten during the winter months and darken again in summer.Because ultraviolet A light is not blocked adequately by conventional sunscreens, it is difficult to prevent this pigmentation. It is best to keep out of the sun as much as possible during pregnancy. Outdoors, a sunscreen such as tinted zinc cream, Clinique Continuous Coverage, Dermablend and pancake make-up is the best choices. The newer sunscreens which contain titanium dioxide and parsol 1789 (methoxy-dibenzoyl methane) give good but incomplete protection from ultraviolet A light. These include Ego SunSense, Ego Sun-sensitive, Clinique City Block, Nivea Visage with sunscreen and UV Low Allergenic Formula.Pigmentation may fade after pregnancy if sun exposure is diligently avoided. Otherwise, it is extremely difficult to treat. Fading creams available from chemists are ineffective. However, a prescription cream containing 5% hydroquinone and retinoic acid may help to fade the pigmentation in some women. This must only be used under a doctor’s supervision after pregnancy. The depigmenting lotion does not bleach the skin white, but rather fades it to its normal colour. Initially it produces some redness and peeling until acclimatization occurs. In severe cases chemical peeling may be useful but is not without risks, and must be done by a suitably qualified doctor.
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