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Skin Health

The Skin Changes to Expect During Pregnancy (and How to Manage Them)


Wow! You are pregnant! Congrats! There are so many changes you will experience in your life as well as your body. Let’s look at the skin changes that may occur during your pregnancy — after all, your skin is your largest organ. 

Dr. Liz Liotta, M.D.

Board-Certified Dermatologist; Fellow, American Academy of Dermatology

In 2005, Dr. Liotta launched her own practice located Frederick, Maryland.  Dr. Liotta is a Board Certified Dermatologist and is extensively trained in both clinical and cosmetic dermatology. She is a fellow of the American Academy of Dermatology, a member of the American Society of Lasers in Medicine, and a member of the Washington D.C. Dermatological Society. Dr. Liotta also served in the U.S. Navy where she completed an outstanding 15-year career. She is also a member of the HealthyWomen Women’s Health Advisory Council.

Stretch marks

Stretch marks are the annoying red marks that can can be seen on the abdomen, breasts, and arms. These occur as the skin expands to accommodate your newest family member’s growth.  Stretch marks occur in up to 90% of pregnancies and are worsened by excessive weight gain. They may also be decreased to some extent by using emollient creams that contain vitamin E or alpha-hydroxy acids. 

The good news is that the red will fade and may turn into silvery, less noticeable lines.  These marks can also be treated with a pulsed dye laser or micro-needling after your little bundle arrives.


Also known as “the mask of pregnancy,” melasma is a result of the pigment-producing cells (melanocytes) increased response to the sun due to hormonal influence. This may be more severe in women who have already had this condition, because of birth control pills or otherwise. Melasma occurs in up to 50% of pregnancies — thanks hormones! 

Melasma can be prevented to some extent by using high-SPF sun protection (especially a mineral sunscreen like those that contain zinc oxide or titanium dioxide), hats, and shade. There are some creams that are safe to use during pregnancy that can help decrease risk and severity of melasma.


The increase in hormones may cause an acne flare up in the first trimester, but this may taper off in the second and third trimesters. If acne is mild, you want to use some benzoyl peroxide to treat it, but avoid topical retinoids during pregnancy. If you have a severe outbreak, see your dermatologist, as they may be able to prescribe treatments that are safe for you to use while pregnant or nursing.

Linea nigra

Linea nigra is the darkened line extending from the belly button to the pubic area that you will begin to see at about the fifth month of pregnancy. This is also caused by an increase in hormones, which may also cause darkening of the labia and nipples.


Moles may increase in size or shape due to your expanding skin, which is not unexpected, however, a new, rapidly changing mole or dramatic color changes in a mole could be a concern and should be evaluated by your physician or dermatologist.

Other skin changes and how to manage them

Mild dryness and itching can be managed with good moisturizers, but may be caused byother conditions.

Prurigo of pregnancy (an itchy, bumpy rash on your abdomen, arms, or legs) may be more likely in women with a history of seasonal allergies or family history of eczema.

Cholestasis of pregnancy occurs in about 1 in 50 pregnancies and will likely present as itching with nausea, vomiting, and/or fatigue with or without jaundice. This could be related to liver or gallbladder issues and can be diagnosed with a blood test.

PUPP-pruritic urticarial papules and plaques of pregnancy usually occur in the third trimester for first-time moms, and will cause very itchy papules developing in the stretch marks on the abdomen, which can also extend to the breasts and arms. This can be treated with topical or systemic steroids, or narrow band ultraviolet light therapy.

Eczema flares can occur in the first of second trimester and may be treated with moisturizers or topical steroids.

Varicose veins occur due to the marked increase in blood flow and weight gain that can happen during pregnancy.  Some people are already prone to this condition, but there are things you can do to decrease your risk and their appearance:

  • Avoid prolonged standing.
  • Walk or move your legs to improve blood.
  • Keep your feet up when possible.
  • Avoid excessive weight gain.
  • Wear support or prescription stockings.
  • Take vitamin C to help your collagen and elasticity.

Pregnancy glow sounds lovely but is real. It’s caused by the 50% increase in blood flow and hormonally induced increase in oil production. If the skin is too oily, use an oil-free moisturizer and gentle foaming skin cleanser.

The best news is that most of these issues will either diminish or resolve after your baby arrives. If skin changes do not subside, you can seek the help of your primary physician or local dermatologist, who can help you treat your specific needs.

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