Pregnancy is life changing with many, many changes occurring even before your newborn arrives. The 9 months prior to arrival involves a careful overhaul of your lifestyle. Red wine is reserved for your other half, raw foods are off limits and even the simplest of cold medications are to be avoided.
This careful approach begins to spread into all areas of your life. What you put onto and into your body suddenly holds much greater importance. Your choices no longer just affect you.
During the 9-month lead-up, your skin will change. It will have an increased vulnerability to environmental factors and it will become prone to pregnancy-specific skin conditions. The skincare decisions you make during this time will never be more important.
The cause of skin related pregnancy symptoms
Skin specific pregnancy symptoms are caused for the same reason acne may be experienced in sync with menstruation. Skin changes significantly throughout pregnancy are a direct consequence of hormonal fluctuations.
The early stages of pregnancy cause a significant rise in estrogen and progesterone levels. A rise that steadily increases throughout each trimester. In fact, the human body makes more estrogen during one pregnancy than during an entire lifetime[i]. The rise in blood serum levels of these two hormones are responsible for ‘pregnancy glow’.
Oestrogen is known to help prevent skin ageing, increase collagen production and even boost skin’s hydration[ii]. Progesterone is less well researched, however, studies conclude similar effects with topical application of progesterone also showing an increase in skin firmness and elasticity[iii]. Although oestrogen and progesterone show the largest increases, accompanying hormones such as androgens and cortisol are also markedly increased.
As with many quick changes these hormonal fluctuations can come partnered with side effects.
Skin related pregnancy symptoms to expect during pregnancy
In balance with pregnancy glow can also come hyperpigmentation, melasma, pregnancy acne and more. Existing skin conditions can be worsened and new ones developed. Oestrogen and progesterone levels account for many admired changes during pregnancy, however the same changes and accompanying androgenic hormones can trigger many of the following side effects.
- Pregnancy acne
Most commonly experienced in the first and second trimester, pregnancy acne is a direct consequence of rising androgen levels. Androgens are hormones most commonly associated with the development of male sex features. Their rise during pregnancy often provokes an increased production of sebum – the natural oil created by skin to waterproof itself. This increase in sebum production can aggravate and manifest acne. With sebum levels increased, dead skin cells are adhered to the skin for longer and growth of acne causing bacteria begins.
Also known as the mask of pregnancy, melasma will affect 10-15%[iv] of women during pregnancy. Melasma is an uneven browning of the skin. The same pigment responsible for tanning – melanin – is also responsible for melasma. All skin types naturally create melanin to varying extents and melanin production can be increased by exposure to sunlight. It’s clear in the formation of pregnancy melasma, that hormonal changes can also provoke uneven hyperpigmentation. Scientists are still working to conclude the exact hormonal change responsible for melasma, however many studies indicate increased oestrogen levels as a trigger.
- Broken veins/spider veins/cherry angiomas
Broken veins and cherry angiomas are another common side effect of pregnancy, caused by a collection of intact or broken capillaries close to the skin’s surface. Both are a pregnancy symptom provoked by a close to doubling of blood volume throughout the 2nd and 3rd trimester[v]. Both blood volume and red blood cell count are increased during pregnancy, this increase helps to supply 2 bodies with much-needed energy and nutrients.
- Skin sensitivity
With a close to doubled blood supply accompanied by a significant change in hormone levels, skin commonly becomes reactive and sensitive during pregnancy. Skincare products that previously worked well, may begin to cause flares, rashes, and reactions. Facial washes may aggravate skin, toners may cause redness and moisturisers may provoke reactivity.
Whether pre-existing or a symptom of pregnancy, eczema can re-appear and worsen as a consequence of hormonal changes[vi] specifically affecting immune cell function. Eczema is the inability of your skin to form an able barrier function. When eczema occurs, skins usually tightly packed cell structure becomes shaken and disarrayed. Hydration is let out and allergens are invited in.
How to combat skin changes during pregnancy
Although there are many changes you cannot control during pregnancy, there are several you can. By following a few simple skin care rules you can reduce your severity of melasma, help to prevent skin sensitivity and even diminish your eczema risk by following these 4 simple rules.
- Design a skincare routine for sensitive skin
Sensitive skincare is free from fragrance, sensitisers and commonly used irritants. Skincare designed for normal, resilient skin often contains ingredients which can be described by one of these 3 phrases to make the overall experience of the product more enjoyable. The effects of such ingredients are cumulative, therefore skin may react after several days, weeks or even months of use. To avoid developing skin sensitivities during pregnancy, design a skincare routine for sensitive skin.
- Use SPF 30 daily
Skin is most sensitive during pregnancy and sensitivity can be caused and provoked by exposure to inflammation causing UV light. When sensitivity is triggered, skin’s health is depleted and the development of conditions like eczema may be experienced. Using a daily SPF of 30 or greater helps to protect skin against interaction with inflammatory UV light.
- Avoid direct sunlight
Melasma, the mask of pregnancy, may be caused and worsened by exposure to UV light. The same pigment responsible for tanning is also responsible for melasma. Therefore melasma may also be worsened and darkened by exposure to UV light. Avoiding direct sunlight accompanied by a daily application of sunscreen will help to prevent and control existing marks of melasma.
- Remove strongly foaming products from your routine
Cleansers, make-up removers, and body washes can all be formulated with strongly cleansing, highly foaming actives. Sometimes called detergents and scientifically referred to as surfactants, the active cleansing ingredients can irritate skin while also encouraging penetration of accompanying actives. During pregnancy, it’s best to remove these from your skincare routine.
Safe skin care for pregnancy – what to avoid
Understanding the principles of pregnancy skin care is just one-half of the story, knowing which ingredients are best to avoid, completes it. While a small list, there are active ingredients used in skincare products which have been linked to birth defects, can be absorbed into the blood stream and may cause increased risk of sensitivity.
The must avoid skincare ingredients
Isotretinoin and Accutane – these branded anti-acne, anti-ageing medications are a no-go during pregnancy. Both are synthetic forms of vitamin A and exposure to them has been directly linked to the formation of birth defects[vii]. While these are orally taken medications, the same active ingredient is also available in prescription strength creams. Avoid these during pregnancy.
Due to the effectiveness of vitamin A against acne and ageing, several similar analogues can be found in general sales skincare. These analogue ingredients are metabolised within the skin to create the biologically active form of vitamin A. While these ingredients are not directly linked to the formation of birth defects, it’s advisable to avoid them during pregnancy.
Skincare ingredients to avoid; Retinol, retinoids, retinyl palmitate, adapalene, retinaldehyde.
Skincare ingredients best avoided during pregnancy
Pregnancy skin care is not an area well researched and therefore many choose to adopt a cautious approach during this time. The below ingredients are ones raising concerns and we advise as best avoided during pregnancy.
Oxybenzone is a synthetic sunscreen filter. Its prevalence in sunscreen formulas is no doubt the reason why this ingredient can be detected in the urine of over 96% of Americans[viii]. Oxybenzone has the potential to mimic hormones and cause skin allergy, with an absorption rate of 1-2%[ix] through the skin, oxybenzone is best avoided during pregnancy. The most favoured alternatives are mineral based sunscreens using zinc oxide or titanium dioxide.
- Benzoyl peroxide
Benzoyl peroxide is a tempting solution for pregnancy acne. Helping to dry oil secretions and control acne-causing bacteria colonies, it may appear an obvious choice. Up to 45%[x] of benzoyl peroxide applied to the skin can flowingly be detected in urine – safety during pregnancy is unproven.
A lightening and brightening agent often prescribed to treat hyperpigmentation, hydroquinone is best avoided during pregnancy. The prescription ingredient can be deeply absorbed by the skin and consequently detected in blood and urine[xi]. Safety of use during pregnancy is unproven.
How to design a pregnancy safe skincare routine
All great pregnancy safe skincare routines will incorporate changes to help combat the skin symptoms of pregnancy while also being free from potentially harmful ingredients. The following 4 steps form the foundations of great pregnancy skincare;
- Incorporate a low to non-foaming cleanser. Soothing cleansers like our griffin+row Cleanse offer the perfect alternative to traditionally strong, often irritating face washes and foaming makeup removers.
- Apply a skin soothing moisturiser. Due to increased skin sensitivity and blood flow rate during pregnancy, inflammation is easily provoked. Incorporating a soothing moisturiser such as our griffin+row Nourish will help to soothe away redness and inflammation.
- Use a daily SPF of 30 or greater and reapply throughout the day as needed. Protection and prevention are better than cure. Using SPF daily helps to protect against pregnancy symptoms of melasma, sensitivity and spider veins.
- Carry a lightweight hydration mist to help cool and calm skin throughout the day. Heat is a cause of inflammation and irritation. Cooling mists help to alleviate symptoms while actively soothing ingredients calm and condition.
After scanning your current routine from ingredients of concern, it’s time to create a sensitive skin friendly pregnancy routine. Ready to treat your skin respectfully? You’ll find the basics you need by visiting our griffin+row shop.
[i] Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009 Dec;114(6):1326-31.
[ii] Estrogen and skin. An overview. M. G. Shah, H. I. Maibach Am J Clin Dermatol. 2001; 2(3): 143–150.
[iii] Effects and side-effects of 2% progesterone cream on the skin of peri- and postmenopausal women: results from a double-blind, vehicle-controlled, randomized study. G. Holzer, E. Riegler, H. Hönigsmann, S. Farokhnia, J. B. Schmidt, B. Schmidt Br J Dermatol. 2005 Sep; 153(3): 626–634.
[iv] Kang HY, Ortonne J-P. What Should Be Considered in Treatment of Melasma. Annals of Dermatology. 2010;22(4):373-378. doi:10.5021/ad.2010.22.4.373.
[v] Blood volume changes in normal pregnancy. F. Hytten Clin Haematol. 1985 Oct; 14(3): 601–612.
[vi] Vaughan Jones, Hern, Nelson-Piercy, Seed and Black (1999), A prospective study of 200 women with dermatoses of pregnancy correlating clinical findings with hormonal and immunopathological profiles. British Journal of Dermatology, 141: 71–81. doi:10.1046/j.1365-2133.1999.02923.x
[vii] Kizer KW, Fan AM, Bankowska J, Jackson RJ, Lyman DO. Vitamin A–a pregnancy hazard alert. Western Journal of Medicine. 1990;152(1):78-81.
[viii] Calafat AM, Wong LY, Ye X, Reidy JA, Needham LL. Concentrations of the sunscreen agent benzophenone-3 in residents of the United States: National Health and Nutrition Examination Survey 2003-2004. Environ Health Perspect. 2008;116(7):893-89
[ix] Hayden CG, Roberts MS, Benson HA. Systemic absorption of sunscreen after topical application. Lancet. 1997;350(9081):863-864
[x] Benzoyl peroxide: percutaneous penetration and metabolic disposition Nacht S., Yeung D., Beasley Jr. J.N., Anjo M.D., Maibach H.I. (1981) Journal of the American Academy of Dermatology, 4 (1) , pp. 31-37.
[xi] Human in vivo and in vitro hydroquinone topical bioavailability, metabolism, and disposition, Ronald C. Wester Joseph Melendres Xiaoying Hui Rebecca Cox Steffany Serranzana Hongbo Zhai Danyi Quan Howard I. Maibach, Journal of Toxicology and Environmental Health, Part A Vol. 54 , Iss. 4,1998