Not every woman will be blessed with the pregnancy glow. Here are some skin issues to expect if you’re pregnant or breastfeeding.
WORDS RACHEL LIM
Eczema, or dermatitis, is a common, chronic skin condition which affects the general population. In mild cases, your skin is dry, inflamed and itchy. In severe cases, skin can become raw and even bleed. Eczema is not contagious.
The most common variety, atopic eczema, is hereditary and triggered by exposure to environmental allergens that are harmless to others.
Other types of eczema such as contact dermatitis are caused by irritants such as chemicals, detergents, yeast and metals. If you have eczema pre-pregnancy, raging pregnancy hormones may either make your condition go into remission or flare-up.
“Moisturisers and gentle soap-free cleansers are often recommended and they are safe to use,” says Dr Tan Hiok Hee, dermatologist, Thomson Specialist Skin Centre. He also assures that the use of a topical steroid cream during pregnancy and while nursing is safe. Dr Tan reminds expectant and lactating mums to always check with their doctor regarding the strength of the steroid cream, how often to use it, and when to stop.
Brown patches of pigmentation on your forehead, cheeks and neck are known as Chloasma, Melasma or mask of pregnancy. It is caused by your body making extra melanin, the tanning hormone, which protects your skin against ultraviolet (UV) light.
“One of the most common prescription items to treat pigmentation is Hydroquinone – however, this is best avoided as there is insufficient data with regards to its safety during pregnancy and when breastfeeding,” warns Dr Tan.
According to Dr Tan, sunscreens are generally safe to use and there is no clear evidence that sunscreen ingredients should be avoided during pregnancy or while breastfeeding. “However, it is common for doctors to recommend that patients consider using a physical sunscreen that contains ingredients such as titanium dioxide or zinc oxide, as opposed to a chemical sunscreen if you find your skin becoming a bit more sensitive during pregnancy,” says Dr Tan.
Higher levels of hormones called androgens are the likely culprits for pregnancy acne because they cause the sebaceous glands in your skin to increase in size and boost production of an oily substance called sebum.
This extra sebum, when combined with shed skin cells that line your hair follicles, clogs your pores and creates an environment in which bacteria can rapidly multiply. This eventually leads to inflammation and skin eruptions of acne.
Pregnancy acne can range from mild to severe. It can occur at any stage of your pregnancy. It may be transient or last the entire pregnancy.
Dr Tan reassures that topical acne medications such as clindamycin and erythromycin are safe to use. He adds that benzoyl peroxide is also considered safe in low concentrations (5 per cent or less). “However, take note that topical retinoids (tretinoin, adapalene, isotretinoin) should be avoided. Also, be aware that some topicals contain combinations of various products (e.g. an antibiotic with a retinoid, or benzoyl peroxide with a retinoid), and you should always check with your doctor or pharmacist before using them,” advises Dr Tan.
Dr Tan points out that topical azelaic acid is a prescription medication that is safe to use during pregnancy and is useful to treat acne as well as lighten some of the dark skin discolouration that occurs after acne subsides.
4. Atopic Eruption of Pregnancy (AEP) and Polymorphic Eruption of Pregnancy (PEP) / Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)
According to Dr Mark Koh, head and consultant, Dermatology Service, KK Women’s and Children’s Hospital, AEP is very common and often occurs in women with a history of atopic eczema, allergic rhinitis or asthma. “However, it can occur for the first time in pregnancy in women without a history of atopy. Itchy red bumps and patches occur recurrently on the trunk, limbs and even the face. It can occur anytime during pregnancy. Inadequate treatment can lead to poor sleep and psychological distress,” says Dr Koh.
PEP or PUPPP is also rather common but occurs later, during the third trimester. “It starts as itchy red bumps or wheals, usually on the abdomen, especially over the stretch marks (striae). If untreated, it may spread to the limbs and can become very itchy,” warns Dr Koh.
Fortunately, he assures that both these conditions do not adversely affect the baby. Both conditions tend to improve after delivery. Treatment includes the use of moisturisers, topical corticosteroids and oral anti-histamines.
5. Nipple eczema
Nipple eczema is a fairly common problem that can occur during breastfeeding, especially in mothers who have a prior history of atopic eczema. “Warning signs of nipple eczema include itching and redness around the nipple area, and could progress to scaly and sometimes oozy patches over the nipple and areola,” highlights Dr Koh.
Treatment includes the frequent use of moisturisers or nipple creams, warm or cool compresses, and topical corticosteroids sometimes with oral or topical antibiotics.
Dr Koh warns, “If left untreated, nipple eczema can lead to skin infections and spread of the eczema to other parts of the body. If severe, direct latch-on may be discouraged until the eczema recovers.”
Dr Tan reminds expectant and lactating mums to avoid prescription retinoids, which are also used to treat this condition in addition to acne. “I also recommend avoiding over the counter retinol, retinyl linoleate, and retinyl palmitate, which are derivatives of vitamin A, because of their structural similarity to retinoids,” he says.
The skin is the largest organ of the human body. Always make sure you are comfortable in your own skin.