Great Expectations: A Definitive Guide to Pregnancy Skincare

We consult the experts to shed light on the most pressing skincare questions of expectant and breastfeeding mothers.
Reading Time: 7 minutes

Navigating the beauty of maternity and understanding our shared skin and bodycare concerns while pregnant and breastfeeding can be quite a maze, what with the bevy of information found online, the unsolicited advice from presumably well-meaning peers, and, well, the mind fog that we like to call “pregnancy brain.” 

So fret not, as we’ve taken it upon ourselves to sit down with the experts and ask everything. From the rapid, crazy transformations that can happen to our body (yes, including changes in our skin type!), to the skincare, makeup, and treatments we can and can’t do, we’ve sought the advice of top gynecologist and obstetrician Dr. Gergen Lazaro-Dizon and board certified dermatologist Dr. Gaile Robredo-Vitas. 

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“Every pregnancy is unique,” begins Dr. Lazaro-Dizon. A woman, for instance, may have different symptoms and experiences for each of her pregnancies, which are largely dependent on her body at that time, including skin changes. 

What are these skin changes?

Pigmentation and Skin Tags

“Hormonal changes during pregnancy—increase in your estrogen, progesterone—really make certain body parts dark, from your nipples to your armpits,” says Dr. Robredo-Vitas. It’s also during pregnancy when patients develop skin tags.”

Melasma

Pregnant women are prone to pigmentation, making “melasma also a common concern. That’s why I really advocate the use of sunscreen. Use physical sunscreens—with zinc oxide or titanium dioxide—because they’re less irritating and they just sit on top of your skin.”

Vascular changes

“Some will experience varicosities,” she adds, “or palmar erythema, where the palm of the hands get red. Some would get spider angioma on their abdomen. That’s why when you’re pregnant, we encourage moving about and not remain sitting or standing for a long time, or sometimes, to use support stockings.

Acne

“Acne is common, you break out when pregnant especially in the first trimester,” says Dr. Lazaro-Dizon.

Less Hair Fall and Quicker Nail Growth

“Most will experience minimal hair fall because of a shift in the hair cycle, the anagen phase (or the active phase of hair growth) gets longer,” says Dr. Robredo-Vitas.

Dry Skin

“This can be caused by skin tightening, skin stretching when your belly grows. So it’s really advisable to apply emollients,” she adds.

But why do some women become exceptionally glowing during pregnancy?

First, Skin Type

Pregnancy glow is real—but just as much as pregnancy acne. Whether you’ll get the latter or the former though has to do with your current skin type and body state. “When you’re pregnant, you have an increased blood flow and more active oil glands. So you look dewy because of more oil and your skin is redder because of the increased blood flow,” explains Dr. Lazaro-Dizon. This is the usual case for those who have dry to normal skin to begin with and they get what everyone calls the pregnancy glow. “The downside of having increased oil production, however, could be acne. If you have acne-prone or oily skin you could get the ‘bad pregnancy skin,”’ she adds. 

Second, Hormones

“Those who have sensitive skin because of hormonal changes usually get better skin when they’re pregnant because the hormones are more stable. These are the ones who, when they have their flow, get cyclic changes and break out. With the pregnancy, their hormones are stable and they get good skin,” adds Dr. Lazaro-Dizon, to which Dr. Robredo-Vitas agrees. “It’s hormones and how you react to them,” she says. “And it can be different for every pregnancy. You could have glowing skin on your first, and acne on your second.”


Debunking Pregnancy Skincare Myths With These Facts

Our resource doctors clarify truths and myths.

Pigmentation and skin darkening in certain areas are not permanent.

“The pigmentation doesn’t last. It’s not something you should worry about. The pigmentation everywhere will improve in time,” assures Dr. Lazaro-Dizon.

You cannot tell a baby’s gender by a pregnant woman’s skin.

“You will usually hear people say that when you have bad skin, you’re having a boy or when you have good skin, you’re having a girl. That’s a myth and does not indicate the baby’s gender. It’s also not true that when you have itchy skin, you’re allergic to the baby or pregnancy,” says Dr. Lazaro-Dizon.

Makeup and skincare are definitely allowed during pregnancy.

“You have to use skincare. Your skin during pregnancy can be drier or more irritated. You can react to things you didn’t react to before. And because of hormones, you tend to get oilier on the face, chest, and back, and so if you forgo your skincare routine, you’re really bound to have breakouts,” says Dr. Robredo-Vitas. 

Scratching your belly does not cause stretch marks.

“It can cause wounds, but not stretchmarks,” says Dr. Lazaro-Dizon. A lot of stretch mark creams work to help with the itch, though. Dr. Robredo-Vitas agrees that it is essential to apply pregnancy-safe stretch mark creams to help with belly dryness and itching.


Pregnancy-Safe Skincare: What to Skip & What to Use

Studies on pregnant and lactating women are limited for the obvious reason that it is unethical to expose them and their babies to the risks of research and such experiments. Many OBs and dermas, for this basis, would err on the side of caution especially when it comes to ingredients that are not 100% proven safe. But of course, there are drugs and ingredients already proven to be harmful when systemically absorbed, secreted into breast milk, or simply transferred to a baby through contact, which you should ultimately avoid during this time.

Stay Away From…

Retinoids

This gold standard in anti-aging is off limits during pregnancy. Oral retinoids such as Isotretinoin are proven to cause major birth defects when taken before, during, and after conception, says Dr. Lazaro-Dizon, so much so that it is not advisable to get pregnant for at least 1 year after taking it. Because of this, both Dr. Lazaro-Dizon and Dr. Vitas-Robredo advise against the use of even topical retinoids (tretinoin, retinol, retinoic acid, etc).  Apart from possible absorption of topicals into the bloodstream, “you also never know how much of it accumulates,” says Dr. Lazaro-Dizon. “One body is different from another, plus the skin is also the largest organ in the body,” she notes. 

Hydroquinone

This is a popular depigmenting agent that has a substantial systemic absorption. “The absorption of hydroquinone in the skin is 30% upon application,” says Dr. Robredo-Vitas. “We don’t really know what effect it could have to the fetus, so might as well avoid it.”

AHAs, BHAs, Benzoyl Peroxide

Other restricted anti-acne ingredients include Alpha Hydroxy Acids like glycolic acid, Beta Hydroxy Acids like salicylic acid, and benzoyl peroxide. Some doctors would allow the use of these in certain percentages, but Dr. Lazaro-Dizon and Dr. Vitas-Robredo still do not recommend them, especially if usage is unnecessary. “If your skin doesn’t really need them and if they’re not a priority, I wouldn’t prescribe them,” says Dr. Lazaro-Dizon. “These are the kinds of ingredients that you might as well not use if you don’t really need them,” Dr. Robredo-Vitas agrees. “Salicylic acid can cause salicylism when applied in higher concentrations and on bigger body parts. For ingredients like this, it’s better to be safe and just avoid.”

Hardworking Alternatives

There are, of course, alternatives and safe ingredients to use during pregnancy and breastfeeding, most of which you probably already have in your skincare arsenal. Sticking to a pared down but hardworking skincare routine is key during this time. “Cleanser, moisturizer, sunscreen,” says Dr. Robredo-Vitas. “Pregnant women should still use skincare and could still use makeup, just read up on the ingredients,” adds Dr. Lazaro-Dizon. “Sunscreen, for example, is still important.”

Azelaic Acid

Proven safe to use during pregnancy, this gentle exfoliant improves skin texture, diminishes spots and blemishes, and works on any skin type. “My number one go-to for acne during pregnancy is azelaic acid because it is really safe,” says Dr. Robredo-Vitas. Azelaic acid is also recommended by Dr. Lazaro-Dizon for spot treatments during pregnancy.

Vitamin C

Naturally produced and needed by the body, vitamin C is a considerably good alternative to retinoids during pregnancy. It brightens the skin tone and improves dark spots, while working as an antioxidant, too. Vitamin C is best used alongside sunscreen.

Hyaluronic Acid

A popular and effective moisturizer, hyaluronic acid is naturally occuring in the body and is safe to use throughout pregnancy. One of the most reliable ingredients for retaining moisture and holding water, HA is found in many skincare creams and serums which help in attaining plumper, dewier skin.

Sunscreens: Zinc Oxide and Titanium Dioxide

“Use physical or mineral sunscreens because they’re less irritating and they just sit on top of your skin,” says Dr. Gaile Robredo Vitas. “These are your zinc oxide and titanium dioxide sunscreens.” Physical sunscreens block UV rays, as opposed to chemical sunscreens which usually absorb them. You want to avoid chemical sunscreens (oxybenzone, octinoxate, octisalate, avobenzone…) when you’re pregnant because of the risk of skin absorption.

Skin Procedures To Avoid During Pregnancy

If you’re planning your pregnancy and have yet to get pregnant, you might want to consider getting all the skincare treatments you need and want before conceiving because many of them are off limits during such time, like…

Skincare Lasers

“All laser procedures aren’t allowed in pregnancy,” says Dr. Robredo-Vitas. “Although theoretically it really shouldn’t be a problem because it’s very specific, it only targets a specific chronoforce, but the thing is, pregnancy skin is very prone to pigmentation. And laser injures the skin; it’s heat. When you do that, you can cause pigmentation on a pregnant woman’s skin. Many times the pain that comes with lasers could also be a stressor that can trigger contractions. So you don’t want anything like that during pregnancy. I wouldn’t advise doing lasers when pregnant.”

If you’re someone who does annual maintenance treatments like Ulthera or Thermage, it’s best to do them before trying to conceive.

Laser Hair Removal

“I wouldn’t advise hair removal lasers when pregnant because they will make your skin pigment more,” adds Dr. Lazaro-Dizon. “These lasers can cause burns, and for such I can’t guarantee if they will disappear after pregnancy.”

Cauterization

“Do your wart removal treatments before getting pregnant. As much as possible you don’t want those when you have a baby and you breastfeed. Although babies are very resilient to that, it’s still a virus. So if you can have those removed before you get pregnant, better,” says Dr. Lazaro-Dizon.

Botulinum Toxin  and Fillers

Botulinum Toxin (Botox, Dysport, Xeomin are some of the most popular brands) isn’t advisable during pregnancy and breastfeeding. “When you think about it, Botox is also very specific, it only goes to your muscles, and not into your breastmilk, right? But since botulism is deadly in children and infants, you don’t want to risk it,” explains Dr. Robredo-Vitas. “It’s when you ingest it that it becomes dangerous. You breastfeed, and it can go to your child, so you don’t want to risk that. Better just avoid.”

Collage by Dannah Valdezco. Mother with stroller by © Syda productions, Person Holding A Dropper With Liquid by © Ron Lach, Country road by © FooTToo, Hands Holding Assorted Skincare Products by © PattPaulStudio, Sea background by © Dontstop, Buildings by © jean52Photosstock via Canva.com.

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